Harnessing the wide-spread availability of cell phones, many nonprofits have launched mobile health (mHealth) programs to deliver information via voice or text to beneficiaries in underserved communities, with maternal and infant health being a key area of such mHealth programs. Unfortunately, dwindling listenership is a major challenge, requiring targeted interventions using limited resources. This paper focuses on Kilkari, the world's largest mHealth program for maternal and child care - with over 3 million active subscribers at a time - launched by India's Ministry of Health and Family Welfare (MoHFW) and run by the non-profit ARRMAN. We present a system called CHAHAK that aims to reduce automated dropouts as well as boost engagement with the program through the strategic allocation of interventions to beneficiaries. Past work in a similar domain has focused on a much smaller scale mHealth program and used markovian restless multiarmed bandits to optimize a single limited intervention resource. However this paper demonstrates the challenges in adopting a markovian approach in Kilkari; therefore CHAHAK instead relies on non-markovian time-series restless bandits, and optimizes multiple interventions to improve listenership. We use real Kilkari data from the Odisha state in India to show CHAHAK's effectiveness in harnessing multiple interventions to boost listenership, benefiting marginalized communities. When deployed CHAHAK will assist the largest maternal mHealth program to date.

Mobile health programs are becoming an increasingly popular medium for dissemination of health information among beneficiaries in less privileged communities. Kilkari is one of the world's largest mobile health programs which delivers time sensitive audio-messages to pregnant women and new mothers. We have been collaborating with ARMMAN, a non-profit in India which operates the Kilkari program, to identify bottlenecks to improve the efficiency of the program. In particular, we provide an initial analysis of the trajectories of beneficiaries' interaction with the mHealth program and examine elements of the program that can be potentially enhanced to boost its success. We cluster the cohort into different buckets based on listenership so as to analyze listenership patterns for each group that could help boost program success. We also demonstrate preliminary results on using historical data in a time-series prediction to identify beneficiary dropouts and enable NGOs in devising timely interventions to strengthen beneficiary retention.

This paper studies restless multi-armed bandit (RMAB) problems with unknown arm transition dynamics but with known correlated arm features. The goal is to learn a model to predict transition dynamics given features, where the Whittle index policy solves the RMAB problems using predicted transitions. However, prior works often learn the model by maximizing the predictive accuracy instead of final RMAB solution quality, causing a mismatch between training and evaluation objectives. To address this shortcoming we propose a novel approach for decision-focused learning in RMAB that directly trains the predictive model to maximize the Whittle index solution quality. We present three key contributions: (i) we establish the differentiability of the Whittle index policy to support decision-focused learning; (ii) we significantly improve the scalability of previous decision-focused learning approaches in sequential problems; (iii) we apply our algorithm to the service call scheduling problem on a real-world maternal and child health domain. Our algorithm is the first for decision-focused learning in RMAB that scales to large-scale real-world problems. \end{abstract}

The widespread availability of cell phones has enabled non-profits to deliver critical health information to their beneficiaries in a timely manner. This paper describes our work to assist non-profits that employ automated messaging programs to deliver timely preventive care information to beneficiaries (new and expecting mothers) during pregnancy and after delivery. Unfortunately, a key challenge in such information delivery programs is that a significant fraction of beneficiaries drop out of the program. Yet, non-profits often have limited health-worker resources (time) to place crucial service calls for live interaction with beneficiaries to prevent such engagement drops. To assist non-profits in optimizing this limited resource, we developed a Restless Multi-Armed Bandits (RMABs) system. One key technical contribution in this system is a novel clustering method of offline historical data to infer unknown RMAB parameters. Our second major contribution is evaluation of our RMAB system in collaboration with an NGO, via a real-world service quality improvement study. The study compared strategies for optimizing service calls to 23003 participants over a period of 7 weeks to reduce engagement drops. We show that the RMAB group provides statistically significant improvement over other comparison groups, reducing ~ 30% engagement drops. To the best of our knowledge, this is the first study demonstrating the utility of RMABs in real world public health settings. We are transitioning our RMAB system to the NGO for real-world use.