An AI-based symptom checker integrated into MomConnect maternal healthcare platform: a prospective, observational mixed-methods study

Abstract High maternal mortality rates persist as a critical challenge in low-resource settings. Here, in this prospective, observational mixed-methods study, we evaluated a Diagnostic Decision Support System integrated into MomConnect, South Africa’s government-led WhatsApp-based maternal health platform. Between May and June 2023, 968 pregnant women and mothers were enrolled, of whom 86.3% faced multiple barriers to care. Behaviour was assessed via platform surveys and phone interviews at 1-week follow-up. A physician panel rated Diagnostic Decision Support System advice safe in 98.4% (181/184; P  < 0.001) of cases. After use, 44.6% (266/596) changed care-seeking intentions, and uncertainty dropped from 17.3% to 6.0%. By follow-up, 43.0% (337/785) had sought care, up from 17.0% initially. Safe behaviours increased by 18.1% ( P  = 0.001) and appropriate behaviour by 10.5% ( P  = 0.053). Half of those receiving treatment had not initially planned to seek care. Integrating clinical artificial intelligence into a government health platform was associated with safe advice and improved health-seeking behaviour. ClinicalTrials.gov: NCT06790069; funded by the Rockefeller Foundation.