LUMANA: A Scenario-Based Field Validation of a Culturally Adapted AI System for Mental Health Screening in Sokoto State, Nigeria

Background: Mental health conditions represent a significant public health burden in sub-Saharan Africa, where access to specialist services remains limited. Sokoto State, Nigeria, has an estimated population exceeding 5.4 million with fewer than five psychiatrists, leaving frontline health workers to provide much of the mental health care. LUMANA is a human-centred artificial intelligence (AI) system developed to support mental health screening in resource-constrained settings. Methods: We conducted a field validation of LUMANA in Sokoto State, Nigeria, on 28-29 January 2026 following ethical approval (SKHREC/014/2026). Twenty stakeholders were enrolled, of whom 17 completed structured evaluations across eight standardized clinical scenarios using five assessment tools. The evaluation examined AI output safety, Hausa language performance, human-AI workflow integration, trust and cultural appropriateness, and implementation readiness. Results: A total of 136 AI output safety assessments were completed. Overall, 113/136 (83%) AI outputs were rated acceptable as shown, while 23/136 (17%) were considered acceptable only with human review; no AI output was rated unacceptable. Religion and culture were identified as important determinants of trust by 14/17 (82%) participants, while 17/17 (100%) agreed that disclosures of self-harm or suicide should always involve a human clinician. Mean language quality scores were 9.9/10 for Hausa transcription, 9.9/10 for Hausa-to-English translation, and 9.2/10 for English-to-Hausa summary generation. Clinicians considered 7/8 (88%) human-AI workflow scenarios comfortable for routine practice. Three operational improvements were identified before pilot implementation: clearer protocols for interpreting distress, refinement of language to minimise potentially stigmatizing expressions, and automatic escalation of suspected psychotic symptoms. Conclusions: This scenario-based field validation provides preliminary evidence that LUMANA is perceived as culturally appropriate, acceptable and capable of supporting human-supervised mental health screening in a low-resource setting. However, the findings are based on a small convenience sample using standardized scenarios rather than live clinical use. Accordingly, the results support progression to a carefully monitored pilot implementation following completion of the identified system improvements, with prospective evaluation of safety, workflow integration and implementation outcomes before consideration of wider deployment.