This paper introduces MaternaAI, a fairness-aware and explainable learning framework designed to enhance maternal healthcare predictions in Kerala, India, and proposes Adaptive Equity Score Optimization (AESO), a novel optimization algorithm that dynamically integrates fairness constraints into model training.
Abstract
Maternal healthcare prediction systems often suffer from algorithmic biases due to socio-economic disparities and imbalanced datasets, limiting their effectiveness for equitable healthcare policymaking. This paper introduces MaternaAI, a fairness-aware and explainable learning framework designed to enhance maternal healthcare predictions in Kerala, India. The framework focuses on three critical health indicators:(1) Tetanus Toxoid (TT) booster uptake,(2) immunization coverage rates, and (3) the percentage of pregnant women completing four or more Antenatal Care (ANC) visits. To address fairness, we propose Adaptive Equity Score Optimization (AESO), a novel optimization algorithm that dynamically integrates fairness constraints into model training. AESO is model-agnostic and adapts group equity weights in response to real-time disparities. We integrate SHAP, LIME, and feature permutation techniques for explainability, enabling transparent global and local interpretation. Empirical results demonstrate that MaternaAI significantly improves fairness metrics and model accuracy across diverse machine learning and deep learning models, offering interpretable and equitable decision support for public health stakeholders.
Fairness-aware federated learning for predicting critical care outcomes is a strong and viable framework balancing privacy, accuracy, and fairness and proves to be an important step in the development of ethical AI in healthcare.
The Routing Disparity metric and multi-level debiasing framework introduced here generalize to MoE systems operating on demographically heterogeneous populations, providing both an audit tool and an architectural intervention for a bias mechanism that existing fairness methods leave unaddressed.
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The results demonstrate that zero-shot inference using GPT-4o-mini achieved comparable balanced accuracy to the supervised baseline while exhibiting substantially higher sensitivity for identifying stunting cases, relatively consistent performance across child sex groups, and stable predictive behaviour across BDHS wav...
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This paper introduces universal fairness, a clinically grounded definition that reframes fairness as maximizing subgroup-aware diagnostic performance under attribute-conditioned health disparities, and proposes MAPPE, a training-free minimax prompt optimization framework that theoretically promotes universal fairness.
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