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Targeted at low-resource environments such as Pakistan, the system integrates a fine-tuned, multilingual automatic speech recognition (ASR) model and a prompt-engineered large language model (LLM) to enable healthcare workers to engage naturally in Urdu, their native language, regardless of literacy or technical background. Through speech-based input and localized understanding, the system generates structured EMRs and flags critical maternal health risks. Over a seven-month deployment in a not-for-profit hospital, the system supported the creation of over 500 EMRs and flagged over 300 potential clinical risks. We evaluate the system's performance across speech recognition accuracy, EMR field-level correctness, and clinical relevance of Al-generated red flags. Our results demonstrate that speech-based AI interfaces, can be effectively adapted to real-world healthcare settings, especially in low-resource settings, when combined with structured input design, contextual medical dictionaries, and clinician-in-the-loop feedback loops. We discuss generalizable design principles for deploying voice-based mobile healthcare AI support systems in linguistically and infrastructurally constrained settings.<\/jats:p>","DOI":"10.1145\/3790115","type":"journal-article","created":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T17:51:14Z","timestamp":1773683474000},"page":"1-37","update-policy":"https:\/\/doi.org\/10.1145\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Awaaz-e-Sehat: A Mobile Voice-based AI System for EMR Generation and Clinical Decision Support in Low-resource Maternal Healthcare"],"prefix":"10.1145","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4948-4459","authenticated-orcid":false,"given":"Maryam","family":"Mustafa","sequence":"first","affiliation":[{"name":"Department of Computer Science, Lahore University of Management Sciences, Lahore, Pakistan"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-7729-7891","authenticated-orcid":false,"given":"Amna","family":"Shahnawaz","sequence":"additional","affiliation":[{"name":"Department of Computer Science, Lahore University of Management Sciences, Lahore, Pakistan"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-2821-2888","authenticated-orcid":false,"given":"Umme","family":"Ammara","sequence":"additional","affiliation":[{"name":"Department of Computer Science, Lahore University of Management Sciences, Lahore, Pakistan"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0583-4625","authenticated-orcid":false,"given":"Moaiz","family":"Abrar","sequence":"additional","affiliation":[{"name":"Department of Computer Science, Lahore University of Management Sciences, Lahore, Pakistan"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9331-5069","authenticated-orcid":false,"given":"Bakhtawar","family":"Ahtisham","sequence":"additional","affiliation":[{"name":"Department of Computer Science, Lahore University of Management Sciences, Lahore, Pakistan"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0265-0990","authenticated-orcid":false,"given":"Fozia Umber","family":"Qureshi","sequence":"additional","affiliation":[{"name":"Lahore Medical and Dental College, University of Biological and Allied Sciences, Lahore, Punjab, Pakistan"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1091-8531","authenticated-orcid":false,"given":"Mostafa","family":"Shahin","sequence":"additional","affiliation":[{"name":"Electrical Engineering and Telecommunications, University of New South Wales, Sydney, NSW, Australia"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1240-6572","authenticated-orcid":false,"given":"Beena","family":"Ahmed","sequence":"additional","affiliation":[{"name":"School of Electrical Engineering and Telecommunications, University of New South Wales, Sydney, New South Wales, Australia"}]}],"member":"320","published-online":{"date-parts":[[2026,3,16]]},"reference":[{"key":"e_1_2_1_1_1","doi-asserted-by":"publisher","DOI":"10.5455\/aim.2013.21.129-134"},{"key":"e_1_2_1_2_1","doi-asserted-by":"publisher","DOI":"10.1101\/2023.12.15.23300009"},{"key":"e_1_2_1_3_1","doi-asserted-by":"publisher","DOI":"10.1145\/3411763.3441347"},{"key":"e_1_2_1_4_1","doi-asserted-by":"publisher","DOI":"10.1145\/3630106.3658982"},{"key":"e_1_2_1_5_1","doi-asserted-by":"publisher","DOI":"10.1145\/3064663.3064669"},{"key":"e_1_2_1_6_1","doi-asserted-by":"publisher","DOI":"10.1145\/3022198.3026328"},{"key":"e_1_2_1_7_1","unstructured":"Paul Boersma and David Weenink. 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