The George Institute for Global Health India, in collaboration with Cachar Cancer Hospital and Research Centre (CCHRC), Assam, held a co-design workshop with Accredited Social Health Activists (ASHAs) to help shape an AI-enabled training platform and multilingual voice chatbot designed to strengthen cervical cancer screening and community counselling in rural Assam.
Around 100 ASHAs joined the session, along with trainers, doctors, programme coordinators, researchers and technologists. Through discussions and exercises, ASHAs shared their experiences of supporting women with cervical cancer screening, discussed the challenges they face, the support they need and how technology could make their community visits and counselling work easier.
The workshop is part of a three-year pilot study, Leveraging Artificial Intelligence for Strengthening Cervical Cancer Screening Through Capacity Building, funded by the Indian Council of Medical Research (ICMR). Running from November 2025 to November 2028, the project aims to build and test an AI-based learning platform for ASHAs, along with a chatbot that can answer questions by voice in multiple languages.
During the workshop, ASHAs reviewed 155 common questions people ask about cervical cancer and screening. They used a bindi-based voting system to identify which questions came up most frequently in the field, raised by women, husbands, family members and others in their communities.
The exercise highlighted that the questions ASHAs face most often in the field are not always the same as those considered clinically important. These insights will inform the development of a chatbot knowledge base that addresses both priority health information needs and the practical concerns ASHAs encounter during their work.
The workshop also explored ASHAs’ comfort and confidence with digital technology. Younger and middle-aged ASHAs said they regularly use mobile phones for reporting, communication and accessing information. ASHAs in older age groups said they find digital tools and language more challenging but expressed a willingness to learn and become more confident in using them.
ASHAs also mapped out their career path, including training, staying sharp on what they have learned, counselling women on pregnancy or childbirth concerns, walking people through test results and making the right referrals. Through this process, many ASHAs recognised their knowledge gaps and discussed using tools such as flipcharts to brush up when needed.
ASHAs also highlighted the value of voice-based interactions in Bangla, simple-language content and search functions that reflect the way ASHAs naturally ask questions. They suggested features such as short audio-visual lessons, frequently asked questions, reminders, quizzes and progress tracking.
One of the ASHA workers who participated in the workshop said, “I am very happy to attend this workshop. This is the first time I have attended something like this. I have attended many meetings before, but this was very different. Even the questions about cervical cancer, what is important and what is not, were explained through an exercise using bindis. It felt like a fun and interactive way of learning, almost like a game. We learnt so much today, and through this workshop we got to know many things that we did not know before.”
The discussions emphasised that digital tools should complement existing training approaches and build on the experience, knowledge and community relationships of ASHAs. Practical considerations such as limited internet connectivity, time available during household visits and the need for reliable, clinically verified information were also considered.
Dr. Anita Gadgil, Principal Investigator of the project and Senior Research Fellow at The George Institute for Global Health; Co Director, WHO Collaboration Center for Emergency Critical and Operative Care, said, “This workshop starts with a simple principle: technology for ASHAs should be designed with ASHAs. Their experience of explaining screening, responding to concerns and finding answers in real time will guide the language, content and functions of this AI platform. Our aim is to develop clinically validated support that fits their work, rather than adding another digital burden.”
Cervical cancer is still a major health concern in India, and gaps in awareness and screening continue to get in the way of early detection. ASHAs are often the ones bridging that gap, reaching women in their communities, explaining what screening involves and connecting them to care.
The inputs from the workshop will directly shape the next phase of the project, which involves building the AI learning platform and chatbot. All the training content and questions will go through clinical review and repeated testing with ASHAs before rollout.
The study will then evaluate AI-supported training and chatbot access against standard training methods through a two-arm cluster-randomised controlled trial across 20 clusters involving approximately 110 ASHAs.
The study will look at how practical and well-received the tool is, along with how well it is being used, how consistently and whether it can scale. Researchers will also track ASHAs’ knowledge, attitudes and practices to build a case for a larger future trial.
The proposed chatbot is intended to support ASHAs with training and field-based information. It will not replace clinical assessment, diagnosis or referral pathways.