Sulakshana Gupta,  Vice President, Partnerships, East and Southern Africa, Viamo

Topic: CHEWA: Voice-First AI Decision Support for Primary Healthcare in Nigeria

Primary healthcare in sub-Saharan Africa faces severe capacity and quality challenges. To address this, PATH and Viamo piloted CHEWA, a voice-first, LLM-enabled decision support tool designed for Community Health Extension Workers (CHEWs) in Nigeria. Accessible via toll-free calls on basic phones, CHEWA provides real-time clinical guidance with built-in senior clinician review as a safety net.

A pre/post study with 100 CHEWs and over 3,000 interactions found that 94.9% of responses were safe, with issues largely tied to speech recognition errors. CHEWs reported improved diagnostic confidence, patient education, and workflow support, often describing CHEWA as a trusted “AI doctor.” Challenges included network disruptions, Nigerian English transcription accuracy, and the need for local language support.

The trial demonstrates that voice-first AI is feasible, acceptable, and largely safe for frontline health workers. With refinements such as local language integration, improved speech recognition, and closer alignment with national clinical protocols, CHEWA has the potential to scale nationally and significantly strengthen primary healthcare delivery in Nigeria.