In 2020, maternal mortality in India was estimated to be as high as 130 deaths per 100K live births, nearly twice the UN's target. To improve health outcomes, the non-profit ARMMAN sends automated voice messages to expecting and new mothers across India. However, 38% of mothers stop listening to these calls, missing critical preventative care information. To improve engagement, ARMMAN employs health workers to intervene by making service calls, but workers can only call a fraction of the 100K enrolled mothers. Partnering with ARMMAN, we model the problem of allocating limited interventions across mothers as a restless multi-armed bandit (RMAB), where the realities of large scale and model uncertainty present key new technical challenges. We address these with GROUPS, a double oracle–based algorithm for robust planning in RMABs with scalable grouped arms. Robustness over grouped arms requires several methodological advances. First, to adversarially select stochastic group dynamics, we develop a new method to optimize Whittle indices over transition probability intervals. Second, to learn group-level RMAB policy best responses to these adversarial environments, we introduce a weighted index heuristic. Third, we prove a key theoretical result that planning over grouped arms achieves the same minimax regret--optimal strategy as planning over individual arms, under a technical condition. Finally, using real-world data from ARMMAN, we show that GROUPS produces robust policies that reduce minimax regret by up to 50%, halving the number of preventable missed voice messages to connect more mothers with life-saving maternal health information.
Read full abstract