Despite steady global advances, maternal mortality remains alarmingly high in Pakistan (155 deaths per 100,000 live births in 2023); largely as a consequence of fragmented paper records, low literacy, poor access to quality healthcare, and gendered barriers that compromise care continuity. Over three years, we designed, deployed, and iteratively developed Awaaz-e-Sehat, a speech-based artificial intelligence (AI) system that generates electronic medical records (EMRs) and supports decision-making in maternal health. The tool evolved from a clinician-facing AI assistant that automated Urdu speech-to-EMR generation into a patient-centred WhatsApp-based platform, enabling women to generate their own structured clinical notes, receive AI-generated antenatal guidance, and share QR-coded records with providers anywhere in the country. This case study documents that translational journey, i.e., how the ground realities of workload, linguistic nuance, and infrastructural constraints reshaped our design. The result is not merely a new method of record-keeping, but a reimagining of antenatal care and electronic medical records themselves. In settings where clinicians are time-constrained and have little institutional incentive to document, Awaaz-e-Sehat proposes a model of care that centres patients as active participants in generating and owning their health data. By keeping patients informed about their own risk factors and integrating them into the clinical decision-support loop, the system transforms EMRs and CDSS from static institutional artefacts into dynamic tools for self-advocacy and shared accountability in maternal health.

翻译：尽管全球范围内取得了稳步进展，巴基斯坦的孕产妇死亡率仍然高得惊人（2023年每10万活产155例死亡），这主要是由碎片化的纸质记录、低识字率、优质医疗服务可及性差以及影响护理连续性的性别障碍所致。在三年时间里，我们设计、部署并迭代开发了Awaaz-e-Sehat——一个基于语音的人工智能（AI）系统，该系统可生成电子病历（EMR）并支持孕产健康领域的决策。该工具从面向临床医生的AI助手（可自动将乌尔都语语音转换为EMR）演变为一个以患者为中心的WhatsApp平台，使女性能够自行生成结构化临床记录、接收AI生成的产前指导，并与全国任何地方的医疗服务提供者共享二维码记录。本案例研究记录了这一转化历程，即工作量的现实情况、语言细微差别和基础设施限制如何重塑了我们的设计。其结果不仅是一种新的记录保存方法，更是对产前护理和电子病历本身的重新构想。在临床医生时间紧张且缺乏机构激励进行记录的环境中，Awaaz-e-Sehat提出了一种护理模式，将患者置于生成和拥有自身健康数据的主动参与者核心位置。通过让患者了解自身的风险因素并将其纳入临床决策支持循环，该系统将EMR和临床决策支持系统（CDSS）从静态的制度化工具转变为用于孕产健康领域自我倡导和共同责任的动态工具。