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MAM-AI: An On-Device Medical Retrieval-Augmented Generation System for Nurses and Midwives in Zanzibar

Yi Ren · Jun 28, 2026 · Citations: 0

Automatic Metrics Medicine Rubric Rating
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How to use this page

Moderate trust

Use this for comparison and orientation, not as your only source.

Best use

Secondary protocol comparison source

What to verify

Validate the evaluation procedure and quality controls in the full paper before operational use.

Evidence quality

Moderate

Derived from extracted protocol signals and abstract evidence.

Abstract

Maternal and newborn mortality remain among the highest in sub-Saharan Africa, where midwifery care is often delivered by nurses who lack midwifery training to international standards, and consulting authoritative guidance at the point of care is hard: the guidelines are long and connectivity is intermittent. We present MAM-AI, a medical question-answering assistant for nurse-midwives in Zanzibar that runs entirely on a commodity Android device: a question is embedded (EmbeddingGemma, 300M) and matched against a curated corpus of 87 guideline documents (63,650 passages), then answered with citations by a 4B int4 generator (Gemma 4 E4B), fully offline, with no query leaving the device. We evaluate the exact deployed configuration with a layered methodology -- retriever, generator under oracle context, end-to-end, and latency -- scored by LLM judges validated against physician rubrics. The evaluation relocates the hard problem. On-device retrieval is essentially solved: the 300M embedder ranks third of seven retrievers and rivals cloud systems, so the passages the system needs are usually found. The small generator is what remains in doubt: adding retrieved context does not improve its answers, and at 4B it cannot be both helpful and safe at once -- of two same-size candidates, the more helpful one commits genuine dangerous errors, so we deploy the other, which is about twice as faithful to its sources (as faithful as a frontier model), and recover its helpfulness with a redesigned prompt that cuts deflection from 33% to 3%. Corpus quality is decisive for the same reason: where the corpus holds the right passage the answer is specific and actionable, and where it does not it goes vague. MAM-AI is a thoroughly evaluated, open-source research prototype, not a fielded product; the system, knowledge base, benchmarks, and evaluation harness are released.

Should You Rely On This Paper?

This paper has useful evaluation signal, but protocol completeness is partial; pair it with related papers before deciding implementation strategy.

Best use

Secondary protocol comparison source

Use if you need

A secondary eval reference to pair with stronger protocol papers.

Main weakness

No major weakness surfaced.

Trust level

Moderate

Usefulness score

65/100 • Medium

Useful as a secondary reference; validate protocol details against neighboring papers.

Human Feedback Signal

Detected

Evaluation Signal

Detected

Usefulness for eval research

Moderate-confidence candidate

Extraction confidence 70%

If you are doing eval pipeline work, start here:

Human Eval Hub LLM-as-Judge Hub Pairwise Preference Hub Tool-Use Eval Hub

What We Could Verify

These are the protocol signals we could actually recover from the available paper metadata. Use them to decide whether this paper is worth deeper reading.

Human Feedback Types

strong

Rubric Rating

Directly usable for protocol triage.

"Maternal and newborn mortality remain among the highest in sub-Saharan Africa, where midwifery care is often delivered by nurses who lack midwifery training to international standards, and consulting authoritative guidance at the point of care is hard: the guidelines are long and connectivity is intermittent."

Evaluation Modes

strong

Automatic Metrics

Includes extracted eval setup.

"Maternal and newborn mortality remain among the highest in sub-Saharan Africa, where midwifery care is often delivered by nurses who lack midwifery training to international standards, and consulting authoritative guidance at the point of care is hard: the guidelines are long and connectivity is intermittent."

Quality Controls

missing

Not reported

No explicit QC controls found.

"Maternal and newborn mortality remain among the highest in sub-Saharan Africa, where midwifery care is often delivered by nurses who lack midwifery training to international standards, and consulting authoritative guidance at the point of care is hard: the guidelines are long and connectivity is intermittent."

Benchmarks / Datasets

missing

Not extracted

No benchmark anchors detected.

"Maternal and newborn mortality remain among the highest in sub-Saharan Africa, where midwifery care is often delivered by nurses who lack midwifery training to international standards, and consulting authoritative guidance at the point of care is hard: the guidelines are long and connectivity is intermittent."

Reported Metrics

strong

Helpfulness

Useful for evaluation criteria comparison.

"The small generator is what remains in doubt: adding retrieved context does not improve its answers, and at 4B it cannot be both helpful and safe at once -- of two same-size candidates, the more helpful one commits genuine dangerous errors, so we deploy the other, which is about twice as faithful to its sources (as faithful as a frontier model), and recover its helpfulness with a redesigned prompt that cuts deflection from 33% to 3%."

Rater Population

strong

Domain Experts

Helpful for staffing comparability.

"Maternal and newborn mortality remain among the highest in sub-Saharan Africa, where midwifery care is often delivered by nurses who lack midwifery training to international standards, and consulting authoritative guidance at the point of care is hard: the guidelines are long and connectivity is intermittent."

Human Feedback Details

  • Uses human feedback: Yes
  • Feedback types: Rubric Rating
  • Rater population: Domain Experts
  • Unit of annotation: Multi Dim Rubric
  • Expertise required: Medicine

Evaluation Details

  • Evaluation modes: Automatic Metrics
  • Agentic eval: None
  • Quality controls: Not reported
  • Evidence quality: Moderate
  • Use this page as: Secondary protocol comparison source

Protocol And Measurement Signals

Benchmarks / Datasets

No benchmark or dataset names were extracted from the available abstract.

Reported Metrics

helpfulness

Research Brief

Metadata summary

Maternal and newborn mortality remain among the highest in sub-Saharan Africa, where midwifery care is often delivered by nurses who lack midwifery training to international standards, and consulting authoritative guidance at the point of care is hard: the guidelines are long and connectivity is intermittent.

Based on abstract + metadata only. Check the source paper before making high-confidence protocol decisions.

Key Takeaways

  • Maternal and newborn mortality remain among the highest in sub-Saharan Africa, where midwifery care is often delivered by nurses who lack midwifery training to international standards, and consulting authoritative guidance at the point of care is hard: the guidelines are long and connectivity is intermittent.
  • We present MAM-AI, a medical question-answering assistant for nurse-midwives in Zanzibar that runs entirely on a commodity Android device: a question is embedded (EmbeddingGemma, 300M) and matched against a curated corpus of 87 guideline documents (63,650 passages), then answered with citations by a 4B int4 generator (Gemma 4 E4B), fully offline, with no query leaving the device.
  • We evaluate the exact deployed configuration with a layered methodology -- retriever, generator under oracle context, end-to-end, and latency -- scored by LLM judges validated against physician rubrics.

Researcher Actions

  • Compare this paper against nearby papers in the same arXiv category before using it for protocol decisions.
  • Check the full text for explicit evaluation design choices (raters, protocol, and metrics).
  • Use related-paper links to find stronger protocol-specific references.

Caveats

  • Generated from abstract + metadata only; no PDF parsing.
  • Signals below are heuristic and may miss details reported outside the abstract.

Recommended Queries

Research Summary

Contribution Summary

  • We present MAM-AI, a medical question-answering assistant for nurse-midwives in Zanzibar that runs entirely on a commodity Android device: a question is embedded (EmbeddingGemma, 300M) and matched against a curated corpus of 87 guideline…
  • We evaluate the exact deployed configuration with a layered methodology -- retriever, generator under oracle context, end-to-end, and latency -- scored by LLM judges validated against physician rubrics.
  • The evaluation relocates the hard problem.

Why It Matters For Eval

  • We evaluate the exact deployed configuration with a layered methodology -- retriever, generator under oracle context, end-to-end, and latency -- scored by LLM judges validated against physician rubrics.
  • The evaluation relocates the hard problem.

Researcher Checklist

  • Pass: Human feedback protocol is explicit

    Detected: Rubric Rating

  • Pass: Evaluation mode is explicit

    Detected: Automatic Metrics

  • Gap: Quality control reporting appears

    No calibration/adjudication/IAA control explicitly detected.

  • Gap: Benchmark or dataset anchors are present

    No benchmark/dataset anchor extracted from abstract.

  • Pass: Metric reporting is present

    Detected: helpfulness

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