How ARMMAN Is Solving Maternal and Child Health Care Through Voice Calls to Pregnant Women in India
What is the problem?
India accounts for ~9% of global maternal mortality. Over 26,000 women die from pregnancy and childbirth-related complications in India annually. India also has the second-highest number of under-five child deaths in the world. Most of these deaths are preventable.
A pregnant woman who is aware of the warning signs of preeclampsia can get help in time. A new mother who knows when her baby needs vaccinations can avoid preventable infections. A frontline health worker who has been properly trained can spot a high-risk pregnancy before it becomes an emergency.
The problem is that education rarely reaches the women who need it most, in their languages, at the moments in pregnancy or early life when it matters.
In rural India, many women cannot read and may not have access to the Internet or a smartphone.
But most women have a basic mobile phone. For 15 years, ARMMAN has built its work around that fact.
What is the solution?
ARMMAN sends free, weekly voicemails to pregnant women and new mothers across India in their own languages.
The messages are timed to the pregnancy stage or the child's age, so a woman in her second trimester gets different information from a mother of a six-month-old. The calls cover warning signs, nutrition, prenatal visits, immunizations, breastfeeding, and newborn care.
ARMMAN runs two main programs. The first, mMitra, launched in 2014, is ARMMAN’s flagship direct-to-mother service in states where ARMMAN operates independently and with partner NGOs.
After seeing mMitra’s results, India’s Ministry of Health and Family Welfare asked ARMMAN to help run and expand Kilkari. Kilkari is the world’s largest government-run mobile maternal health program.
ARMMAN also runs Mobile Academy, a mobile-based training course that trains frontline health workers (ASHAs) across India. Together, these channels give ARMMAN every village: direct messages to the mother and skills training for the health worker who visits her.
What is the business model?
ARMMAN operates as a Mumbai-based nonprofit. It does not sell its services. Revenue comes from philanthropic foundations, bilateral and multilateral donors, and government partnerships.
The Kilkari partnership exemplifies ARMMAN’s structural approach: rather than building a parallel healthcare system, ARMMAN builds inside the government system. India’s Ministry of Health owns Kilkari. ARMMAN helps run it. This lets the program scale through existing government infrastructure (ASHA networks, government maternal health databases, state-level implementation agencies) without ARMMAN having to recreate any of it.
The model keeps per-woman costs extremely low (reportedly a few cents per call) and lets ARMMAN scale to tens of millions of women on a nonprofit budget.
Key donors include the Bill and Melinda Gates Foundation, the Skoll Foundation, Co-Impact, Rockefeller Foundation, LGT Venture Philanthropy, Google.org, and USAID.
Who is the founder?
Dr. Aparna Hegde founded ARMMAN in 2008. Hegde is a Stanford and Cleveland Clinic-trained urogynecologist who continues to practice medicine alongside running ARMMAN. She has said she started the organization after witnessing too many preventable maternal deaths during her residency at a government hospital in Mumbai.
It took her five years to raise ARMMAN’s first external funding. Dr. Hegde was named to Fortune’s World’s Greatest Leaders list in 2020 and elected an Ashoka Fellow in 2021.
Why is it innovative?
ARMMAN’s biggest insight is that mobile infrastructure is also healthcare infrastructure.
A pregnant woman in a village without a clinic, a doctor, or a reliable road still has a phone. Voice calls work on basic phones, do not require literacy, and can be delivered in dozens of Indian languages.
The company partnered with Google Research India to apply machine learning to its voice-call data, specifically to predict which pregnant women are at highest risk of dropping out of the program or facing complications.
This lets ARMMAN prioritize follow-up outreach to the women who need human contact most, rather than trying to call every woman equally.
This is one of the few AI-for-good projects at this scale with a real, measurable public health outcome.
The company’s “tech plus touch” model (combining mobile technology with ASHA community health worker networks) has become a global reference model for mobile public health.
What is the impact?
Over 71 million women and children.
Active across 28 states in India.
Over 506,000 health workers (ASHAs/ANMs) are upskilled via mobile health training platforms.
The Kilkari Program (Government Partnership) has reached nearly 78 million cumulative registrations. It currently broadcasts preventative voice health messages in 10+ regional languages.
The mMitra Program (Direct Service) has reached over 3 million women directly in urban slum communities before evolving into broader municipal partnerships
System capacity has scaled to support 12 million concurrent Kilkari subscribers at any given time (up from a previous threshold of 3 million).
ARMMAN's Predictive AI modeling—developed alongside partners like Google.org—has optimized the identification and management of high-risk conditions, culminating in the formal district-wide rollout of the Integrated High Risk Pregnancy Tracking & Management program.
What needs to improve?
ARMMAN faces three main challenges.
First, the limitation of a one-way voice call. Information dissemination helps, but a recorded call cannot replace a doctor’s examination, a diagnostic test, or an in-person conversation.
ARMMAN’s Virtual OPD and ASHA training programs partially address this, but the gap between information and clinical care remains the single biggest limit on how much maternal mortality mobile voice can prevent.
Second, drop-off and engagement. Not every woman who signs up for mMitra or Kilkari answers every call. Call pickup rates vary by state and demographic group. ARMMAN’s AI partnership with Google partly aims to predict which women are at risk of disengagement so human health workers can follow up, but keeping tens of millions of women engaged throughout pregnancy is a constant operational challenge.
Third, funding fragility. As a nonprofit, ARMMAN depends on grants and government partnerships, both of which are vulnerable to shifts in donor priorities or political change. The organization has diversified its funding, but running a program at this scale on philanthropic capital rather than earned revenue leaves it exposed in a way that a for-profit social enterprise is not.
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