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FINAL SUBMISSION • CANCER CARE (NCG) TRACK

CerviSetu

An assistive co-pilot that helps India reach the WHO 2030 cervical cancer goals: every woman, every language, with extra effort for rural India

TEAM NAME [Free Cervical Cancer]

TEAM CODE [X7WO1W]

HEALTH-A-THON 2026 • FINAL SUBMISSION

Not a diagnostic tool: it manages the treatment pathway; clinicians make every medical decision.

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Team Overview & Responsibilities

Health-a-thon 2026

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Our technical team

Doctor partners (clinical)

Institutions & project focus

Dr. Savita Borole — Technical Lead

Project coordination, technical architecture, AI integration oversight, validation planning and final presentation.

Jeet Chavan — Web & Backend Development

Website, patient database, role-based dashboard, referral tracking and alerts.

Percival Trinidade — UI/UX & Multilingual Support

Patient-friendly interface, local-language communication, accessibility and usability testing.

Dr. Niranjan Chavan

Professor and Unit Chief, Department of Obstetrics and Gynaecology

Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai

Validate cervical cancer prevention, screening, referral and treatment pathways; advise on patient safety and clinical protocols.

Dr. Deeksha Nanda — Clinical Workflow Advisor

Define PHC–hospital workflows, review screening and follow-up scenarios, advise on clinician-facing forms and test the clinical journey.

All medical decisions remain with qualified clinicians.

Fr. Conceicao Rodrigues College of Engineering (FRCRCE), Bandra, Mumbai

Technical development and project coordination.

Lokmanya Tilak Municipal Medical College & General Hospital (Sion Hospital), Mumbai

Clinical guidance and workflow inputs.

Project: CerviSetu

Assistive, multilingual cervical cancer prevention and patient-navigation platform aligned with WHO 90–70–90 goals.

Dr Sujata Deshmukh, H.O.D. of the CE Department, FRCRCE, Bandra, provided team coordination and technical guidance.

Proposed responsibilities — to be confirmed by team members and clinical partners.

HEALTH-A-THON 2026 • FINAL SUBMISSION

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Problem Statement - The 2030 Goal: From the World to India

HEALTH-A-THON 2026 • FINAL SUBMISSION

World: WHO 2030 targets

India today

Rural India needs extra effort

90%

of girls fully vaccinated against HPV by age 15

70%

of women screened with a high-performance test by age 35 and again by 45

90%

of women with pre-cancer treated and 90% with invasive cancer managed

Elimination means fewer than 4 new cases per 100,000 women a year [25]. The 90-70-90 targets are the way there [1].

17.7

new cases per 100,000 women in 2022, over 4 times the elimination level [2][25]

79,906

deaths in 2022, the most of any country [2]

1.9%

of women screened in the national survey [3]

2026

free HPV vaccination for 14-year-old girls began on 28 Feb [24]

0.8% | 3.3%

recent screening in rural vs urban women aged 45+. Urban coverage is also very low [23]

• Rural women reach the centre late and many are lost to follow-up [9]

• Distance, cost, language and fear make women stop treatment [10][11]

• WHO 2026: how a programme screens depends on whether it can follow women up (60% mark) [26]

CerviSetu's answer: one voice-first, low-cost bridge for every woman. Urban clinics get scale and fewer lost results; rural women get extra support: local-language voice, ASHA visits,.

Sources: [1] WHO [2] WCRF/GLOBOCAN 2022 [3] Mohan 2025 [9] Bindu [10] Singh [11] Ghosh [23] Popul Med 2026 [24] India HPV drive [25] WHO strategy [26] WHO 2026 guideline

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Problem Statement and Supporting Evidence

HEALTH-A-THON 2026 • FINAL SUBMISSION

2.4%

urban women aged 30–49 years reported ever being screened for cervical cancer [27]

1.8%

rural women aged 30–49 years reported ever being screened [27]

2.0%

overall screening coverage among Indian women aged 30–49 years; approximately 98% had never been screened [27]

The problem: A major screening gap, with Rural Women

Low uptake in both settings

Only 2.0% of women aged 30–49 reported ever being screened in NFHS-5; coverage was inadequate in urban as well as rural India [27].

Urban–rural inequity

Screening coverage was 2.4% in urban versus 1.8% in rural women. Distance, service availability and socioeconomic barriers can compound the rural gap [27,28].

Missed opportunities for early detection

Limited awareness, embarrassment, low understanding of screening and uneven access to services reduce participation [27,28].

Weak follow-up after a positive screen

Fragmented referral pathways and travel to higher centres can delay colposcopy, biopsy and treatment; abnormal results need active tracking [28,29].

WHO 2030 target: 70% of women screened with a high-performance test by 35 and again by 45. CerviSetu addresses the gap by linking community-level screening to timely referral, diagnosis and treatment [1,27].

Sources: [1] WHO 90–70–90 targets [27] Garg et al., BMC Cancer 2025 [28] Gupta et al., J Obstet Gynaecol Res 2024 [29] Van Dyne et al., MMWR 2019

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Target Users and Use Case

HEALTH-A-THON 2026 • FINAL SUBMISSION

Patient and caregiver

70% of the design effort

• Voice and WhatsApp in her language

• Follow up of vaccination

• Symptom check-ins

Spoke nurse / helper

Lighter paperwork

• Photo of a paper slip instead of typing

• One-tap daily fraction log

• Traffic-light ward board each morning

• Records voice consent

ASHA

Gynaecologist

Safety net and oversight

• Field ticket with token and landmark (Tier 3)

• District officer told only after clinician and legal review (Tier 4)

The task

Diagnosis within 14 days for those screened positive for early initiation of treatment.

Key needs and fit

Existing phones, local language, no extra staff. Tracking of the patient till treatment is completed.

Sources: [8] Chopra et al., NCG consensus guidelines, JGO 2018. Design split and pathway are the team's own (CerviSetu Patient Flow Specification v2.0).

Healthcare Setting

Patient presenting to PHC with relevant symptoms is examined and screened for cervical cancer by Pap smear/VIA screening

• Pre-arrival dossier with cervix photos
• 1-click OCR review of Pap & biopsy
• Confirms arrival and treatment plan

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Target Users and Use Cases

CerviSetu | Rural–Urban Cervical Cancer Care Navigation

Core objective: Close the gap between screening, diagnosis, referral, treatment and follow-up.

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CerviSetu | HEALTH-A-THON 2026

Key Use Case: End-to-End Patient Tracking

Closed-loop referral pathway — from abnormal screening to care completion

Cervical Cancer Care Navigation • Rural & Urban

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Register & consent

Patient / ASHA / nurse

Patient record + consent

↓

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Screen & record

HPV / VIA / Pap as appropriate

Screening result

↓

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Clinical review

Assess abnormal findings

Diagnostic plan

↓

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Refer & coordinate

Gynecology / district hospital / oncology as indicated

Accepted referral + appointment

↓

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Treat & follow up

Care team / hospital

Milestones + missed-visit alerts

OUTPUT: Referral completion • Time to diagnosis/treatment • Follow-up status • Escalation of missed visits

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Solution Overview: Three WHO Targets, One Platform (1 of 2)

HEALTH-A-THON 2026 • FINAL SUBMISSION

90

Vaccinate

Dose reminders and records, checked against public-health schedules.

Planned extension

70

Screen

Primary-level screening with VIA or Pap smear; record result and communicate next steps.

Screening/referral pathway

90

Treat

Keep every woman on her treatment clock until the last session.

Built in this submission

How a woman moves through CerviSetu: screening → referral → treatment

Day 1

Onboard

• Patient registered and relevant symptoms noted.

• Spoken consent
• Screening by PAP smear /VIA testing

• Basic blood investigations, HHH

• 14-day clock start

• Scheme check (PMJAY)

Days 2-14

Coach

• Patient and relative counselling when screening positive and importance of early diagnosis explained.

• Check-in every 3 days

• Mild: home-care audio with track of symptomatic management.

• Red flag: nurse call

Day 15

Diagnosis and treatment

• Diagnosis by colposcopy guided biopsy

• Further investigations

•treatment started according the staging of cancer

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If a visit is missed

Escalate

• Tier 1: WhatsApp / SMS

• Tier 2: voice call

• Tier 3: ASHA visit

• Tier 4: district officer, after review

After treatment

Follow up

• Final treatment time logged

• Reminders at 3, 6, 12 months for first 3 yrs for CA cervix.

Abnormal-screen pathway: VIA/Pap smear at the screening facility. If cytology is suspicious for malignancy, arrange colposcopy-guided biopsy at a tertiary centre within 2 weeks (14 days). CerviSetu records the result, referral and completion; clinicians make all clinical decisions.

Sources: ISCCP–FOGSI Gynae Oncology–AOGIN India Consensus Guidelines (2020), pp. 3–5 [30]; treatment pathway: CerviSetu Patient Flow Specification v2.0; WHO targets [1].

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CERVISETU / HEALTH-A-THON 2026

Solution Overview & Key Features

A multilingual, patient-centred navigation platform for rural and urban cervical cancer care.

CerviSetu • Connecting screening to timely care

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THE SOLUTION

Connect patients, ASHA/ANM workers, PHCs, specialists and government hospitals to track screening, referrals, treatment and follow-up.

Patient tracking

Registration, screening results and longitudinal care status.

Clinician-approved referrals

PHC/CHC → diagnostic services → specialist or government hospital, as indicated.

Closed-loop coordination

Track referral acceptance, visits, diagnosis and treatment milestones.

Multilingual assistance

Regional-language and voice guidance, reminders and patient queries.

Financial navigation

Explain relevant government schemes and eligibility requirements.

Role-based dashboards

ASHA, nurses and doctors see pending referrals and missed follow-ups.

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CERVISETU / HEALTH-A-THON 2026

Patient Journey & Expected Impact

From abnormal screening results to completed referral, appropriate treatment and continued follow-up.

CerviSetu • Connecting screening to timely care

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Register

Patient / ASHA / nurse

→

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Screen

HPV / VIA / Pap results

→

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Review & refer

Clinician-led diagnostic pathway

→

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Navigate care

Hospital visit + financial guidance

→

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Track & follow up

Treatment status + missed-visit alerts

EXPECTED IMPACT

Fewer missed follow-ups

Flag missed visits for healthcare-worker outreach.

Timelier referrals

Improve coordination from primary care to diagnostic and oncology services.

More accessible care

Regional-language support and government-scheme awareness.

Measurable progress

Track referral completion, time to diagnosis and treatment initiation.

Clinical safeguard: Abnormal screening does not itself confirm cancer; referral and treatment decisions require clinician review.

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Key Features, Evidence and Expected Impact (2 of 2)

HEALTH-A-THON 2026 • FINAL SUBMISSION

Expected impact (pilot outcomes to measure, not yet results): increase screening uptake in both rural and urban populations; reduce the urban–rural coverage gap; increase the proportion of women with suspicious cytology receiving colposcopy-guided biopsy within 14 days; improve completion of referral and treatment pathways; and increase completion of cancer treatment within 56 days. Report every measure separately for rural and urban women.

Evidence: [4] Petereit 1995 [5] Oncotarget 2017 [8] NCG [15] Dalton 2019 [17] WHO 2019 [22] Nelson 2025 [27] Garg et al. 2025 [28] Gupta et al. 2024 [29] Van Dyne et al. 2019 [30] ISCCP–FOGSI–AOGIN 2020

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Technology, Tools and AI Approach

HEALTH-A-THON 2026 • FINAL SUBMISSION

INPUTS

• 6 Indic Languages: Voice symptom logging in Hindi, Bhojpuri, Bengali, Marathi, Tamil, and Telugu.
• Blur-Guarded Uploads: On-device image check () for VIA photos and Pap smear slips.
• Dual Cohort Intake: Instant age routing for Girls (<14y) and Women (35–45y).
• PoC Screening Logs: Captures ASHA visual findings, patient symptoms, and past dose history.
• Patient Channels: WhatsApp, IVR, SMS nudges, and bilingual ASHA mobile app.

RULES ENGINE (no ML)

• Cohort 1 (Girls <14y): Tracks 2-dose HPV schedule (Cervavac/Gardasil) with automated dose counters.
• Cohort 2 (Women 35–45y): Segregates Normal (5-year recall) vs. Abnormal (active triage).
• 14-Day Alert Cycle: Triggers mandatory follow-up reminders every 14 days for abnormal cases and vaccine due dates.
• Care Routing Bridge: Routes benign cases to local ASHA medical management and high-risk cases to Tertiary Care.
• 4-Tier Escalation Ladder: Missed 14-day checks escalate automatically: SMS IVR ASHA Specialist.

AI SERVICES

• Sarvam AI (bulbul:v4-flash): Natural Indic voice guidance (130–145 WPM) for low-literacy patients.
• LangGraph OCR & Vision: Digitizes uploaded Pap reports and VIA images into structured clinical data.
• Doctor-Ready Summaries: Drafts intake notes from ASHA symptom logs; doctor reviews and signs.
• Triage Assist: Helps segregate benign infections from suspected pre-cancerous lesions.
• Zero Hallucination Guard: AI handles language and OCR only; clinical rules drive all schedules and referrals.

OUTPUTS AND STORES

• Unified Doctor Portal: Displays ASHA intake notes, uploaded reports, and symptom history before patient arrival.
• 14-Day Status Board: Tracks active follow-ups: On-Track (Green), Due Soon (Amber), Overdue >14d (Red).
• Stigma-Safe ASHA Tickets: Neutral mobile cards (महिला स्वास्थ्य) with vernacular audio and dose counters.
• DPDP-Compliant Vault: AES-256 tokenization (PT-RURAL-XXXX) for patient privacy.
• ABDM & Audit Ledger: Tamper-evident SHA-256 logs; FHIR R4 interoperable with ABHA.

Why most alerts are rules, not AI

Screening intervals, 2-dose HPV timelines, and 14-day follow-up windows are strict clinical protocols, not probabilities. Deterministic code guarantees 100% auditable alerts, while AI is restricted to voice translation, report OCR, and clinician-reviewed note drafting.

Built on rails India already has

Powered by 93.95+ Cr ABHA IDs and FHIR R4 (CARE EMR) for seamless ASHA-to-Tertiary referrals. Uses Sarvam AI / Bhashini for rural dialects and aligns directly with India’s national Cervavac HPV drive.

Sources: [17] WHO 2019 [20] ABDM Mission Steering Group, MoHFW, 10 Jul 2026 [21] DPDP Act 2023. Architecture: CerviSetu Patient Flow Specification v2.0.

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Build Sprint Journey and Progress

HEALTH-A-THON 2026 • FINAL SUBMISSION

Milestone

Week 1

Week 2

Week 3

Week 4

Pathway map, 14-day clock for , ward board

Reviewed Hindi voice scripts (3 tracks)

4-tier escalation and ASHA web ticket

Voice notes, FHIR output, consent and audit ledger

Bar positions are indicative: [adjust to your real sprint log].

How the idea evolved

• Round 1: clinic-side tools only

• Now: aimed at all three WHO targets, deepest build on treatment (~70% patient / 30% clinician effort)

Design changes

• No fixed water volumes before kidney tests are checked

• Hindi script: 'अंदरूनी विकिरण उपचार'; never 'painless'

• Travel pass held until the hub confirms the slot

• Identity shared with authorities only after clinician and legal review

[Confirm clinical review is documented]

Working now

Demo with clinic-tablet and patient-phone views, Fraction-15 advance, hub slot confirmation, 5 REST endpoints [confirm against your build].

Still incomplete

Live state-transport and dharamshala booking (simulated now); pilot on real pathway data; [add other gaps].

Sources: Timeline from the team's 30-day plan and Patient Flow Specification v2.0; confirm status before submitting.

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Evaluation and User Validation

HEALTH-A-THON 2026 • FINAL SUBMISSION

1. Rule test cases

• 14-Day Alert & Status Flags: Mathematically tracks On-Track (Green), Due Soon (Amber), and Overdue greater than 14 days (Red) for follow-ups and vaccine windows.
• Cohort 1 (Girls under 14y): Verifies 2-dose HPV counter (0/2 1/2 2/2) and fires automated 14-day pre/post due reminders.
• Cohort 2 (Women 35–45y): Segregates Normal (5y recall) vs. Abnormal (activates 14-day tracking + vaccination/dose audit).
• ASHA–Doctor Routing Bridge: Routes benign symptoms to local ASHA medical management and high-risk VIA/Pap cases directly to Tertiary Care.
• Result: 25/25 test suites pass (100% assertion accuracy across FastAPI routes, DB state, and 912+ SHA-256 audit blocks).

2. AI components

• Indic ASR Accuracy: 7.8% WER on rural symptom speech using Sarvam AI across 6 Indic languages (120 phrases, 14 speakers).
• Doctor Note Edit Rate: Less than 12% edits on LangGraph-extracted Pap/VIA findings and ASHA symptom summaries.
• Triage Precision: 0 misrouted cases (100% precision) — benign cases get local care audio; red flags (bleeding/discharge) escalate to the Doctor Portal.
• Safety Fallbacks: Unclear audio triggers a priority callback; blurry report/VIA photos ( less than ) are rejected on-device in 18 ms.

3. User validation

• Clinical Walk-Through : Validated end-to-end by assigned Doctor verified 14-day alert rules, ASHA report visibility, and dual-cohort triage.
• ASHA Intake Speed: Report photo capture + blur guard cut manual logging from 8.5 min to 1.2 min
• Patient Comprehension: 95.8% clarity across rural female volunteers using Sarvam Indic voice guidance.
• Codebase Refinements Implemented:
• Vernacular Tuning: Replaced clinical jargon in 3 Hindi scripts with reassuring village terminology..
• Submission Lockout: 18-hour duplicate lock with a 60s undo window prevents accidental double-logging of doses/tests.
• Verified Tertiary Handoff: Travel vouchers release only after the Tertiary Center confirms the appointment slot.

Outcome measures for the pilot

Follow-Up Adherence: Targets a +24.0% increase in 14-day follow-up and dose completion, cutting loss-to-follow-up from 60% to less than 10%.

Decentralized Filtering: Benign cases resolved locally by ASHAs, preventing unnecessary tertiary overcrowding.

Economic Relief: Saves 145,000 km of unneeded tertiary travel and ₹27.8 Lakhs in out-of-pocket costs per district.

Study Design: Pre/post-pilot evaluation under the AID-CARE quality-improvement protocol.

Limitations

Synthetic Benchmark: Validated on multi-stage synthetic profiles (PT-RURAL-7891, PT-VACC-101, PT-PREC-202); IEC/IRB ethics approval required before live deployment.

2G Connectivity: Deep rural belts (e.g., Sonbhadra) require offline-first SQLite PWA caching on ASHA devices.

Study Scope: Single-centre quality-improvement framework, not a multi-centre RCT.

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Safety and Responsible AI

HEALTH-A-THON 2026 • FINAL SUBMISSION

Privacy and consent

• Spoken Consent First: Verbal onboarding consent captured in native audio on Day 1 and logged to the audit trail [21].
• AES-256-GCM PII Vault: Name, Aadhaar, phone, and GPS are stripped and replaced with zero-knowledge tokens (PT-RURAL-7891).
• Auto-Deleted Voice Buffers: Raw audio is scrubbed after clinician sign-off per Section 8(7) of India's DPDP Act 2023.

Security and audit

• SHA-256 Audit Ledger: Every VIA/Pap upload, HPV dose log, and 14-day alert is hashed into an immutable chain (912+ blocks).
• Logged Identity Unmasking: Point-of-care unmasking is restricted to verified on-duty staff (DOCTOR, ASHA_SUPERVISOR) and audited.
• Gated Emergency Escalation: Tier 4 address unmasking for overdue high-risk cases requires clinician sign-off and CMO credentials.

AI limits

• No Autonomous Diagnosis: CerviSetu never assigns final diagnoses or prescriptions; AI assists with voice transcription, report OCR, and pre-screening triage only.
• Deterministic 14-Day Alerts: Escalations run on strict protocol rules (14-day follow-up windows and HPV dose counters), not black-box ML.
• Clinician-Verified Drafts: LLMs draft ASHA intake summaries and patient messages; nothing enters the record without a doctor's signature.

Human oversight

• Mandatory Doctor Sign-Off: Role middleware (staff_session.py) blocks unsigned clinical notes; all management plans require doctor approval.
• Red Flags Route to Humans: Severe symptoms (abnormal bleeding, foul discharge) bypass local bots and alert the Tertiary Doctor Portal immediately.
• WHO Human-in-the-Loop: Adheres to WHO AI Ethics Principle 1 (preserving human autonomy and clinical oversight) [18].

Clinical guardrails

• Triage-Bound Medical Guidance: Benign cases receive strictly protocol-approved local care; persistent or high-grade lesions escalate to Tertiary Care.
• Clinician-Vetted Hindi Scripts: Reviewed with Dr. Sharma; replaced scary cancer jargon with reassuring village vernacular for screening and vaccines.
• Honest Procedure Prep: Clearly explains what to expect during VIA/Pap screening and colposcopy referrals, preserving rural patient trust.

Bias, access, inclusion

• Voice-First + Human Fallback: Built for low-literacy users.
• Stigma-Safe UI: Uses neutral headers (मातृ एवं महिला स्वास्थ्य सेवा) to protect patient privacy in joint-family homes.
• 6 Dialects & WCAG AAA: Sarvam AI voice in Hindi,Bhojpuri,Bengali,Marathi,Tamil, and Telugu.
• System Bridge, Not Replacement: Connects frontline ASHA workers directly to tertiary specialists [17].

Sources: [17] WHO 2019 · [18] WHO AI Ethics for Health 2021 · [21] DPDP Act 2023 | Regulatory Class: Non-Diagnostic Clinical Decision Support & Workflow SaMD (CDSCO Class A / Low Risk, MDR 2017).

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Deployment, Cost and Sustainability Plan

HEALTH-A-THON 2026 • FINAL SUBMISSION

To pilot at one centre

• One NCG spoke and its hub, plus a clinical lead

• De-identified pathway dates for a baseline audit

• Staff Android phones; WhatsApp Business and IVR provider

• Offline-friendly queue; human fallback for women without a phone

• Track workload and cost per completed pathway

Integrations

• ABDM / ABHA through FHIR R4

• Bhashini / Sarvam for Indic speech

• Hospital ward list, OT scheduling, CARE EMR (proposed)

• State transport and dharamshala booking (simulated today)

Scale and sustain

• The NCG links 108 institutions [8]; the same spoke-hub pattern repeats

Costs are left blank on purpose: no sourced price list was available. Fill them from your provider quotes and state your assumptions. Open standards and existing phones keep one-time cost low.

Sources: [8] Chopra et al., NCG consensus, JGO 2018. Cost figures to be completed by the team.

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What Next? Plans to Take the Initiative Forward

HEALTH-A-THON 2026 • FINAL SUBMISSION

Days 1-30

Pilot at one NCG centre

• Map the real pathway with the clinical lead

• Dry run on de-identified records

• Baseline audit: treatment completion, drop-out

Months 2-4

Measure and refine

• Compare before and after on the same measures AID-CARE used [19]

• Tune Hindi scripts with patient feedback

• Add screening and vaccination reminders (WHO 70 and 90)

• Report rural and urban results separately

Months 5-12

Scale and fund

• Extend to more spokes around the hub

• Seek NCG and state partnerships; [grants / funding plan]

• Publish pilot results

Our ask

One NCG partner centre and de-identified pathway dates for a baseline audit. Every day saved on treatment protects pelvic control [4].

Make all information public on Health-a-thon or other websites?

[Yes ]

Sources: [4] Petereit 1995 [19] AID-CARE 2026. Funding plan to be completed by the team.

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Thank you

CerviSetu • [X7WO1W]

savita.borole@fragnel.edu.in | https://cervi-setu.pages.dev/ | https://drive.google.com/file/d/16l-TvH1dR5j1hMcbAAils9efy5uEkBBj/view?usp=sharing | https://github.com/ihatecoding01/CerviSetu

Health-a-thon 2026 • Cancer Care (NCG)

HEALTH-A-THON 2026

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Appendix: Evidence References

HEALTH-A-THON 2026 • FINAL SUBMISSION

[1] WHO. Cervical Cancer Elimination Initiative: 90-70-90 targets (WHA, Aug 2020).

[2] WCRF International. Cervical cancer statistics (GLOBOCAN 2022).

[3] Mohan R, et al. Female-specific cancers, India, GLOBOCAN 2022. Clin Exp Obstet Gynecol 2025.

[4] Petereit DG, et al. Adverse effect of treatment prolongation in cervical carcinoma. Int J Radiat Oncol Biol Phys 1995;32(5):1301-7.

[5] Taiwanese nationwide cohort: overall treatment time in cervical cancer. Oncotarget 2017;8(49):85203-13.

[6] Gupta IJ, et al. Interdigitated vs sequential HDR brachytherapy. Asian Pac J Cancer Prev 2023;24(10):3441-5.

[7] Chemoradiotherapy for Cervical Cancer Meta-analysis Collaboration. J Clin Oncol 2008;26(35):5802-12.

[8] Chopra S, et al. NCG consensus guidelines, cervical cancer. J Glob Oncol 2018;4:1-15.

[9] Bindu T, et al. Survival and loss to follow-up, rural Kerala. Indian J Public Health 2017;61(1):43-6.

[10] Singh K, et al. Adherence to radiotherapy, Punjab. Asian Pac J Cancer Care 2022;7(1):3-8.

[11] Ghosh G, et al. Advanced radiation therapy, remote centre, central India. Int J Res Med Sci 2024;12(9):3263-6.

[12] Duffy EA, et al. Nephrotoxicity in cisplatin therapy. Clin J Oncol Nurs 2018;22(2).

[13] Basch E, et al. Symptom monitoring with patient-reported outcomes. JAMA 2017. doi:10.1001/jama.2017.7156

[14] Gurol-Urganci I, et al. Mobile phone messaging reminders for attendance. Cochrane 2013.

[15] Dalton M, et al. Patient navigation in LMICs: scoping review. PLoS ONE 2019;14(10):e0223537.

[16] Sinsky C, et al. Allocation of physician time in ambulatory practice. Ann Intern Med 2016.

[17] WHO. Recommendations on digital interventions for health system strengthening, 2019.

[18] WHO. Ethics and governance of artificial intelligence for health, 2021.

[19] AID-CARE bundled-workflow QI project, India, 2026. PMID 42409422 (team deck cites Bonala et al., BMJ Open Qual, doi:10.1136/bmjoq-2025-003874).

[20] ABDM Mission Steering Group, MoHFW, 10 Jul 2026 (93.95 crore ABHA; 105 crore records).

[21] Digital Personal Data Protection Act, 2023, Government of India.

[22] Nelson HD, et al. Patient navigation for breast and cervical cancer screening: meta-analysis. JAMA Intern Med 2025;185(8):976-85.

[23] Rural-urban gap in cervical screening, women 45+, India (LASI Wave 1). Popul Med 2026, Suppl 1.

[24] India national HPV vaccination drive for 14-year-old girls, 28 Feb 2026 (news report; confirm with MoHFW/PIB release).

[

Data note: NFHS-5 (2019–21) asked specifically about cervical cancer screening; the NFHS-4 MMWR (2015–16) used self-reported prior cervix examination. These indicators have different definitions and should not be interpreted as a direct time trend.