Explainable Machine Learning on Health Management Information System Data to Unveil Health Factors Affecting Maternal Mortality Ratio of Districts in India towards Achieving Sustainable Development Goals

Purpose: Maternal mortality remained to persist in many developing countries. India being the most populous developing country has several cultural differences and beliefs on health systems and may have disparities in receiving proper maternal health care. High data availability and under-utilization of data centric decision making is a key reason for ineffective performance of health systems. Enacting machine learning on such data to aid in sub-divisional policy formulation to address area level problems will eradicate major disparities in recipients of health services. Methods: Glass box machine learning models are trained on the data to obtain importance of features in defining the maternal mortality of a district. Furthermore, black box machine learning models are trained with hyper-parameter tuning and best model is chosen to perform explainable machine learning to generate explanations for each district prediction. A hybrid explainable machine learning approach is proposed on black-box machine learning models where Shapley Additive Explanation and Local Interpretable Model-agnostic Explanations are combined to generate final explanations. Results: There may be several differences even among nearby districts. Health Management Information System data is analyzed with help of Machine Learning techniques and Explainable Machine Learning techniques are used on the trained models to evaluate the contributing factors for each district. Conclusion: The factors that are specific to each district can help in formulating region specific health policies that minimize the disparities of progress of preventing maternal mortality over the districts of India. The paper has highlighted the advantages of using explainable machine learning in extracting complicated patterns of the data.