'Being Hopeful is Mandatory': Characterizing Gaps Between the Imaginaries and Realities of AI-enabled Healthcare in Nepal

As noncommunicable diseases (NCDs) become more prevalent, countries around the world are investing resources into the development of artificial intelligence (AI) enabled tools to support the last mile delivery of NCD care. Through 14 interviews with government officials, community health workers, and senior health practitioners in Nepal, we outline eight facets of the imagined future of AI-enabled NCD care. We create a blueprint of the technology systems needed to support a simple AI-enabled NCD diagnostic in Nepal, and connect the components in this blueprint to interviewee-described realities of working at the margins of the Nepali health system. By ensconcing the technology systems needed to support AI-enabled NCD care into current lived experiences of caregiving, we unearth frictions that may prevent the realization of the imagined futures of AI-enabled health. Through our method and analysis, we aim to empower researchers and leaders to create sociotechnical systems that can deliver on their potential and promise.