arXiv:2601.07866v1 Announce Type: new Abstract: While machine learning shows promise for maternal health risk prediction, clinical adoption in resource-constrained settings faces a critical barrier: lack of explainability and trust. This study presents a hybrid explainable AI (XAI) framework combining ante-hoc fuzzy logic with post-hoc SHAP explanations, validated through systematic clinician feedback. We developed a fuzzy-XGBoost model on 1,014 maternal health records, achieving 88.67% accuracy (ROC-AUC: 0.9703). A validation study with 14 healthcare professionals in Bangladesh revealed strong preference for hybrid explanations (71.4% across three clinical cases) with 54.8% expressing trust for clinical use. SHAP analysis identified healthcare access as the primary predictor, with the engineered fuzzy risk score ranking third, validating clinical knowledge integration (r=0.298). Clinicians valued integrated clinical parameters but identified critical gaps: obstetric history, gestational age, and connectivity barriers. This work demonstrates that combining interpretable fuzzy rules with feature importance explanations enhances both utility and trust, providing practical insights for XAI deployment in maternal healthcare.

arXiv:2511.09043v1 Announce Type: cross Abstract: Healthcare federated learning requires strong privacy guarantees while maintaining computational efficiency across resource-constrained medical institutions. This paper presents MedHE, a novel framework combining adaptive gradient sparsification with CKKS homomorphic encryption to enable privacy-preserving collaborative learning on sensitive medical data. Our approach introduces a dynamic threshold mechanism with error compensation for top-k gradient selection, achieving 97.5 percent communication reduction while preserving model utility. We provide formal security analysis under Ring Learning with Errors assumptions and demonstrate differential privacy guarantees with epsilon less than or equal to 1.0. Statistical testing across 5 independent trials shows MedHE achieves 89.5 percent plus or minus 0.8 percent accuracy, maintaining comparable performance to standard federated learning (p=0.32) while reducing communication from 1277 MB to 32 MB per training round. Comprehensive evaluation demonstrates practical feasibility for real-world medical deployments with HIPAA compliance and scalability to 100 plus institutions.