Rule-Bottleneck RL: Learning to Decide and Explain for Sequential Resource Allocation via LLM Agents in Public Health
Rule-Bottleneck RL: Learning to Decide and Explain for Sequential Resource Allocation via LLM Agents in Public Health
Guojun Xiong, Mauricio Tec, Haichuan Wang, Francesca Dominici, Joseph Ngonzi, Adeline Boatin, Milind Tambe
Proceedings of the Thirty-Fifth International Joint Conference on Artificial Intelligence
AI and Social Good. Pages 7512-7520.
https://doi.org/10.24963/ijcai.2026/835
Reducing preventable maternal mortality remains a global health priority. Under Sustainable Development Goal (SDG) target 3.1, the WHO emphasizes timely and equitable allocation of limited maternal health resources. Motivated by Department of Obstetrics and Gynecology at several important hospitals in Uganda and Ghana, we study the problem of sequential allocation of wearable vital sign monitoring devices among maternal mothers. While deep reinforcement learning (RL) has shown promise for sequential resource allocation, its limited interpretability hinders adoption in such high-stakes settings. In contrast, large language model (LLM) agents provide human-readable reasoning but often struggle with effective long-term decision making. To bridge this gap, we introduce Rule-Bottleneck RL (RBRL), the first LLM agent framework for resource allocation problems that jointly optimizes language-based decision policy and explainability. At each step within RBRL, an LLM first generates candidate rules---language statements capturing decision priorities tailored to the current state. RL then optimizes rule selection to maximize environmental rewards and explainability, with the LLM acting as a judge. Finally, an LLM chooses the action (optimal allocation) based on the rule. We provide conditions for RBRL performance guarantees as well as the finite-horizon evaluation gap of the learned RBRL policy. Experiments in maternal health show that RBRL outperforms baseline LLM agents and approaches the performance of deep RL, while producing clearer, policy-relevant explanations. Human evaluations further confirm improved trust and usability, demonstrating RBRL as a practical AI approach aligned with SDG target 3.1.
Keywords:
Agent-based and Multi-agent Systems: Agent-based and Multi-agent Systems
Multidisciplinary Topics and Applications: Multidisciplinary Topics and Applications
Planning and Scheduling: Planning and Scheduling
