Text-Only Domain Adaptation for Low-Resource Medical ASR: Shallow Fusion and Density Ratio Rescoring for Hausa

Automatic speech recognition (ASR) systems often struggle with specialised medical vocabulary, especially in low-resource languages where domain-specific speech data are scarce. We investigate text-only domain adaptation for Hausa medical ASR using the fixed MMS-1B-FL102 acoustic model and two decoding-time language-model fusion methods: Shallow Fusion (SF) and the Density Ratio Approach (DRA). A 4-gram KenLM trained on 19,421 Hausa health sentences serves as the medical target model, while a 75,372-sentence general-domain model provides the source prior for DRA. Evaluation uses 250 recordings of 25 physician-reviewed prompts from 10 speakers across six northern Nigerian states. Under prompt-disjoint five-fold cross-validation, SF and DRA reduce WER from 29.56% to 23.55% and 23.33%, respectively. Both significantly outperform greedy decoding (p < 0.001), while their difference is not significant (p = 0.423). However, general-LM-only SF achieves 23.96% WER, indicating that the medical LM's additional improvement over a general LM is modest. Medical Term Error Rate also improves under fusion, but does not establish a distinct medical-domain advantage. These findings demonstrate that lightweight, text-only language-model fusion can improve Hausa medical ASR without additional domain-specific speech collection.