Evaluating a digital platform for community-led TB monitoring in Mozambique: implementation research findings

Tuberculosis (TB) remains a major cause of death in Mozambique, particularly among people with HIV. Stigma, discrimination, and health system challenges limit access to care. OneImpact, a community-led monitoring digital platform, enables patient-driven reporting on TB service access and quality to address barriers. Yet, its acceptability, usability, and impact on improving care have not been evaluated. A sequential explanatory mixed-methods design was employed to assess the acceptability, usability, and feasibility of the OneImpact CLM platform. Quantitative data were extracted from the OneImpact digital platform database for the period 2021–2023 to to characterize platform users and describe patterns of barrier reporting. These findings were subsequently elaborated through qualitative focus group discussions (FGDs) and key informant interviews (KIIs) with TB patients, community leaders, and healthcare workers, analysed using thematic analysis. Data from 1,202 OneImpact digital platformusers (2021–2023) were extracted, who were mostly male (53%) from rural areas (66%). Despite reported limited digital literacy, the platform improved communication, service access, medication availability, and stigma reduction. Key reported barriers to service were unavailability (77%) and stigma (64%). The OneImpact CLM tool has enhanced patient engagement and TB care but requires expanded digital literacy training and infrastructure improvements for broader impact.