Qualitative findings on integration of new technology into the benefit medical examination process for ex-miners in Mozambique
1
Faculty of Medicine, Universidade Eduardo Mondlane, Maputo, Mozambique
2
School of Population and Public Health, the University of British Columbia, Vancouver, Canada
Popul. Med. 2026;8(Supplement Supplement 1):
ABSTRACT
BACKGROUND:
Computer-aided detection (CAD) is a technology used to support disease detection and is now widely applied for identifying tuberculosis (TB) on chest X-rays. The accuracy of CAD for TB detection has been demonstrated in systematic reviews through independent comparisons and validations of available CAD systems. Ultra-portable X-ray devices (UP-XR) further expand screening capacity by enabling chest X-ray screening in remote and hard-to-reach settings, overcoming limitations of traditional, stationary equipment concentrated in health facilities. While current miners are screened annually for disease, former miners in Mozambique are dispersed and recruitment for occupational health exams is difficult. In Mozambique, CAD and UP-XR were implemented to screen former miners for occupational lung disease such as silicosis and tuberculosis.
METHODS:
A pilot program integrating CAD and UP-XR was implemented in Mozambique from August to October 2025. In October, semi-structured interviews were conducted with 20 stakeholders across two sites—Xai-Xai and Inhambane. Participants included nurses, doctors, and technicians operating the equipment, as well as key stakeholders such as Ministry of Health representatives. Interview data were thematically analyzed to identify and categorize barriers and facilitators to effective implementation.
RESULTS:
Four factors were identified as critical to successful implementation: training, including initial instruction, language considerations and ongoing skills reinforcement; communication, encompassing clarity of workflows but also to former miners who have expectations regarding screening and compensation; access, referring to the availability and reliability of equipment and infrastructure including the mobile vans; and support, including information on project funding and sustainability of initiatives.
CONCLUSIONS:
While CAD and UP-XR offer promising solutions for expanding TB screening in this population, their successful implementation requires attention to contextual factors beyond technology alone. Meaningful training, communication that manages expectations around screening and compensation, dependable access to mobile services, and sustained institutional support are central to program acceptability and long-term viability.
Computer-aided detection (CAD) is a technology used to support disease detection and is now widely applied for identifying tuberculosis (TB) on chest X-rays. The accuracy of CAD for TB detection has been demonstrated in systematic reviews through independent comparisons and validations of available CAD systems. Ultra-portable X-ray devices (UP-XR) further expand screening capacity by enabling chest X-ray screening in remote and hard-to-reach settings, overcoming limitations of traditional, stationary equipment concentrated in health facilities. While current miners are screened annually for disease, former miners in Mozambique are dispersed and recruitment for occupational health exams is difficult. In Mozambique, CAD and UP-XR were implemented to screen former miners for occupational lung disease such as silicosis and tuberculosis.
METHODS:
A pilot program integrating CAD and UP-XR was implemented in Mozambique from August to October 2025. In October, semi-structured interviews were conducted with 20 stakeholders across two sites—Xai-Xai and Inhambane. Participants included nurses, doctors, and technicians operating the equipment, as well as key stakeholders such as Ministry of Health representatives. Interview data were thematically analyzed to identify and categorize barriers and facilitators to effective implementation.
RESULTS:
Four factors were identified as critical to successful implementation: training, including initial instruction, language considerations and ongoing skills reinforcement; communication, encompassing clarity of workflows but also to former miners who have expectations regarding screening and compensation; access, referring to the availability and reliability of equipment and infrastructure including the mobile vans; and support, including information on project funding and sustainability of initiatives.
CONCLUSIONS:
While CAD and UP-XR offer promising solutions for expanding TB screening in this population, their successful implementation requires attention to contextual factors beyond technology alone. Meaningful training, communication that manages expectations around screening and compensation, dependable access to mobile services, and sustained institutional support are central to program acceptability and long-term viability.
| eISSN: | 2654-1459 |
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