Abstract
BackgroundAs more countries worldwide develop national viral hepatitis strategies, it is important to ask whether context-specific factors affect their decision-making. This study aimed to determine whether country-level socioeconomic factors are associated with viral hepatitis programmes and policy responses across WHO Member States (MS).MethodsWHO MS focal points completed a questionnaire on national viral hepatitis policies. This secondary analysis of data reported in the 2013 Global Policy Report on the Prevention and Control of Viral Hepatitis in WHO Member States used logistic regression to examine associations between four survey questions and four socioeconomic factors: country income level, Human Development Index (HDI), health expenditure and physician density.ResultsThis analysis included 119 MS. MS were more likely to have routine viral hepatitis surveillance and to have a national strategy and/or policy/guidelines for preventing infection in healthcare settings if they were in the higher binary categories for income level, HDI, health expenditure and physician density. In multivariable analyses, the only significant finding was a positive association between having routine surveillance and being in the higher binary HDI category (adjusted odds ratio 26; 95% confidence interval 2.0–340).ConclusionCountries with differing socioeconomic status indicators did not appear to differ greatly regarding the existence of key national policies and programmes. A more nuanced understanding of the multifaceted interactions of socioeconomic factors, health policy, service delivery and health outcomes is needed to support country-level efforts to eliminate viral hepatitis.
Highlights
As more countries worldwide develop national viral hepatitis strategies, it is important to ask whether context-specific factors affect their decision-making
Ninety-nine (83%) reported having routine surveillance for viral hepatitis; 53 (45%) reported funding viral hepatitis awareness campaigns; 84 (71%) reported having a strategy and/or policy/guidelines for preventing hepatitis B and hepatitis C infection in healthcare settings; and 77 (79%) reported that health workers were vaccinated against hepatitis B prior to starting work that might put them at risk of exposure to blood
They were more likely to report having a national strategy and/or policy/guidelines for preventing infection in healthcare settings if they were in the higher binary categories for income level, Human Development Index (HDI), health expenditure and physician density
Summary
As more countries worldwide develop national viral hepatitis strategies, it is important to ask whether context-specific factors affect their decision-making. This study aimed to determine whether country-level socioeconomic factors are associated with viral hepatitis programmes and policy responses across WHO Member States (MS). The inclusion in the Sustainable Development Goals of a target to “combat hepatitis” [5] reflects a growing consensus that this group of diseases, HBV and HCV, must be addressed decisively at the global and national policy levels. MS endorsed WHO’s goal of eliminating viral hepatitis as a public health threat with their approval of the Global Health Sector Strategy on Viral Hepatitis, 2016–2021 [3]
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