Abstract Background Notwithstanding the WHO’s initiative to eliminate viral hepatitis by 2030, there are currently 58 million individuals infected with Hepatitis C Virus (HCV). 73% of infected individuals live in low- and middle-income countries (LMIC) where conventional diagnostics are inaccessible due to high costs and lack of trained personnel. The emergence of low-complexity Point of Care tests is critical for improving accessibility and reducing the spread of infection. Additionally, there is a need for external quality controls (EQC) that monitor the accuracy of test results. Given that LMIC have limited access to laboratory equipment, EQC must have simplified handling procedures and storage conditions. Unfortunately, these materials are not available at scale. Microbix strived to develop HCV EQC swab formulations that are stable at ambient temperature. Since this format deviates from standard HCV diagnostic workflows, we sought to establish a simple yet reproducible workflow that can be followed by laboratories worldwide. Methods Microbix developed HCV swab-based EQC that are stable when stored at 2-30°C. The contrived specimens are formulated with protected synthetic HCV whole-genome nucleic acid and human cells. The formulation was quantified via ddPCR and benchmarked against the WHO HCV standard using Xpert® HCV Viral Load Fingerstick Assay. Sample performance was evaluated with various elution buffers (PrimeStore® MTM, eNAT®, TE buffer, Microbix’s proprietary buffer) and handling procedures that require minimal use of laboratory equipment. Each EQC workflow was assessed based on its ability to consistently demonstrate a viral load of 100-200 IU/mL when tested on Cepheid’s platform. Results The EQC tested positive for HCV when eluted in each buffer and processed using a hand-mixing procedure. Only the workflows that used PrimeStore® MTM or eNAT® consistently reported a viral load between 100-200 IU/mL. Conclusions Microbix developed an HCV swab-based EQC that is stable at ambient temperature; however, we observed that consistent elution conditions are imperative for achieving reproducible results. Our findings demonstrate that a universal workflow should be followed to standardize results across testing sites as deviations in elution buffers, volumes, and handling procedures can influence test outcomes.