Patients’ experience of accessing hepatitis C treatment through the Myanmar national hepatitis C treatment program: a qualitative evaluation

Author:

Draper BridgetORCID,Yee Win Lei,Bowring Anna,Naing Win,Kyi Khin Pyone,Htay Hla,Howell Jessica,Hellard Margaret,Pedrana Alisa

Abstract

Abstract Background Globally, 56.8 million people are living with hepatitis C and over three-quarters of those reside in low and middle-income countries (LMICs). Barriers and enablers to hepatitis C care among people who inject drugs in high-income countries are well documented. However, there is scant literature describing the patient experience in LMICs. Understanding the barriers and enablers to care from the patient perspective is important to inform service refinements to improve accessibility and acceptability of hepatitis C care. Methods We conducted a qualitative evaluation of the patient experience of accessing the national hepatitis C program at eight hospital sites in Myanmar. Semi-structured interviews were conducted with four to five participants per site. Interview data were analysed thematically, with deductive codes from Levesque et al.’s (2013) Framework on patient-centred access to healthcare. Results Across the eight sites, 38 participants who had completed treatment were interviewed. Barriers to accessing care were mostly related to attending for care and included travel time and costs, multiple appointments, and wait times. Some participants described how they did not receive adequate information on hepatitis C, particularly its transmission routes, and on the level of cirrhosis of their liver and what they were required to do after treatment (i.e. reduce alcohol consumption, liver cirrhosis monitoring). Many participants commented that they had few or no opportunities to ask questions. Provision of treatment at no cost was essential to accessibility, and gratitude for free treatment led to high acceptability of care, even when accessing care was inconvenient. Conclusions These findings highlight the importance of streamlining and decentralising health services, adequate human resourcing and training, and affordable treatment in maximising the accessibility and acceptability of hepatitis C care in LMICs. Findings from this work will inform future service delivery refinements for national program and other decentralised programs to improve accessibility and acceptability of hepatitis C care in Myanmar.

Funder

National Health and Medical Research Council

Publisher

Springer Science and Business Media LLC

Subject

Health Policy

Reference49 articles.

1. Blach S, Terrault NA, Tacke F, Gamkrelidze I, Craxi A, Tanaka J, et al. Global change in Hepatitis C virus prevalence and cascade of care between 2015 and 2020: a modelling study. Lancet Gastroenterol Hepatol. 2022;7(5):396–415.

2. World Health Organization (WHO). Global progress report on HIV, viral hepatitis and sexually transmitted Infections, 2021. Accountability for the global health sector strategies 2016–2021: actions for impact. Geneva; 2021.

3. World Health Organization (WHO). Progress report on access to hepatitis C treatment: focus on overcoming barriers in low- and middle-income countries. Geneva; 2018.

4. Clinton Health Access Initiative (CHAI). HCV Market Intelligence Report 2021 and Preliminary HBV Market Insights. 2021.

5. World Health Organization (WHO). Updated recommendations on treatment of adolescents and children with chronic HCV Infection, and HCV simplified service delivery and diagnostic. Geneva; 2022.

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