Barriers and facilitators to viral hepatitis testing in Uzbekistan: scoping qualitative study among key stakeholders, healthcare workers, and the general population
Loading...
Date
2024
Authors
Mazhnaya, Alyona
Geurts, Brogan
Brigida, Krestina
Bakieva, Shokhista
Sadirova, Shakhlo
Witzigmann, Annika
Musabaev, Erkin
Brandl, Michael
Weishaar, Heide
Dudareva, Sandra
Journal Title
Journal ISSN
Volume Title
Publisher
Abstract
Introduction In the World Health Organization European Region, an estimated 14 million people live with a chronic hepatitis B virus infection (HBV), and 12 million are affected by a hepatitis C virus infection (HCV). Uzbekistan bears a major burden of HBV and has one of the highest HCV prevalence in the region. Following a presidential decree in May 2022, significant funds were allocated to the viral hepatitis (VH) elimination program in Uzbekistan. The program expands VH testing to reach 500,000 people annually during 2022–2025 as part of the VH elimination strategy that includes the provision of free testing and affordable treatment. Exploring the existing barriers and facilitators to VH testing is pivotal for informing these interventions. Methods This study uses a cross-sectional qualitative design to identify and explore the barriers and facilitators to VH testing among the general population in Uzbekistan. We collected data during October-November 2022 through semi-structured interviews with 12 key informants (KIs) and 7 focus group discussions with two target populations: the general population and healthcare workers (HCW) in Tashkent, Uzbekistan. Results Following the capability-opportunity-motivation-behavior model (COM-B model) as a framework for the analysis, we identified major capability barriers to VH testing primarily linked to low health literacy and limited knowledge about VH types, symptoms, transmission, testing and treatment. Physical opportunity barriers included the time and financial costs associated with testing, diagnostics, and treatment. Sociocultural opportunity barriers involved anticipated negative reactions and stigmatization, particularly affecting women. Motivational barriers included a reluctance to be tested when asymptomatic and a general fear of receiving positive test results. The involvement of healthcare workers in promoting VH awareness and motivating the general population emerged as a facilitator. Conclusions A multi-pronged approach is recommended to achieve VH testing goals among the general population, focusing on raising awareness and health literacy and creating an enabling environment that ensures easy accessibility and minimizing VH testing-associated costs.
Description
Keywords
hepatitis testing, Central Asia, elimination, barriers and facilitators, behavior change, article
Citation
Barriers and facilitators to viral hepatitis testing in Uzbekistan: scoping qualitative study among key stakeholders, healthcare workers, and the general population / Alyona Mazhnaya, Brogan Geurts, Krestina Brigida, Shokhista Bakieva, Shakhlo Sadirova, Annika Witzigmann, Erkin Musabaev, Michael Brandl, Heide Weishaar, Sandra Dudareva and Charbel El Bcheraoui // BMC Public Health. - 2024. - Vol. 24, Issue 1. - 12 p. - https://doi.org/10.1186/s12889-024-18953-5