Perspectives of hepatitis B treatment and vaccinations within the community in Nepal: Insights from healthcare workers.

BACKGROUND Hepatitis B virus (HBV) infections are a critical public health issue, especially in lower resource setting where the potential for chronic infections is increased. In Nepal an HBV vaccination program has been in place since the early 2000s, though knowledge and awareness of HBV has been recorded as being low within community settings. This study explored inequalities which may influence the overall healthcare system within Nepal regarding HBV, specifically vaccination programs, knowledge, awareness, and stigma associated with HBV.

METHODS In-depth interviews (n = 21) were conducted with healthcare professionals from different healthcare districts in Nepal. These interviews were then transcribed before thematic analysis was performed.

RESULTS Several potential sources of inequality of service provision were identified. Awareness of HBV was reasonable among the participants; however, level of knowledge was variable. Participants felt while the vaccination program had been somewhat successful, there were still several areas in the Nepalese health system which needed to be strengthened to further mitigate risk of HBV infections. This included the need to strengthen and standardise vaccination processes within Nepal.

CONCLUSION Based on our findings, efforts to provide appropriate resources and equipment to community health centres needed to be reinforced. An increase is also needed in education and awareness programs around health issues, specifically those involving infectious diseases such as Hepatitis B at the community level. There also should be continued commitment to enhancing the healthcare services provided in rural and other underserved areas of Nepal.