Healthcare system readiness to manage viral hepatitis in Viet Nam and the Philippines: results of a brief health facility assessment

Chronic hepatitis B (HBV) and hepatitis C (HCV) pose significant public health challenges in Viet Nam and the Philippines. Both countries have initiated national strategies aimed at decentralizing hepatitis care to primary healthcare facilities, but the availability and readiness of these facilities to manage hepatitis remains unclear. This study aimed to evaluate the availability and readiness of primary care facilities in Viet Nam and the Philippines to provide comprehensive hepatitis services and to identify key gaps in care delivery. A mixed-methods approach was used, combining health facility surveys and focus group discussions (FGDs) with healthcare workers to assess service availability and identify barriers and enablers of hepatitis care. Data were collected from 18 health facilities and 36 healthcare workers through 6 FGDs across both countries. The study identified critical gaps in hepatitis service availability, healthcare worker training, diagnostic capacities, and community engagement at the primary care level. While provincial level facilities were well-equipped, most primary care facilities lacked essential resources such as viral load testing, medications, and adequately trained healthcare workers. A key barrier was the lack of social health insurance coverage or reimbursement for hepatitis services at the primary care level in both countries. Gaps identified may require coordinated action from both national and subnational stakeholders. Expanding social health insurance coverage to include hepatitis services at the primary care level, improving healthcare worker training and support, and ensuring the availability of diagnostics and antivirals at the primary care level are essential steps to meet the 2030 hepatitis elimination targets in Viet Nam and the Philippines.