Health care providers’ perspectives on barriers and enablers to providing hepatitis C screening and treatment for immigrants in Canada: A theory-informed qualitative study

Background: Canada has committed to eliminating hepatitis C virus (HCV) by 2030. Despite highly effective treatments, screening and treatment uptake remains suboptimal. Immigrants from HCV-endemic countries account for 35% of HCV cases and face distinct barriers to care. This study explored health care providers’ perspectives on barriers and facilitators to providing HCV screening and treatment among immigrant populations. Methods: We conducted a qualitative descriptive study guided by the Theoretical Domains Framework (TDF). Semi-structured interviews were performed with health care providers in two Canadian cities. Transcripts were independently coded by two researchers, and key themes were identified. Results: Twelve health care providers (seven female, five male) were interviewed, including eight family doctors, two infectious disease specialists, one nurse, and one social worker. Participants identified multiple barriers including limited familiarity with immigrants’ specific clinical guidelines, low confidence in managing HCV, and difficulty addressing culturally sensitive issues. Providers perceived patient-related barriers such as stigma, limited awareness, and competing life priorities as factors that may hinder engagement with HCV care. Language and communication challenges frequently interfered with care. System-level issues including fragmented services, long wait times, and shortages of family physicians further constrained access. Conclusion: This study underscores the complex barriers health care providers face in delivering HCV care to immigrant populations in Canada. While some challenges reflect broader health care system gaps, they are compounded for immigrants by linguistic and cultural differences. Strengthening provider capacity, improving system coordination, and embedding culturally and linguistically responsive approaches are essential to advancing HCV elimination.