Characteristics of public sector HCV programs by country as of December 2019
| Cambodia | India | Indonesia | Myanmar | Nigeria | Rwanda | Vietnam | |
| Date of programme initiation | 2018 | 2018 | 2017 | 2017 | 2015 | 2014 | 2017 |
| Geographic coverage | All provinces | All states* | 15 provinces | 8 states and regions | 1 state | Nationwide | 7 provinces |
| No of sites | 68 | 90 | 37 | 18 clinics in 12 sites | 19 | 552 | 9 |
| No of HCWs trained | 319 | 3000+ | 310 HCWs+135 prison peer educators | 300 | 548 | 792 | 689 |
| Decentralisation and task shifting | Phased rollout of HCV care to all ART sites across all 25 provinces | HCV care rolled out to national state (medical colleges) and tertiary (district) level hospitals using a train the trainer approach with 100 master trainers; screening increasingly decentralised through integration | Screening mostly at primary care facilities with some providing VL testing; treatment provided at secondary and tertiary level facilities | Only secondary and tertiary hospitals provide HCV care | Only secondary and tertiary hospitals provide HCV care | HCV care at health centres; nurses trained to prescribe treatment | Only secondary and tertiary hospitals provide HCV care |
| Programme leadership | National Centre for HIV/AIDS, Dermatology and STDs | National Viral Hepatitis Control Programme | Sub-directorate of Hepatitis and Digestive Infection, MOH | National Hepatitis Control Programme, MOHS | National Viral Hepatitis Control Programme—a unit within National HIV/AIDS and STI Control Programme | Rwanda Biomedical Center, MOH | No national programme; programme led by the National Hospital for Tropical Diseases |
| Budget support | Global Fund (HIV/HCV coinfected patients only) | Formal national budget line with partial allocation to states (state cofinancing requirement) | Formal national budget line | Formal national budget line | No national budget line | Formal budget line; local and international fundraising | No national budget line but HCV services and commodities reimbursable under national health insurance |
| National policy documents | 2017: Clinical guidelines for HIV/HCV coinfected patients 2019: National strategic plan and clinical guidelines | 2018: National clinical guidelines | 2015: National action plan 2017: Management and referral guideline of HCV in health facilities 2019: Clinical guidelines | 2017: National strategic plan, action plan and M&E plan 2017 to 2019: Clinical guidelines 2018: Testing guidelines | 2015: National policy 2016: National strategic plan and clinical guidelines 2018: National directory | 2015 to 2018: National policy and clinical guidelines 2018–2020: Elimination plan | 2015 to 2019: National strategic plan 2016: Clinical guidelines 2019: Diagnostics guidelines |
| Approach to case finding | PLHIV on ART | General adult population, PLHIV, PWIDs, prisoners, patients from private sector tested positive | PWIDs, prisoners, PLHIV, patients at liver wards, patients at haemodialysis wards, blood donors, HCWs | Patients at medical wards, PLHIV, PWIDs, men who have sex with men, female sex workers, multitransfused recipients, HCWs, haemodialysis patients, patients from private sector or blood donors tested positive and eligible for public sector care | General adult population (provider initiated testing and counselling), PLHIV, PWIDs | Campaigns targeting PLHIV (2016 campaign), prisoners and people 45+ years (2017 campaign), people 22–44 years in high-risk districts (2018 campaign), adults 15+ years (2019 onwards) | PLHIV, PWIDs, HCWs, patients at liver wards; 2019 campaign targeting general population in one province |
| Integration with other programmes | Coinfection programme led by HIV programme; fully integrated with ART sites and services | Punjab and Haryana have initiated integration of services for screening of high-risk groups in ART clinics, opioid substitution therapy sites and prisons | Multidisease testing on diagnostics platforms across tuberculosis/HIV/HCV in all sites that provide diagnostics services for these diseases | Pilot on integration of HCV VL testing alongside HIV VL and early infant diagnosis testing conducted at national reference laboratory | Integrated diagnostic platforms; use of tuberculosis GeneXpert platforms for hepatitis in Nasarawa; integrated HIV online platform (HIV PACE ECHO) for learning to deliver viral hepatitis lectures | Integrated diagnostic system across programmes, leveraging HIV infrastructure | Multidisease testing on diagnostics platforms at select hospitals |
| Patient screening, diagnosis and treatment fee structure | Free of charge | Free of charge | Free of charge if in public hospital and using national insurance; if not using national insurance patients have to pay for consumables (US$1.70 for RDT, US$6 for VL) | Free of charge (PPP patients pay for VL and treatment) | Out of pocket | Free of charge except for other pretreatment tests such as CT scans for liver damage (10% insurance copay) | Out of pocket or insurance copay |
| National HCV M&E system in place | Aggregate reporting of paper-based site records to government | Custom web-based system | Web-based national hepatitis health management information system (Sihepi) | Open-sourced facility-based health management information system (OpenMRS) | None (three hepatitis indicators included in DHIS2 as of 2019) | Excel-based system (through 2019); DHIS2 (2020 onwards) | None (cross-disease national surveillance system in place but limited HCV indicators and not widely in use) |
*CHAI support has been focused primarily in Punjab.
ART, antiretroviral therapy; CHAI, Clinton Health Access Initiative; ECHO, Extension for Community Healthcare Outcomes; HCV, hepatitis C virus; HCW, healthcare worker; M&E, monitoring and evaluation; MOH, Ministry of Health; PACE, Partnership for Achieving Control of Epidemic; PLHIV, people living with HIV; PPP, public private partnership; PWID, people who inject drugs; RDT, rapid diagnostic test; STD, sexually transmitted disease; STI, sexually transmitted infection; VL, viral load.