The Cornerstone Program for Hepatitis B and C Screening & Access to Care in Vietnam focuses on screening 4,000 adults throughout 25 wards in Ho Chi Minh City (HCMC), Vietnam and subsequently provide access to care pathways for infected individuals or vaccination for those determined to be HBV naïve. This program relies on the established framework of trusted and fruitful relationships between V-VHA and key partners in Vietnam, and that of V-VHA’s extensive navigational capacity in Vietnam. This project stems from the 2016 Hepatitis B and C Screening and Access to Care Pilot Program in which over 1,000 adults in HCMC were screened and provided access to care as appropriate. The completion of Cornerstone Program will be an important Demonstration Program that will further prove the feasibility and public health impact of a significant program, with grassroots community outreach and education as backbone, to build awareness, screen for, and provide access to care for HBV and or HCV in Vietnam. The program will also lay the foundation for the design and implementation of an exemplary surveillance database for viral hepatitis in HCMC. Through these collective efforts, V-VHA will continue to form new- and augment pre-existing relationships with key leaders and institutions in Vietnam to promote for policy change and create a model for replication throughout Vietnam, on regional and international levels in the decade of the 2020’s and beyond with the goal of virtually eliminating HBV and or HCV as major public health problems. The Cornerstone Program is provided in partnership with Vietnam Viral Hepatitis Alliance (VVHA), Ho Chi Minh City Health Department (Sở Y Tế), and Pham Ngoc Thach University of Medicine (PNTU).
In the summer of 2016, V-VHA launched its annual international conference on viral hepatitis with over 300 attendees, most of whom are physicians. This conference was a collaboration among Vietnam Viral Hepatitis Alliance (VVHA), Ho Chi Minh City Health Department (Sở Y Tế), and Ho Chi Minh City Medical Association (Hội Y Học). This annual event will be held at the end of July, around the time of World Hepatitis Day, which is July 28th each year. This conference aims at bringing the information; discussions revolved around the topic should be prioritized because this is how we can help get closer to the goal of eliminating hepatitis B and C by 2030.
Post-Screening Linkage to Care
The linkage to care program incorporates an aggressive case management element. The approach is an integrated care model, consisting of a multidisciplinary team (i.e. MDs, nurses, social workers) at a major health care hospital system (i.e. Medic Medical Center), supplemented by other health care facilities in HCMC that are in partnership with V-VHA, and harmoniously supported by a robust coordination and patient case management team being led by V-VHA’s program manager and 4 social workers (2 for the Pilot Project, 2 more for the Cornerstone Program). This infrastructure has been successfully leveraged in HCV care programs in overcoming challenges for linkage to and retention in care in the US. It has now been adapted and implemented in Vietnam. The program team will link HBV naïve (negative for 3 HBsAg, antiHBs, antiHBcT) for HBV vaccination, patients with positive HCV antibody tests for confirmatory testing or HBsAg+ patients for further clinical evaluation. The linkage to care will start once screening results are available from the proposed Cornerstone Program and expect to continue until end of 2018.
H.E.L.P. for Vietnam
The Health Education for Liver Professionals in Viral Hepatitis (HELP) for Vietnam is being adapted from a similar HELP program in the US as part of V-VHA’s comprehensive program to help eliminate the severe viral hepatitis disease burden in Vietnam. Research has demonstrated that the provider’s advice is a chief determinant as to whether testing and subsequent provision of access to care for viral hepatitis occurs. Rather than the traditional silo-ed approach, HELP for Vietnam seeks to deliver, in a pilot fashion, an integrated team-based education program to clinical staff including doctors, pharmacists, nurses and social workers in Ho Chi Minh City (HCMC). Upon completion of the program, participants will acquire core medical knowledge about HBV and HCV, a team-based approach, and a sense of empowerment to viral hepatitis screening and control. In addition to in-person training courses, a digital platform will be developed and optimized through which e-learning courses will be offered. Ultimately, the proposed program will serve as the foundation for V-VHA’s scale up of HELP in HCMC and extension of HELP education coverage to further regions across the country.