Abstract:
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BACKGROUND: As more countries worldwide develop national viral
hepatitis strategies, it is important to ask whether
context-specific factors affect their decision-making. This
study aimed to determine whether country-level socioeconomic
factors are associated with viral hepatitis programmes and
policy responses across WHO Member States (MS). METHODS: WHO MS
focal points completed a questionnaire on national viral
hepatitis policies. This secondary analysis of data reported in
the 2013 Global Policy Report on the Prevention and Control of
Viral Hepatitis in WHO Member States used logistic regression to
examine associations between four survey questions and four
socioeconomic factors: country income level, Human Development
Index (HDI), health expenditure and physician density. RESULTS:
This analysis included 119 MS. MS were more likely to have
routine viral hepatitis surveillance and to have a national
strategy and/or policy/guidelines for preventing infection in
healthcare settings if they were in the higher binary categories
for income level, HDI, health expenditure and physician density.
In multivariable analyses, the only significant finding was a
positive association between having routine surveillance and
being in the higher binary HDI category (adjusted odds ratio 26;
95% confidence interval 2.0-340). CONCLUSION: Countries with
differing socioeconomic status indicators did not appear to
differ greatly regarding the existence of key national policies
and programmes. A more nuanced understanding of the multifaceted
interactions of socioeconomic factors, health policy, service
delivery and health outcomes is needed to support country-level
efforts to eliminate viral hepatitis. |