The ‘missing’ in the ‘endgame’ of hepatitis C elimination: A qualitative study in New South Wales, Australia

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Treloar, Carla; Lancaster, Kari; Rhodes, Tim; Lafferty, Lise; Bryant, Joanne and Rance, Jake. 2024. The ‘missing’ in the ‘endgame’ of hepatitis C elimination: A qualitative study in New South Wales, Australia. Drug and Alcohol Review, 43(5), pp. 1256-1263. ISSN 0959-5236 [Article]

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Official URL: https://doi.org/10.1111/dar.13845

Abstract or Description

Introduction: After a promising start in Australia, elimination efforts for hepatitis C are not on track. Following the global campaign to ‘find the missing’ in hepatitis C response, this qualitative study explores stakeholder perspectives on the ‘missing’ in the ‘endgame’ of hepatitis elimination in the state of New South Wales, Australia.

Method: Twenty-eight key informants working in New South Wales, elsewhere in Australia and internationally in high income countries participated in a semi-structured qualitative interview. Analysis examined key informant accounts of the ‘missing’ in efforts to eliminate hepatitis C.

Results: Participants' accounts framed the missing in relation to epidemiological knowledge, making-up four population categories ‘missing’ or ‘missed’ in hepatitis C response. In turn, accounts situated the missing in relation to where and how individuals were presumed to connect, or not, with existing health-care infrastructures. This gave rise to concerns about the capacity of health services to be made available for those at risk or in need, with systems said to create opportunities for people to ‘miss out’ on hepatitis C services.

Discussion and Conclusions: The ‘missing’ in the ‘endgame’ of hepatitis C elimination effort is not simply a function of who—populations missed—but of where and how, that is, situation and context. Our findings encourage a focus on how services, systems and contexts may create situations in which people become missed or are ‘made missing’ from care. We therefore advocate for a systemic, and not only population-based, approach in the final push towards hepatitis C's elimination.

Item Type:

Article

Identification Number (DOI):

https://doi.org/10.1111/dar.13845

Additional Information:

Funding information: NSW Ministry of Health; Australian Research Council, Grant/Award Numbers: DE230100642, DP210101604

Keywords:

elimination, health services, hepatitis C, populations, strategy

Departments, Centres and Research Units:

Sociology

Dates: