Theme: Social Science & Policy Research Year: 2024
Background: While point-of-care testing for hepatitis C virus (HCV) offers multiple benefits to key populations (e.g., reducing need for venepuncture and simplifying pathways to diagnosis) and healthcare providers (e.g., allowing more staff to deliver testing), its widespread implementation has yet to be fully realised. This analysis investigates the impact of the health system on the sustainability of point-of-care HCV testing in Australia.
Methods: Between September 2023 and January 2024, in-depth, semi-structured interviews were conducted with people involved in HCV policymaking in Australia. Data were coded using WHO’s Health System Building Blocks framework with preliminary thematic analyses examining how the health system supports and hinders the long-term sustainability of HCV point-of-care testing.
Results: There were 29 participants working in 7 Australian jurisdictions or nationally: 13 from departments of health, 6 from community-led organisations, 5 from local health services, and 5 from pathology. For Health Workforce, having staff experienced in providing health services in the community (through outreach or peer-delivered services) bolstered support for HCV testing outside of traditional healthcare settings. For Financing, sustainability was threatened by lack of long-term funding mechanisms for point-of-care testing. For Medical Technologies, there was some confusion around how to select the most appropriate test according to person and setting. For Leadership, state and national HCV elimination targets were seen as important to drive point-of-care testing at the local level especially when they were reflected in services’ key performance indicators. For Demand, peer-led organisations were emphasised as key partners to shape testing strategies and deliver point-of-care testing to those who needed it.
Conclusion: The analysis highlights the key components of the health system that should be strengthened to sustain HCV point-of-care testing in Australia, including centring community demand. Study findings are critical to inform a long-term testing strategy in Australia and internationally.
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