Challenges in implementing the national HBV elimination program in Bangladesh
1
Department of Public Health, Daffodil International University, Dhaka, Bangladesh
Popul. Med. 2026;8(Supplement Supplement 1):A1825
ABSTRACT
BACKGROUND:
Bangladesh has a 6% prevalence of Hepatitis B virus (HBV and faces unique challenges in implementing a national HBV elimination program (HEP). This study examines the challenges affecting the development and execution of the program.
METHODS:
This mixed-methods study (conducted from July to December 2024) used a literature review (peer-reviewed studies, reports, and health policies) and key informant interviews (healthcare providers, HBV patients, and NGO representatives) to identify barriers to HEP implementation.
RESULTS:
National HEP implementation faces major challenges, including limited epidemiological data due to a weak surveillance system. Only government health facilities report data to the national management information system, excluding the private sector. Low awareness among the population about HBV transmission, prevention, and treatment, combined with misinformation, creates barriers to early diagnosis and treatment-seeking behavior. The healthcare system is constrained by limited government healthcare facilities capable of providing HBV treatment, a shortage of trained professionals, and inadequate laboratory capacity, especially outside major urban centers. Major financial barriers included the absence of health insurance and high out-of-pocket costs for diagnosis and treatment. Policy gaps, including the lack of comprehensive national guidelines, sustained funding, and inclusion of antivirals in the essential drug list, further hinder elimination efforts. Vertical transmission remains a major concern due to inadequate maternal screening, especially in cases of home births, and the absence of a birth dose of the Hepatitis B vaccine. Additionally, vulnerable populations, including people who inject drugs, men who have sex with men, and female sex workers, present unique challenges due to their higher risk and limited access to care.
CONCLUSIONS:
Targeted interventions are needed to improve surveillance, awareness, healthcare capacity, and access to treatment, with special focus on preventing vertical transmission and reaching vulnerable populations. Strong political commitment, adequate resources, and a multi-sectoral approach are essential for HBV elimination in Bangladesh.
Bangladesh has a 6% prevalence of Hepatitis B virus (HBV and faces unique challenges in implementing a national HBV elimination program (HEP). This study examines the challenges affecting the development and execution of the program.
METHODS:
This mixed-methods study (conducted from July to December 2024) used a literature review (peer-reviewed studies, reports, and health policies) and key informant interviews (healthcare providers, HBV patients, and NGO representatives) to identify barriers to HEP implementation.
RESULTS:
National HEP implementation faces major challenges, including limited epidemiological data due to a weak surveillance system. Only government health facilities report data to the national management information system, excluding the private sector. Low awareness among the population about HBV transmission, prevention, and treatment, combined with misinformation, creates barriers to early diagnosis and treatment-seeking behavior. The healthcare system is constrained by limited government healthcare facilities capable of providing HBV treatment, a shortage of trained professionals, and inadequate laboratory capacity, especially outside major urban centers. Major financial barriers included the absence of health insurance and high out-of-pocket costs for diagnosis and treatment. Policy gaps, including the lack of comprehensive national guidelines, sustained funding, and inclusion of antivirals in the essential drug list, further hinder elimination efforts. Vertical transmission remains a major concern due to inadequate maternal screening, especially in cases of home births, and the absence of a birth dose of the Hepatitis B vaccine. Additionally, vulnerable populations, including people who inject drugs, men who have sex with men, and female sex workers, present unique challenges due to their higher risk and limited access to care.
CONCLUSIONS:
Targeted interventions are needed to improve surveillance, awareness, healthcare capacity, and access to treatment, with special focus on preventing vertical transmission and reaching vulnerable populations. Strong political commitment, adequate resources, and a multi-sectoral approach are essential for HBV elimination in Bangladesh.
| eISSN: | 2654-1459 |
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