Abstract：
In Vietnam and the Philippines, viral hepatitis is the leading cause of cirrhosis and liver cancer. This study aims to understand the barriers and enablers of people receiving care for hepatitis B and C to support both countries\' efforts to eliminate viral hepatitis as a public health threat by 2030. Retrospective, semi-structured interviews were conducted with a purposive, quota-based sample of 63 people living with hepatitis B or C in one province of Vietnam and one region of the Philippines. A rapid deductive approach to thematic analysis produced key findings among the three phases of care: (1) pre-awareness and testing, (2) linkage and treatment initiation and (3) ongoing treatment and recovery. The research found that participants followed five typical journeys, from a variety of entry points. Barriers during the pre-awareness and testing phase included limited awareness about hepatitis and its management, stigma and psychological impacts. Enablers included being familiar with the health system and/or patients benefiting from social connections within the health systems. During the linkage and treatment initiation phase, barriers included difficult physical access, complex navigation and inadequate counselling. In this phase, family support emerged as a critical enabler. During the ongoing treatment and recovery phase, the cost of care and socially and culturally informed perceptions of the disease and medication use were both barriers and enablers. Exploring peoples\' journeys with hepatitis B and C in Vietnam and the Philippines revealed many similarities despite the different cultural and health system contexts. Insights from this study may help generate a contextualized, people-centred evidence base to inform the design and improvement of primary care services for hepatitis in both research sites.
摘要：
在越南和菲律宾，病毒性肝炎是肝硬化和肝癌的主要原因。这项研究的目的是了解的障碍和推动者的人接受治疗的乙型和丙型肝炎，以支持这两个国家的努力，以消除病毒性肝炎作为一个公共卫生威胁到2030年。回顾性,半结构化访谈是有目的的，以配额为基础的样本，包括越南一个省和菲律宾一个地区的63名乙型肝炎或丙型肝炎患者。主题分析的快速演绎方法在护理的三个阶段中产生了关键发现：（1）预意识和测试，（2）联系和治疗开始；（3）持续治疗和恢复。研究发现，参与者遵循了五种典型的旅程，从各种切入点。预先认识和测试阶段的障碍包括对肝炎及其管理的认识有限，耻辱和心理影响。包括熟悉卫生系统和/或受益于卫生系统内社会关系的患者。在连接和治疗开始阶段，障碍包括难以物理进入，复杂的导航和不充分的咨询。在这个阶段,家庭支持成为一个关键的推动者。在正在进行的治疗和恢复阶段，护理成本以及社会和文化上对疾病和药物使用的认知既是障碍又是促成因素.尽管文化和卫生系统环境不同，但在越南和菲律宾探索乙型和丙型肝炎的人们的旅程揭示了许多相似之处。这项研究的见解可能有助于产生一个情境化的，以人为中心的证据基础，为两个研究地点肝炎初级保健服务的设计和改进提供信息。
