{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T18:56:11Z","timestamp":1781636171664,"version":"3.54.5"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T00:00:00Z","timestamp":1771545600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T00:00:00Z","timestamp":1774569600000},"content-version":"vor","delay-in-days":35,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Health Serv Res"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Direct-acting antiviral (DAA) therapy has transformed hepatitis C management by enabling cost-effective outpatient treatment. Pakistan, with one of the world\u2019s highest hepatitis C burdens, has set ambitious policy targets for the rollout of DAA therapy supported by rapid screening and confirmatory testing. This study assessed the service readiness of public and private healthcare facilities to inform future scale-up of hepatitis C services in Pakistan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Between June 2021 and January 2022, a purposive sample of 39 facilities was selected from 14 high-burden districts in consultation with the National Hepatitis Program: 15 public hospitals, 15 private hospitals, 6 standalone private laboratories, and 3 private blood banks. A cross-sectional descriptive assessment was conducted to evaluate service availability, commodity stocks, staff training, quality-of-care guidelines, reporting mechanisms, supervision, and community engagement. Data were collected through structured questionnaires administered to facility managers and staff, supplemented by an observation checklist.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>DAA therapy was available at 10\/15 (66.7%) public hospitals and 13\/15 (86.7%) private hospitals. HCV screening was offered at 9\/15 (60.0%) public hospitals compared to 3\/15 (20.0%) private hospitals, with most private hospitals referring patients to standalone laboratories. Case notification was reported by 6\/15 (40.0%) public facilities and 4\/15 (26.7%) private facilities. In the public sector, DAA stock was available at 7\/15 (46.7%) hospitals, but 5\/10 (50.0%) of those offering treatment reported recent stock-outs. Private facilities generally prescribed DAAs from external pharmacies. Private laboratories had stronger systems for equipment calibration (4\/5, 80.0%) and electronic reporting (5\/6, 83.3%), while public facilities were more often supported with standardized guidelines (10\/15, 66.7%). Awareness of community referral campaigns remained low in both sectors (\u224820\u201325%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study found that public facilities were stronger in programmatic guidance, training, and supervision, whereas private facilities demonstrated greater functionality in equipment maintenance and electronic reporting. However, both sectors faced significant gaps: public facilities experienced resource shortages and relied heavily on paper-based systems, while private facilities lacked integration with case notification and standardized guidelines. Scaling up the provision of HCV testing and DAA therapy in Pakistan and similar LMICs requires quality leadership and electronically supported information systems to precede future extensive investment in commodities. Leveraging the comparative strengths of private facilities, services, resources, and online reporting, alongside strengthening public supply chains, will be critical to achieving universal access to hepatitis control services.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12913-025-13684-8","type":"journal-article","created":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T02:06:55Z","timestamp":1771553215000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Service readiness of Public and private health facilities for roll-out of hepatitis C screening and management: a cross-sectional study"],"prefix":"10.1186","volume":"26","author":[{"given":"Asma","family":"Ummad","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amna Rehana","family":"Siddiqui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aroosa","family":"Nighat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atif","family":"Riaz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hasan Nawaz","family":"Tahir","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saeed","family":"Hamid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shehla","family":"Zaidi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,2,20]]},"reference":[{"issue":"2","key":"13684_CR1","doi-asserted-by":"publisher","first-page":"e0228847","DOI":"10.1371\/journal.pone.0228847","volume":"15","author":"SV Patel","year":"2020","unstructured":"Patel SV, Jayaweera DT, Althoff KN, Eron JJ, Radtchenko J, Mills A, Moyle G, Santiago S, Sax PE, Gillman J, Mounzer K, Elion RA, Huhn GD. Real-world efficacy of direct-acting antiviral therapies in patients with HIV\/HCV. PLoS One. 2020;15(2):e0228847. https:\/\/doi.org\/10.1371\/journal.pone.0228847.","journal-title":"PLoS One"},{"key":"13684_CR2","doi-asserted-by":"publisher","unstructured":"Gower E, Estes C, Blach S, Razavi-Shearer K, Razavi H. Global epidemiology and genotype distribution of the hepatitis C virus infection. J Hepatol. 2014;61(1 Suppl):S45\u2013S57. https:\/\/doi.org\/10.1016\/j.jhep.2014.07.027.","DOI":"10.1016\/j.jhep.2014.07.027"},{"issue":"8","key":"13684_CR3","doi-asserted-by":"publisher","first-page":"681","DOI":"10.3390\/pathogens13080681","volume":"13","author":"A Gomaa","year":"2024","unstructured":"Gomaa A, Gomaa M, Allam N, Waked I. Hepatitis C elimination in Egypt: story of success. 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J Hepatol. 2020;72(4):pp. 680\u2013687. https:\/\/doi.org\/10.1016\/j.jhep.2019.11.019.","journal-title":"J Hepatol"},{"issue":"Suppl","key":"13684_CR6","doi-asserted-by":"publisher","first-page":"S15","DOI":"10.26719\/2010.16.Supp.15","volume":"16","author":"H Qureshi","year":"2010","unstructured":"Qureshi H, Bile KM, Jooma R, Alam SE, Afridi HUR. Prevalence of hepatitis B and C viral infections in Pakistan: findings of a national survey appealing for effective prevention and control measures. East Mediterranean Health J. 2010;16(Suppl):S15\u201323. PMID:. Available at: https:\/\/pubmed.ncbi.nlm.nih.gov\/21495584\/.","journal-title":"East Mediterranean Health J"},{"key":"13684_CR7","unstructured":"Government of Punjab. Population-based prevalence survey of hepatitis B & C Punjab. Available at: 2018. https:\/\/bos.punjab.gov.pk\/system\/files\/14.%20Final%20Report-HPS%20April%2026%2C19.pdf."},{"key":"13684_CR8","unstructured":"WHO (World Health Organization). 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Clearance was taken from the respective medical superintendent or chief medical officers of public and private hospitals, followed by written informed consent from the participants prior to data collection.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval and consent to participate"}},{"value":"The authors alone are responsible for the views expressed in this article, and these do not represent the views of the funding agency.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interest"}}],"article-number":"411"}}