Author information

¹National Drug Research Institute, Curtin University, Perth, Australia; Burnet Institute, Melbourne, Australia; Public Health and Preventative Medicine, Monash University, Melbourne, Australia. Electronic address: shelley.walker@curtin.edu.au.

²The International Network on Health and Hepatitis in Substance Users (INHSU).

³The Kirby Institute, University of New South Wales (UNSW), Sydney, Australia.

⁴The Kirby Institute, University of New South Wales (UNSW), Sydney, Australia; School of Biomedical Sciences, University of New South Wales (UNSW), Sydney, Australia.

⁵The hepatitis C Trust, London, England, United Kingdom.

⁶Bensther Development Foundation, Enugu, Nigeria.

⁷Gastroenterology and Hepatology Department, University Hospital Marques de Valdecilla, Santander, Spain; Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL) Santander, Spain.

⁸Department of Medicine, Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montréal, Québec, Canada; Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montréal, Québec, Canada.

⁹Department of Medicine, Albert Einstein College of Medicine / Montefiore Medical Centre, New York, USA.

Abstract

Background: The World Health Organization (WHO) has established targets to eliminate the hepatitis C virus (HCV) by 2030. Prisons are a key focus of elimination efforts, however, access to HCV services in prisons remains low globally. With the aim of increasing advocacy efforts to help address this gap, the International Network on Health and Hepatitis in Substance Users (INHSU) Prisons, developed a Prisons Hepatitis C Advocacy Toolkit.

Methods: Toolkit development involved a co-design process to ensure advocacy resources met end-user needs. A scoping study was conducted, involving a web-based survey and in-depth interviews, to understand advocacy resource needs of key stakeholders from countries of different socio-economic strata. Data were analysed, and suggested advocacy resources were mapped onto the Advocacy Strategy Framework with the audiences resources are targetting and the changes they aim to influence. Advocacy resources were co-developed and validated by interview participants before incorporation into the web-based platform.

Results: Survey responses (n = 181) and interview data (n = 25) highlighted several barriers to enhancing HCV services in prisons globally, and an understanding that advocacy efforts are needed to bring about this change. Advocacy resources were suggested for influencing three key audiences: policymakers/funders, implementers, and community. Thereafter, a suite of 20 de novo tools were co-developed with key stakeholders including case studies of evidence-based models of HCV care, policy briefs, HCV infographics, and fact sheets about how to leverage funding and build advocacy campaigns. Findings underscore the importance of capitalising on the knowledge and expertise of potential end-users, to ensure Toolkit resources are context-specific and match their needs.

Conclusion: The Toolkit holds promise for progressing the WHO elimination goals by increasing advocacy efforts for enhanced prison HCV services globally. The co-design of Toolkit resources with potential end-users has increased its potential accessibility, acceptability, and inclusivity for a globally diverse audience.