Strategy Implementation

This third section of the toolkit builds on the strategy defined in Section 2 and looks at the practicalities of implementation of viral hepatitis services in prisons. Using the care cascade as a framework, it will provide an overview of prevention, screening, clinical diagnosis, treatment, monitoring and follow-up and linkage to care post-release into the community. It will also look at some population groups in the prison including women, youth and migrant populations and minority groups.

The care cascade, or care continuum, was originally constructed to assess the quality of HIV care delivery, and has since been adapted to other diseases, including viral hepatitis.

The monitoring of each of the distinct steps along the cascade is a systematic way to identify any gaps along the continuum that can help in tailoring interventions. For this reason, when considering applying implementation strategies, this framework can be helpful in ensuring all stages are addressed and to maximise efficiencies within the prison.

Figure 6. Cascade of viral hepatitis care in for people in prison settings

Prevention

Screening

Clinical diagnosis

Treatment

Monitoring and follow-up

Linkage to care post release

Iconography by the International Network on Health and Hepatitis in Substance Users, 2024

This section will cover challenges and solutions you may encounter at each stage of the continuum of care as we take a deeper dive into implementation and the different interventions which are available to support you.