Using data to guide policy: Next steps for preventing perinatal hepatitis B virus transmission in Cambodia

Background

Cambodia is highly endemic for hepatitis B virus (HBV) infection. Preventing perinatal HBV transmission should be prioritized in health facilities by providing hepatitis B vaccination to all infants within 24 h of birth (timely birth dose coverage).

Methods

Teams assessed birth dose policy, practices and coverage in hospitals and health facilities in 10 provinces in Cambodia.

Results

Fifty-one sites were assessed. Median (interquartile range) timely birth dose coverage was 66% (48–92%); coverage was 88% (range = 60–96%) in facilities vaccinating on-site and 48% (range = 20–52%) in those referring off-site (p < 0.0001). Overall, 5 (29%) of 16 hospitals that referred vaccination off-site did not tell mothers vaccination should take place within 24 h of birth, and 6 (35%) discharged mothers when no vaccination services were available for infants to receive the birth dose.

Conclusions

Newborns can miss a time-sensitive opportunity to be protected against perinatal HBV infection when they are referred for vaccination off-site rather than being vaccinated in the delivery facility. These data support the case to strengthen policies and practices to provide hepatitis B birth dose vaccination in the delivery facility.