Table 1 Gateway to care campaign: Haimen city project goals, srategies and targets

1) Raise public awareness

2) Educate providers and leaders

3) Prevent perinatal transmission

 Implement a citywide public health information campaign to increase understanding and acceptance of current knowledge about hepatitis and liver cancer among the general public.

 Educate government officials, community leaders, and healthcare providers to increase their knowledge about hepatitis B and liver cancer.

 Initiate evidence-based practices for pregnant women to prevent perinatal transmission of hepatitis B and to ensure appropriate care and referral of chronically infected women.

• Initiate a culturally competent public awareness campaign to inform the public about hepatitis B and the importance of prevention, screening and management of this serious liver infection in partnership with the Haimen City Health Bureau and HCCDC.

• Educate city and township government officials to gain their support of public health programs. Work with Haimen City government to present seminars to city and township officials who can play an important role in supporting critical public health initiatives, and in reducing social stigma and discrimination.

• Evaluate current practices in perinatal care for HBV-infected and non-infected pregnant women. Work with HCCHWC to retrospectively review HBV testing, follow-up, and antepartum treatment of 1,000 pregnant women, and passive-active immunization of neonates after birth ( including completion rates of the three shot series)

• Disseminate information in partnership with and through the comprehensive HCCDC network of city hospitals, city and township health centers, and village doctors.

• Educate community leaders to gain their support of public health programs. Work with HCCDC to present seminars to the village head, party secretary, accountant, and women’s representatives from 239 villages in Haimen City who will, in turn, distribute educational materials to residents of their villages.

• Establish a centralized registration, and management system for all pregnant women in the city to ensure appropriate screening and care. Work with HCCHWC to create an interactive system to register and estimated 6,000 pregnant women in the city, and input data from HBV-positive women and their newborns.

• Create simple and appealing educational literature, posters and interactive materials (e.g., calendars, posters, playing cards, paper cups). Coordinate media outreach through print, televisions, and broadcast outlets to include news articles, personal stories, and community events. Key message: hepatitis B can lead to liver cancer, but it can be prevented with a safe vaccine and managed with effective treatments.

• Educate township-level public health officials and physicians to emphasize the importance of testing and referral to care. Develop health education curricula and work with HCCDC to present seminars to public health officials and physicians at township-level health care centers and hospitals.

• Conduct a prospective study to evaluate failures of perinatal immunoprophylaxis (HBIG and HBV vaccine). HBV DNA quantitation will be used to determine if there is any correlation between high maternal viral load and perinatal prophylactic failure.

• Develop targeted educational materials for individuals with CHB to increase their knowledge about hepatitis B and liver cancer and encourage them to seek and maintain regular care.

• Educate community-based physicians about importance of prevention, screening, management, and referral to liver specialists. Work with HCCDC to present seminars to village doctors from 239 villages.

• Develop a standard protocol to educate and test spouses and relatives of all pregnant women. Education will be provided to family members to increase their knowledge about HBV abd reduce the social stigma of hepatitis B.

• Educate school nurses about HBV transmission, vaccination of susceptible children, and preventing discrimination against infected children. Work with the Haimen City Educational Bureau to present seminars to school nurses at primary and secondary schools in the city.

• Educate obstetricians and midwives about prevention of perinatal HBV transmission. Work with HCCHWC to present seminars to obstetrical providers in the city. Develop evidence-based screening, vaccination, and HBV management guidelines for pregnant women.

Disease awareness information distribution to healthcare centers and administrative buildings in all 239 villages, as well as hospitals, and health service centers in all 23 townships.

At least 90% of government officials and community leaders and 100% of village doctors, obstetricians, and school nurses will have attended at least one formal education session.

100% of newly registered pregnant women screened for HBV and infected women followed under evidence-based protocols over a 12-month period. 100% of newborns to receive HBV vaccine and HBIG with 12 hours of birth. 100% of infants born to infected mothers to receive HBV vaccine and HBIG within 12 hours of birth.