Future research / gaps identified:

1) Advocate for HBV infant birth dose in alignment with WHO recommendation and publicly-funded “catch-up” vaccinations for unvaccinated adults

2) Establish national screening guidelines for hepatitis B beyond prenatal testing

3) Education providers on best practices for communicating results to patients

4) Advocate for broad public coverage to treatment options – public coverage for HV testing; Improve provider knowledge of drug coverage by immigration status

Key recommendations:

Improve Access to Prevention and Screening

• Establish national screening guidelines for hepatitis B beyond prenatal testing, including offer free, universal, voluntary screening for newcomers from high-endemic countries.
• Adopt WHO recommendations by advocating for universal birth-dose HBV vaccination and comprehensive catch-up programs for unvaccinated individuals.

• Establish national standards to ensure affordable or no-cost access to treatment for uninsured and underinsured individuals, including those covered under the Interim Federal Health Program (IFHP) and provincial drug plans.

  Ensure Affordable and Equitable Access to Drug and Health Coverage

• Like HCV advocate to expand public and private drug coverage to include all approved HBV antiviral therapies, regardless of immigration status or insurance eligibility.
• Establish national standards to ensure affordable or no-cost access to treatment for uninsured and underinsured individuals, including those covered under the Interim Federal Health Program (IFHP) and provincial drug plans.

Expand Access to Care

• Enable primary-care providers and nurse practitioners to manage stable HBV cases through a shared-care model with specialist support.

• Fund virtual consultation networks to reduce wait times and connect community clinicians to specialists.

  Create a More Culturally Responsive Health System by Supporting Evidence-Based Approaches

  • Invest in community-based navigation models by partnering with immigrant-serving and settlement organizations to embed cultural brokers and health navigators within care teams, supporting clients through diagnosis, referral, follow-up, and communication.
  • Mandate cultural safety and anti-stigma training for providers involved in viral hepatitis and infectious disease care.

  • Equip providers with practical tools for patient care and preventive measures, such as effective communication about risk and results, and assessing/updating vaccinations for newly arrived persons.

  Support Knowledge Mobilization and De-Stigmatizing Community Education

  • Strengthen community-led, culturally-informed communication and education, addressing stigma and misinformation.
  • Improve health system capacity to deliver accessible, equitable HBV information and support, recognizing that health-seeking practices are impacted by previous health system experiences.

  Strengthen Provider Knowledge and Confidence in HBV Prevention, Testing, and Management

  • Enhance provider knowledge of viral hepatitis risks and appropriate testing, including high-endemic regions, at-risk populations, and the distinction between population-based screening and symptom-based testing.

  Strengthen Data Systems and Accountability for Equitable Hepatitis Care

  • Establish a national Hepatitis B Equity Strategy with measurable targets for timely and culturally safe care, supported by the integration of immigration and health data systems to inform evidence-based policies, identify inequities, and improve outcomes for diverse populations.
  • Provide sustained public health funding to support integrated referral and tracking systems across public health, primary care, and specialist services, and to enable disaggregated data collection by immigration status and ethnicity

Key populations: Newcomers (less than 5 years) and Immigrants to Canada

Open access: Yes

Community organizations: Calgary Catholic Immigration Society; SUCCESS BC; CATIE

Integration timeline: Newcomers>5 years in Canada

Location: Alberta, British Columbia, Ontario