Post-Exposure Hepatitis B-Treatment in Newborns: A Qualitative Study on Interprofessional Practices in Norway

Children born to mothers with chronic Hepatitis B virus (HBV) infection are at substantial risk of developing chronic HBV-infection without appropriate perinatal post-exposure treatment. This study aimed to explore midwives' and public health nurses' (PHNs) experiences with HBV-post-exposure treatment for infants and identify factors influencing the timeliness of follow-up care.

Data were collected through individual and focus group interviews with midwives and PHNs in hospitals and catchment-area municipalities and analysed with thematic analysis.

The study revealed significant vulnerabilities in the care pathway, primarily due to fragmented information sharing and a lack of seamless interprofessional collaboration between hospital and municipal healthcare services. Unclear roles, poor communication, and inconsistent documentation impede timely intervention. High workload and reliance on temporary staff further compromised continuity of care. Contrary, the within-hospital joint mother-child medical record and co-location of PHNs, general practitioners, and municipal antenatal care midwives enhanced implementation.

Despite individual awareness of responsibilities, significant system-level challenges persist in ensuring effective interprofessional collaboration and holistic mother-infant pathways after perinatal HBV-exposure in Norway. System-based improvements, such as electronic pregnancy records and automated reporting to the National Immunisation Registry could improve documentation, easing communication and ensuring appropriate and timely follow-up for all high-risk infants.