Aagahi: Hepatitis C awareness, screening and linkage to care among the Pakistani community in Montréal

The project Aagahi was planned to increase Hepatitis C (HCV) awareness, screening and linkage to care among the Pakistani community in Montréal through appropriate cultural and linguistic services.

In Canada, 44% of people who live with hepatitis C do not know their status and immigrants account for 35% of all HCV cases. The prevalence for HCV in Québec is 0.71% however the prevalence for HCV in Pakistan is 5.6%. Approximately 13 000 Pakistani immigrants live in Québec and 98% are residents of the greater Montréal. This project targeted the Pakistani community in Montréal.

The project included three steps:

  • Raise awareness about hepatitis C;
  • Offer HCV screenings through easy and fast testing kit (Oraquick);
  • Enhance linkage to care.

To develop this project we engaged a consultant, Syeda Nayab Bukhari from the Pakistani community. Two out of the three nurses working on the project were also members of the Pakistani community, as well as one of the volunteers. Thanks to this team composition, we were able to provide services in Urdu, Punjabi, English and French.

In order to make the project inclusive and successful, we created partnerships with key representatives of the Pakistani community. For reaching out to the community, we decided to access the community through their grand cultural activities. During these events, hosted in different part of Montréal (Parc Extension, Brossard, St Laurent) we provided information in a culturally sensitive manner about HCV, identified and addressed knowledge gaps and misperceptions, provided materials and tools developed in English and Urdu.

A scientific research supervised by Dr. Christina Greenaway was also conducted for this project. It addressed key public health problems surrounding immigrants’ health and assessed knowledge and prevalence of HCV among this community. The study design included a questionnaire (demographics, risk factors, HCV knowledge and awareness) and a point-of-care HCV screening.

We organised six screening events during the summer of 2019. They all took place during community events like Pakistan Independence Day festivals and cultural events in different mosques. We created partnerships and worked with key representatives of the community and community organisation leaders to develop new opportunities to implement Aagahi sessions. During these events, we screened 164 people for HCV. Two of them were positive for HCV Antibodies. These identified patients were linked to care at the Jewish General Hospital to do further examination to know if they had an active virus.

This model (information booth in community events and screening tents) worked well to screen a large amount of people. However, to address people’s questions on hepatitis C and increase knowledge on HCV it would be preferable to have longer periods with people (through workshops or one to one interviews).

The main strength of the project was the cultural and linguistic adapted approach that really reduced the barriers to engage with people, creating a bond of trust. People seem to have appreciated the opportunity to access HCV screening, especially with services provided in Urdu and from people of the Pakistani community (the study highlighted that only 65% of the people we met had a family doctor and only 13% had previously been tested for HCV).

As a multidisciplinary team, every member and volunteer were enthusiastic about the learning and fulfilling experience we shared. The project built linkages with the community and paved the way for future collaborations for health related initiatives.


In the end, we want to highlight learnings from the project:

  1. It is necessary to develop cultural and linguistic services for immigrants and new comers, also in order to support people to navigate the healthcare system in an effective way.
  2. It is necessary to raise awareness about HCV among doctors, especially family physicianswho can encourage screening among their patients.
  3. Migrants with precarious status need to have access to screening and treatment for HCV.