The Coherence of Care: An IPC-Integrated Implementation Science Framework for Viral Hepatitis Elimination and Cirrhosis Stewardship in Low-Resource Settings

Title: The Coherence of Care: An IPC-Integrated Implementation Science Framework for Viral Hepatitis Elimination and Cirrhosis Stewardship in Low-Resource Settings Description / Abstract: This article addresses the critical "Proven-to-Practice" bottleneck in global hepatology, specifically within the context of viral hepatitis B and C elimination and the management of cirrhosis in low-resource settings (LRS). Despite pharmacological advancements, clinical outcomes remain constrained by systemic fragilities and healthcare-associated infections (HAIs). Utilizing a novel synthesis of Implementation Science (IS) and the Integrated Adaptive Intelligence Framework (IAIF), the authors introduce a Viable System Model (VSM) that repositions Infection Prevention and Control (IPC) from a secondary compliance metric to a foundational architectural constraint. The paper employs TRIZ (Theory of Inventive Problem Solving) to resolve chronic technical contradictions, such as the tension between high patient throughput and rigorous sterilization protocols. Key Features of the Study: Falsification of Traditional Models: Critiques the reliance on top-down educational interventions in favor of deterministic system engineering. Operational Constructor Proof: Includes a detailed matrix of TRIZ-based resolutions for common LRS clinical bottlenecks. Technological Integration: Discusses the application of Mamba-based Selective State Space logic for real-time, low-latency IPC surveillance on mobile hardware. Substrate Autopoiesis: Proposes a "self-repairing" clinical safety environment where systemic integrity is maintained through automated, antifragile feedback loops. This work serves as a blueprint for clinicians, hospital administrators, and global health policy-makers seeking to bridge the implementation gap and achieve the WHO 2030 targets through structural and cybernetic integrity. Keywords: Hepatology, Implementation Science, Infection Prevention and Control (IPC), Viral Hepatitis Elimination, Low-Resource Settings, TRIZ, Viable System Model, Mamba Architecture, Healthcare-Associated Infections (HAI), Systemic Stewardship. Communities: Hepatology, Global Health, Implementation Science, Clinical Safety. License: Creative Commons Attribution 4.0 International (CC BY 4.0)