Exploring the drivers of health and healthcare access in Zambian prisons
A health systems approach
Bibliographic Data
| ID | 11491816 |
|---|---|
| Authors | Stephanie M Topp (0000-0002-3448-7983, Centre for Infectious Disease Research in Zambia, corresponding author), Clement N Moonga (Centre for Infectious Disease Research in Zambia), Nkandu Luo, Michael Kaingu (National Assembly), Chisela Chileshe, George Magwende, Jody Heymann (0000-0003-0008-4198), S Jody Heymann, German Henostroza (Centre for Infectious Disease Research in Zambia) |
| Year | 2016 |
| Volume | 31 |
| Issue | 9 |
| Pages | 1250-1261 |
| Publication date | 2016-11-01 |
| Peer Reviewed | Yes |
| Open Access | Yes |
| Type | ARTICLE |
| Venue | Health Policy and Planning (JOURNAL) |
| Journal identifiers | ISSN: 0268-1080 • E-ISSN: 1460-2237 |
| Publisher | Oxford University Press (PUBLISHER • GB) |
| DOI | 10.1093/heapol/czw059 |
| PMID | 27220354 |
| OpenAlex | W2394714047 |
| Language | EN |
| Citations received | 16 |
| References cited | 29 |
BACKGROUND: Prison populations in sub-Saharan Africa (SSA) experience a high burden of disease and poor access to health care. Although it is generally understood that environmental conditions are dire and contribute to disease spread, evidence of how environmental conditions interact with facility-level social and institutional factors is lacking. This study aimed to unpack the nature of interactions and their influence on health and healthcare access in the Zambian prison setting. METHODS: We conducted in-depth interviews of a clustered random sample of 79 male prisoners across four prisons, as well as 32 prison officers, policy makers and health care workers. Largely inductive thematic analysis was guided by the concepts of dynamic interaction and emergent behaviour, drawn from the theory of complex adaptive systems. RESULTS: A majority of inmates, as well as facility-based officers reported anxiety linked to overcrowding, sanitation, infectious disease transmission, nutrition and coercion. Due in part to differential wealth of inmates and their support networks on entering prison, and in part to the accumulation of authority and material wealth within prison, we found enormous inequity in the standard of living among prisoners at each site. In the context of such inequities, failure of the Zambian prison system to provide basic necessities (including adequate and appropriate forms of nutrition, or access to quality health care) contributed to high rates of inmate-led and officer-led coercion with direct implications for health and access to healthcare. CONCLUSIONS: This systems-oriented analysis provides a more comprehensive picture of the way resource shortages and human interactions within Zambian prisons interact and affect inmate and officer health. While not a panacea, our findings highlight some strategic entry-points for important upstream and downstream reforms including urgent improvement in the availability of human resources for health; strengthening of facility-based health services systems and more comprehensive pre-service health education for prison officers.
Context (archaeology) · Criminology · Economic growth · Economics · Environmental health · Geography · Health care · Overcrowding · Prison · Criminal Justice and Corrections Analysis · Global Maternal and Child Health · Medicine · Poverty, Education, and Child Welfare · Psychology
Prison health situation and health rights of young people incarcerated in sub-Saharan African prisons and detention centres
Tuberculosis treatment outcomes among prisoners and general population in Zomba, Malawi
Revealing spatiotemporal inequalities, hotspots, and determinants in healthcare resource distribution
Mapping the Research on Health Policy and Services in the Last Decade (2009–2018)
Prison Overcrowding and Harsh Conditions
Male Prisoners’ Perspectives of Access to Quality Health Care at a Prison Infirmary in Ghana
Doing Qualitative Research in a Controlled Site
Health provision and health professional roles under compromised circumstances
Healthcare Accessibility and Utilization by Women in Indian Prisons
Mapping the Zambian prison health system
Health and healthcare access among Zambia’s female prisoners
The health system accountability impact of prison health committees in Zambia
Equipe de saúde penitenciária
Assistência farmacêutica prisional paraense
Penitentiary health team
Prison pharmaceutical care in the State of Pará, Brazil
Building the Field of Health Policy and Systems Research
The health of prisoners
Health and human rights of women imprisoned in Zambia
Namibian prisoners describe barriers to HIV antiretroviral therapy adherence
HIV/Aids, STIs and condom use beliefs among male prison inmates in two South African provinces
A qualitative exploration of the human resource policy implications of voluntary counselling and testing scale-up in Kenya
Systems thinking for strengthening health systems in LMICs
Understanding pathways for scaling up health services through the lens of complex adaptive systems
Understanding the dynamic interactions driving Zambian health centre performance
Theorising Interventions as Events in Systems
Access point analysis on the state of health care services in South African prisons
Unhealthy prisons
| Unique citing works | 16 |
|---|---|
| Citations per year | 1,6 |
| Citation span | 2016 - 2026 (11) |
| Citation velocity | current |
| Highly cited | No |
| Citation types | Neutral: 15 |