Challenges in ensuring robust research and reporting of health outcomes in sub-Saharan African prisons

Mhlanga-Gunda, Rosemary; Motsomi-Moshoeshoe, Nthabeleng; Plugge, Emma; Hout, Marie Claire Van

doi:10.1016/s2214-109x(19)30455-3

Cited by 17 publications

(35 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Research activity on prison health in the SSA region is historically of low priority and generally restricted to rapid situational assessment of HIV and TB in selected prisons, human rights, UN and African Union country missions, MSc and PhD thesis, documentation of good practices, some qualitative studies and books (Telisinghe et al, 2016;Mhlanga-Gunda et al, 2019). Lengthy and often difficult bureaucratic procedures governing access to and conducting of research in prisons in Malawi, as in other SSA countries, have contributed to the low coverage of routine or academic enquiry into health of persons incarcerated in prisons and health situations (Mhlanga-Gunda et al, 2019 Chimphambano et al, 2007aChimphambano et al, , 2007bTwea, 2013;Van Hout and Mhlanga-Gunda, 2018, 2019a, 2019b. This paper is unique in its contribution to our understanding of the challenges in health-care provision for women in Malawi prisons.…”

Section: Discussionmentioning

confidence: 99%

‘Prison facilities were not built with a woman in mind’: an exploratory multi-stakeholder study on women’s situation in Malawi prisons

Gadama

Thakwalakwa

Mula

et al. 2020

IJPH

View full text Add to dashboard Cite

Purpose Sub-Saharan African prisons have seen a substantial increase in women prisoners, including those incarcerated with children. There is very little strategic literature available on the health situation and needs of women prisoners and their circumstantial children in Malawi. The study aims to explore this issue. Design/methodology/approach A qualitative exploratory study using in-depth key informant interviews with senior correctional stakeholders (commissioner of prison farms, senior correctional management staff, senior health officials and senior officers in charge) (n = 5) and focus group discussions (FGD) with women in prison of age between 18 and 45 years (n = 23) and two FGD with correctional staff (n = 21) was conducted in two prisons in Malawi, Chichiri and Zomba. Narratives were transcribed and analysed using thematic analysis. Findings Three key themes emerged and are as follows: “hygiene and sanitary situation across multiple prison levels and subsequent health implications for women”; “nutritional provision and diets of women and children in prison”; and “women’s access to prison-based and external health services”. Divergence or agreement across perspectives around sanitation and disease prevention, adequacy of nutrition for pregnant or breast-feeding women, health status and access to prison-based health care are presented. Practical implications Garnering a contemporary understanding of women’s situation and their health-care needs in Malawian prisons can inform policy and correctional health practice change, the adaptation of technical guidance and improve standards for women and their children incarcerated in Malawi. Originality/value There is a strong need for continued research to garner insight into the experiences of women prisoners and their children, with a particular emphasis on health situation.

show abstract

Section: Discussionmentioning

confidence: 99%

‘Prison facilities were not built with a woman in mind’: an exploratory multi-stakeholder study on women’s situation in Malawi prisons

Gadama

Thakwalakwa

Mula

et al. 2020

IJPH

View full text Add to dashboard Cite

show abstract

“…Prison health research is traditionally low priority and there is a lack of engagement in routine prison health enquiry and academic prison health research in many LMICs, due in part due to the focus in these countries on security and punishment, prejudices and the devaluation of prisoners as citizens, the lack of political commitment and domestic resources to improve health standards and the presence of significant barriers to access to those outside the system seeking to investigate. 10 There are potentially a myriad of substantial ethical concerns in terms of prison officials influencing research data, structural obstacles to voluntariness, lack of voluntariness and the coercion of imprisoned people and prison staff, and embargoing of academic publications at country levels. This creates a dearth of published literature which directly addresses the assurance of health rights of both imprisoned people (and prison staff) coupled with a distinct lack of clear prison focused guidance and oversight in line with international standards to ensure ethical and robust prison health research.…”

Section: Discussionmentioning

confidence: 99%

“…2 , 3 , 4 , 5 , 6 , 7 , 8 Despite their many health concerns, people in prison remain significantly under-represented in health research, and this inequity mirrors global inequities in health research more broadly. 9 , 10 Compared to high income countries such as Australia, Canada, the United Kingdom and the United States of America, there are few studies from countries in low and middle-income countries (LMICs) despite the fact that the prison population in LMICs is estimated to be 7.58 million, that is, 71% of the global prison population estimate. 1 This deficit is important because research into the health of people in prison is crucial to improving this population's health, reducing health inequalities, creating a better understanding of their complex health needs, and in a gender and culturally sensitive manner, empowering and advocating for people in prison, and ultimately informing the development of prison health and social care policies and services, and wider prison reform and procedural changes.…”

Section: Introductionmentioning

confidence: 99%

Ethical guidance for health research in prisons in low- and middle-income countries: a scoping review

Ako¹,

Plugge

Mhlanga-Gunda

et al. 2020

Public Health

View full text Add to dashboard Cite

Objectives This study examined the extent, range and nature of the published literature, prison policies and technical guidance relating to the ethical conduct of health research in prisons in low- and middle-income countries (LMICs). Study design Scoping Review. Methods We adhered to the five stages of the scoping review iterative process: identifying the research question, identifying relevant studies, study selection, charting the data, and collating, summarizing and content analysis of polices. Disagreements around allocation of content were resolved through team discussion. We also appraised the quality of the included articles. Results We included nine records that examined the ethical aspects of the conduct of health research in prisons in LMICs; eight of these were peer-reviewed publications, and one was a toolkit. Despite the unique vulnerabilities of this group, we could find no comprehensive guidelines on the ethical conduct of health research in prisons in LMICs. Conclusions The majority of the world's imprisoned populations are in LMICs, and they have considerable health needs. Research plays an important role in addressing these needs and in so doing, will contribute to the achievement of the Sustainable Development Goals. With regards to health research, imprisoned people in LMICs are ‘left behind’; there is a lack of clear, prison-focused guidance and oversight to ensure high quality ethical health research so necessary in LMICs. There is an urgent need for prison health experts to work with health research ethics experts and custodial practitioners for procedural issues in the development of prison-specific ethical guidance for health research in LMICs aligned with international standards.

show abstract

“…Prison health surveillance and prison health research in Africa is also under-developed (Mhlanga-Gunda et al, 2020), compounding COVID-19 response efforts.…”

Section: Covid-19 and Tackling Communicable Disease In African Prisonsmentioning

confidence: 99%

“Ubuntu” I am because we are: COVID-19 and the legal framework for addressing communicable disease in the South African prison system

Hout

Wessels²

2021

IJPH

Self Cite

View full text Add to dashboard Cite

Purpose The purpose of the paper was to conduct a legal-realist assessment of the South African prison system response to COVID-19. Severely congested and ill-resourced prison systems in Africa face unprecedented challenges amplified by COVID-19. South Africa has recorded the highest COVID-19 positivity rate in Africa and, on March 15th 2020, declared a national state of disaster. The first prison system case was notified on April 6th 2020. Design/methodology/approach A legal-realist assessment of the South African prison system response to COVID-19 in the 12 months following initial case notification focused on the minimum State obligations to comply with human rights norms, and the extent to which human, health and occupational health rights of prisoners and staff were upheld during disaster measures. Findings A legal-realist account was developed, which revealed the indeterminate nature of application of South African COVID-19 government directives, ill-resourced COVID-19 mitigation measures, alarming occupational health and prison conditions and inadequate standards of health care in prisons when evaluated against the rule of law during State declaration of disaster. Originality/value This legal-realist assessment is original by virtue of its unique evaluation of the South African prison system approach to tackling COVID-19. It acknowledged State efforts, policymaking processes and outcomes and how these operated within the prison system itself. By moving beyond the deleterious impacts of the COVID-19 pandemic on the already precarious South African prison system, the authors argue for rights assurance for those who live and work in its prisons, improved infrastructure and greater substantive equality of all deprived of their liberty in South Africa.

show abstract

Challenges in ensuring robust research and reporting of health outcomes in sub-Saharan African prisons

Cited by 17 publications

References 8 publications

‘Prison facilities were not built with a woman in mind’: an exploratory multi-stakeholder study on women’s situation in Malawi prisons

‘Prison facilities were not built with a woman in mind’: an exploratory multi-stakeholder study on women’s situation in Malawi prisons

Ethical guidance for health research in prisons in low- and middle-income countries: a scoping review

“Ubuntu” I am because we are: COVID-19 and the legal framework for addressing communicable disease in the South African prison system

Contact Info

Product

Resources

About