Mapping the Zambian prison health system: an analysis of key structural determinants

Topp, Stephanie M., Moonga, Clement N., Luo, Nkandu, Kaingu, Michael, Chileshe, Chisela, Magwende, George, and Henostroza, German (2017) Mapping the Zambian prison health system: an analysis of key structural determinants. Global Public Health, 12 (7). pp. 858-475.

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Health and health service access in Zambian prisons are in a state of 'chronic emergency'. This study aimed to identify major structural barriers to strengthening the prison health systems. A case-based analysis drew on key informant interviews (n = 7), memos generated during workshops (n = 4) document review and investigator experience. Structural determinants were defined as national or macro-level contextual and material factors directly or indirectly influencing prison health services. The analysis revealed that despite an favourable legal framework, four major and intersecting structural factors undermined the Zambian prison health system. Lack of health financing was a central and underlying challenge. Weak health governance due to an undermanned prisons health directorate impeded planning, inter-sectoral coordination, and recruitment and retention of human resources for health. Outdated prison infrastructure simultaneously contributed to high rates of preventable disease related to overcrowding and lack of basic hygiene. These findings flag the need for policy and administrative reform to establish strong mechanisms for domestic prison health financing and enable proactive prison health governance, planning and coordination.

Item ID: 44767
Item Type: Article (Research - C1)
ISSN: 1744-1706
Keywords: prison; governance; health system; human resources for health; policy
Funders: European Union (EU)
Projects and Grants: EU DCI-NSAPVD/2012/309-909
Date Deposited: 23 Aug 2016 00:19
FoR Codes: 42 HEALTH SCIENCES > 4203 Health services and systems > 420399 Health services and systems not elsewhere classified @ 60%
44 HUMAN SOCIETY > 4407 Policy and administration > 440706 Health policy @ 40%
SEO Codes: 92 HEALTH > 9205 Specific Population Health (excl. Indigenous Health) > 920599 Specific Population Health (excl. Indigenous Health) not elsewhere classified @ 30%
94 LAW, POLITICS AND COMMUNITY SERVICES > 9404 Justice and the Law > 940408 Rehabilitation and Correctional Services @ 40%
94 LAW, POLITICS AND COMMUNITY SERVICES > 9402 Government and Politics > 940204 Public Services Policy Advice and Analysis @ 30%
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