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Van Hout MC, Southalan L, Kinner S, Mhango V, Mhlanga-Gunda R. COVID-19, conflict, climate change, and the human rights of people living in African prisons. Lancet Planet Health 2023; 7:e352-e353. [PMID: 37164508 PMCID: PMC10166579 DOI: 10.1016/s2542-5196(23)00080-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 03/31/2023] [Indexed: 05/12/2023]
Affiliation(s)
- Marie Claire Van Hout
- Public Health Institute, Faculty of Health, Liverpool John Moores University, Liverpool L3 2ET, UK.
| | - Louise Southalan
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Stuart Kinner
- School of Population Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Victor Mhango
- Centre for Human Rights Education Advice Assistance, Blantyre, Malawi
| | - Rosemary Mhlanga-Gunda
- Family Medicine, Global and Public Health Unit, Centre for Public Health Interventions, University of Zimbabwe, Harare, Zimbabwe
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Mhlanga-Gunda R, Rusakaniko S, Chinyuku AN, Pswarayi VF, Robinson CS, Kewley S, Van Hout MC. "We sleep 10cm apart so there is no social distancing": COVID-19 preparedness in a Zimbabwean prison complex. Int J Prison Health 2022; 19:157-180. [PMID: 35089667 DOI: 10.1108/ijph-10-2021-0101] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE Prisons in Africa face unprecedented challenges during Coronavirus disease 2019 (COVID-19). In July 2020, the first prison system case of COVID-19 was notified in Zimbabwe. Subsequently, the Zimbabwe Prisons and Correctional Services released their COVID-19 operational plan. The purpose of the study was to assess preparedness, prevention and control of COVID-19 in selected prisons in Zimbabwe. DESIGN/METHODOLOGY/APPROACH A multi-method situation assessment of COVID-19 preparedness was conducted across three Zimbabwean prisons. The World Health Organization checklist to evaluate preparedness, prevention and control of COVID-19 in prisons was administered to frontline health managers. Information garnered was further explored during site observation and in multi-stakeholder key informant interviews with policymakers, prison health directorate, frontline health-care professionals, officers in charge and non-governmental organizations (n = 26); focus group discussions with correctional officers (n = 18); and male/female prisoners (n = 36). Data was triangulated and analyzed using content thematic analysis. FINDINGS Outdated infrastructure, severe congestion, interrupted water supply and inadequate hygiene and sanitation were conducive to ill-health and spread of disease. Health professionals had been well-trained regarding COVID-19 disease control measures. COVID-19 awareness among prisoners was generally adequate. There was no routine COVID-19 testing in place, beyond thermo scanning. Access to health care was good, but standards were hindered by inadequate medicines and personnel protective equipment supply. Isolation measures were compromised by accommodation capacity issues. Flow of prison entries constituted a transmission risk. Social distancing was impossible during meals and at night. ORIGINALITY/VALUE This unique situation assessment of Zimbabwean prisons' preparedness and approach to tackling COVID-19 acknowledges state and prison efforts to protect prisoners and staff, despite infrastructural constraints and inadequate resourcing from government.
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Affiliation(s)
| | - Simbarashe Rusakaniko
- Global and Public Health Unit, College of Health Sciences, University of Zimbabwe, Harare, Zimbabwe
| | | | | | | | - Stephanie Kewley
- School of Psychology, Faculty of Health, Liverpool John Moores University, Liverpool, UK
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Ako T, Plugge E, Mhlanga-Gunda R, Van Hout MC. Ethical guidance for health research in prisons in low- and middle-income countries: a scoping review. Public Health 2020; 186:217-227. [PMID: 32861921 PMCID: PMC7449980 DOI: 10.1016/j.puhe.2020.07.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 06/29/2020] [Accepted: 07/03/2020] [Indexed: 11/17/2022]
Abstract
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.
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Affiliation(s)
- T Ako
- Chief Medical Office, Cameroon Penitentiary Services, Cameroon.
| | - E Plugge
- UK Collaborating Centre for the WHO (Europe) Health in Prisons Programme, Health and Justice, ADT-J Division, Public Health England, Wellington House, 133-155 Waterloo Road, London, SE1 8UG, England, United Kingdom.
| | - R Mhlanga-Gunda
- College of Health Sciences, Centre for Evaluation of Public Health Interventions, Department of Community Medicine, University of Zimbabwe, Harare, Zimbabwe.
| | - M C Van Hout
- Public Health Institute, Liverpool John Moore's University, Liverpool, L32ET, United Kingdom.
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Mhlanga-Gunda R, Kewley S, Chivandikwa N, Van Hout MC. Prison conditions and standards of health care for women and their children incarcerated in Zimbabwean prisons. Int J Prison Health 2020; 16:319-336. [PMID: 33634659 DOI: 10.1108/ijph-11-2019-0063] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The Sub-Saharan African (SSA) region remains at the epicentre of the HIV epidemic and disproportionately affecting women, girls and prisoners. Women in prison are a minority group and their special health needs relating to gender sensitivity, reproductive health, their children and HIV/AIDs are frequently neglected. Our study responded to this need, and aimed to investigate the issue. DESIGN/METHODOLOGY/APPROACH A qualitative study using focus group discussions and key informant interviews explored the perspectives of women in prison, correctional officers, correctional health professionals and non-governmental organisations around prison conditions and standards of health care while incarcerated in a large female prison in Zimbabwe. Narratives were transcribed and analysed using thematic analysis. FINDINGS The three key themes that emerged are as follows: "Sanitation and hygiene in the prison", "Nutrition for women and children" and "Prison-based health services and health care". Divergence or agreement across perspectives around adequate standards of sanitation, hygiene, quality and adequacy of food, special diets for those with health conditions, access to health care in prison and the continuum of care across incarceration and community are presented. PRACTICAL IMPLICATIONS Understanding prison environmental cultures which shape correctional staff's understanding and responsiveness to women in prison, environmental health conditions and access to health care are vital to improve conditions and continuum of care in Zimbabwe. ORIGINALITY/VALUE Policy and technical guidance continues to emphasise the need for research in SSA prisons to garner insight into the experiences of women and their children, with a particular emphasis on the prison environment for them, their health outcomes and health-care continuum. This unique study responded to this need.
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Affiliation(s)
| | - Stephanie Kewley
- Department of Psychology, Liverpool John Moores University, Liverpool, UK
| | - Nehemiah Chivandikwa
- Department of Theatre Arts, Faculty of Arts, University of Zimbabwe, Harare, Zimbabwe
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Mhlanga-Gunda R, Motsomi-Moshoeshoe N, Plugge E, Van Hout MC. Challenges in ensuring robust research and reporting of health outcomes in sub-Saharan African prisons. The Lancet Global Health 2020; 8:e25-e26. [DOI: 10.1016/s2214-109x(19)30455-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 10/11/2019] [Indexed: 10/25/2022]
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Van Hout MC, Mhlanga-Gunda R. Prison health situation and health rights of young people incarcerated in sub-Saharan African prisons and detention centres: a scoping review of extant literature. BMC Int Health Hum Rights 2019; 19:17. [PMID: 31118008 PMCID: PMC6532240 DOI: 10.1186/s12914-019-0200-z] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 05/02/2019] [Indexed: 12/19/2022]
Abstract
Background Treatment and special protection of the rights of incarcerated young people in prisons are mandated under the Sustainable Development Goals (SDG), as well as under United Nations (UN) human rights instruments. Methods A scoping review mapped what is currently known about prison conditions and health situation of detained and incarcerated young people in sub- Saharan African (SSA) prisons. A systematic search collected and reviewed all available and relevant published and grey literature. Following application of exclusion measures, 54 records remained, which represented 37 of the 49 SSA countries. These records were charted and thematically analysed. Results The ages of children and adolescents held in SSA prisons ranged from 12 to 18 years. Three main themes were generated during the charting exercise; the prison environment for young people; availability and accessibility of basic necessities and navigating the prison system for health care and outside continuum of care. Conclusions The review highlights the grave and continuing deplorable situation of young people held in SSA prisons. The violation of international human rights norms is observed in the systemic abuse and detention of young people with adults. Basic needs are not met in relation to sanitation, ventilation, safe spaces, protection from physical and sexual violence, clothing, food and access to HIV and medical care. Electronic supplementary material The online version of this article (10.1186/s12914-019-0200-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Marie-Claire Van Hout
- Public Health Institute, Exchange Station, Liverpool John Moore's University, Liverpool, L32ET, UK.
| | - Rosemary Mhlanga-Gunda
- College of Health Sciences, Centre for Evaluation of Public Health Interventions, Department of Community Medicine, University of Zimbabwe, Harare, Zimbabwe
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Van Hout MC, Mhlanga-Gunda R. 'Mankind owes to the child the best that it has to give': prison conditions and the health situation and rights of children incarcerated with their mothers in sub-Saharan African prisons. BMC Int Health Hum Rights 2019; 19:13. [PMID: 30836967 PMCID: PMC6402132 DOI: 10.1186/s12914-019-0194-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2018] [Accepted: 02/08/2019] [Indexed: 12/18/2022]
Abstract
Background In recent times, sub-Saharan African (SSA) prisons have seen a substantial increase in women prisoners, including those incarcerated with children. Methods A scoping review mapped what is currently known about the health situation and unique rights violations of children incarcerated with their mothers in SSA prisons. A systematic search collected and reviewed all available and relevant published and grey literature (2000–2018). Following application of exclusion measures, 64 records remained, which represented 27 of the 49 SSA countries. These records were charted and thematically analysed. Results Four main themes were generated as follows: 1) the prison physical environment; 2) food availability, adequacy and quality; 3) provision of basic necessities and 4) availability and accessibility of health services for incarcerated children. Conclusions The review highlights the grave situation of children incarcerated with their mothers in SSA prisons, underpinned by the lack of basic necessities, inadequate hygiene, sanitation and safe drinking water, exposure to diseases in overcrowded cells, inadequate nutrition, lack of provision of clothing and bedding, and difficulties accessing paediatric care. Reported paediatric morbidity and mortality associated with such prison conditions is deeply concerning and contrary to international mandates for the rights of the child, right to health and standards of care. Electronic supplementary material The online version of this article (10.1186/s12914-019-0194-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Marie-Claire Van Hout
- Public Health Institute, Liverpool John Moore's University, Liverpool, L32ET, UK. .,Public Health Institute, Exchange Station, Liverpool John Moore's University, Liverpool, L32ET, UK.
| | - Rosemary Mhlanga-Gunda
- College of Health Sciences, Centre for Evaluation of Public Health Interventions, Department of Community Medicine, University of Zimbabwe, Harare, Zimbabwe
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Van Hout MC, Mhlanga-Gunda R. Contemporary women prisoners health experiences, unique prison health care needs and health care outcomes in sub Saharan Africa: a scoping review of extant literature. BMC Int Health Hum Rights 2018; 18:31. [PMID: 30081894 PMCID: PMC6080512 DOI: 10.1186/s12914-018-0170-6] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2018] [Accepted: 07/24/2018] [Indexed: 11/10/2022]
Abstract
BACKGROUND Sub Saharan African (SSA) prisons have seen a substantial increase in women prisoners in recent years. Despite this increase, women prisoners constitute a minority in male dominated prison environments, and their special health needs are often neglected. Research activity on prison health remains scant in SSA, with gathering of strategic information generally restricted to infectious diseases (human immunodeficiency virus infection HIV/tuberculosis TB), and particularly focused on male prisoners. Health care provisions for women (and pregnant women) in SSA prisons are anecdotally reported to fall far short of the equivalence care standards mandated by human rights and international recommendations, and the recent agreements set out in the Southern African Development Community (SADC) Minimum Standards for HIV in Prisons. METHODS A scoping review mapped what is currently known about women prisoners' health experiences, unique prison health care needs and health care outcomes in SSA. A systematic search collected and reviewed all available and relevant published and grey literature (2000-2017). Following removal of duplicates and application of exclusion measures, 46 records remained, which represented 18 of the 49 SSA countries. These records were subsequently charted and thematically analysed. RESULTS Three themes were generated; 'The Prison Regime'; 'Navigating inside the Prison Health Infrastructure' and 'Accessing the outside Community and Primary Care Health Services'. Women in SSA prisons experience the same substandard nutrition, overcrowding and unhygienic conditions which exacerbate poor health and infectious disease transmission as males. Human rights abuses, substandard prison conditions and poor access to prison based and community clinical care, along with the invisible nature of women and that of their unique health needs are deplorable. CONCLUSIONS The review has highlighted the dearth of gender specific strategic information on women prisoners in the region, appalling environmental conditions and prison health care provision, and violation of human rights for those incarcerated. Enhanced donor support, resource allocation, prison health and population health policy reform, health systems surveillance and gender sensitive prison health service provision is warranted. This will help address women prisoners' conditions and their specific health needs in SSA prisons, and ultimately bridge the gap between prison and population health in the region.
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Affiliation(s)
| | - Rosemary Mhlanga-Gunda
- College of Health Sciences, Centre for Evaluation of Public Health Interventions, Department of Community Medicine, University of Zimbabwe, Harare, Zimbabwe
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