Tài liệu Women’s health in prison Correcting gender inequity in prison health ppt

Women’s health in prison

Correcting gender inequity in prison health

2009

ABSTRACT

In 1995, the WHO Regional Office for Europe launched the Health in Prisons Project, supported by the WHO

Collaborating Centre for Health and Prisons in the Department of Health, United Kingdom. The Project works

within a network of countries committed to protecting and promoting health in prisons in the interests of prisoners,

of staff and of public health. The network combines shared experience with expert advice to produce guidance for

countries wishing to improve health care and circumstances in their prisons and, in particular, to develop their role

in preventing the spread of disease. The network aims to maximize an important opportunity for promoting health

in a marginalized group and contributing to general public health in their communities. At the request of the

Member States involved, the WHO Health in Prisons Project, together with partner organizations and experts and

with the support of the United Nations Office on Drugs and Crime, the Quaker Council for European Affairs, the

Quaker United Nations Office, the Sainsbury Centre for Mental Health, the AIDS Foundation East-West and the

European Monitoring Centre for Drugs and Drug Addiction, has reviewed all issues affecting women’s health in

the criminal justice system and has especially considered the gross inequities in women’s health in prisons. The

Project has adopted the enclosed declaration and background paper as evidence fully justifying the

recommendations and call for action in its conclusion.

Keywords

PRISONS

PRISONERS

WOMEN’S HEALTH

EUROPE

EUR/09/5086974

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Address requests about publications of the WHO Regional Office for Europe to:

Publications

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DK-2100 Copenhagen Ø, Denmark

Alternatively, complete an online request form for documentation, health information, or for permission to quote or translate, on the

Regional Office web site (http://www.euro.who.int/pubrequest).

© World Health Organization 2009

All rights reserved. The Regional Office for Europe of the World Health Organization welcomes requests for permission to

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iii

Contents

Foreword......................................................................................................................................... v

Acknowledgements....................................................................................................................... vii

Kyiv Declaration on Women’s Health in Prison ............................................................................ 1

Introduction..................................................................................................................................... 9

Need for a declaration on women’s health in prison ............................................................... 9

Objectives of a declaration on women’s health in prison...................................................... 10

Definitions ............................................................................................................................. 10

Women, prison and society........................................................................................................... 12

Facts and figures .................................................................................................................... 12

Human rights standards and international conventions ......................................................... 13

Women in prison and society................................................................................................. 16

Women’s health and prison .......................................................................................................... 21

Need for gender-specific health care ..................................................................................... 21

Organization of health care services for women in prison .................................................... 22

HIV, hepatitis C and other infectious diseases ...................................................................... 23

Substance use......................................................................................................................... 25

Mental health and mental ill health........................................................................................ 27

Self-harm and suicide ............................................................................................................ 29

Learning disabilities............................................................................................................... 30

Sexual health and reproductive health ................................................................................... 30

Pregnancy, postnatal care and breastfeeding ......................................................................... 32

Violence and abuse ................................................................................................................ 33

Multiple and complex treatment needs.................................................................................. 35

Pre-release preparations and continuity of care after release................................................. 36

How can the situation be improved? What can, should and must be done?................................. 39

Recent developments and emerging plans............................................................................. 40

Recommendations.................................................................................................................. 42

Concluding remarks............................................................................................................... 50

References..................................................................................................................................... 51

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v

Foreword

Prison policies often overlook the special needs of women and their health. Many women in

prison have high levels of mental illness and drug or alcohol dependence as well as histories of

sexual and physical abuse and violence. Issues arising from gender-specific health care needs

and family responsibilities are also frequently neglected. Although women represent a small

percentage of the total prison population, their numbers are increasing and the rate of increase is

much greater than that of men.

The rise and rapid spread of HIV infection, the resurgence of other serious communicable

diseases such as tuberculosis and hepatitis and the increasing recognition that prisons are

inappropriate receptacles for people with drug or alcohol dependence and mental health

problems have thrust prison health high on the public health agenda. As WHO has emphasized,

any national health strategy must include prison policies that address these serious health

problems.

Health is a fundamental human right, especially for individuals held in the custody of the state.

Although women should be entitled to the same rights as men, prison systems were primarily

designed for men, and many prisons do not have adequate facilities to protect women’s rights or

to promote their health. Compounding the difficulty of addressing this problem is the lack of data

and research about women’s health status while in prison. Health systems must include

penitentiary health policies that integrate women’s health needs in all phases of planning and

implementation.

Since 1995, the WHO Regional Office for Europe has been committed to reducing the public

health hazards associated with prisons and protecting and promoting health in prisons. Regional

Office reports such as the 2007 Health in prisons: a WHO guide to the essentials in prison health

have combined the latest research and analysis from experts in the field and have raised the

profile of prison health issues. Building on the WHO Gender Policy, the Regional Office has

supported research to develop evidence-based guidance on the major aspects of women’s health

in connection with prisons and the criminal justice system as a whole.

vi

The principles and recommendations of the Kyiv Declaration on Women’s Health in Prison are

important steps towards improving health systems and addressing the health needs of women

involved in the criminal justice system. I hope that this report, which outlines the evidence and

the expert opinions considered at the special conference held in Kyiv in November 2008, will

convince all Member States to adopt and implement the Kyiv Declaration in fulfilment of their

commitment to human rights and health promotion for all.

Nata Menabde

WHO Deputy Regional Director for Europe