Implementation Science

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Browsing Implementation Science by Author "Chipeta, Lisa"

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    Assessing health status among inmates in malawian prisons
    (Kamuzu University of Health Sciences, 2022-04-11) Mvula, Ireen; Mponda, James; Chipeta, Lisa; Nyamuka, Dingaan
    Overcrowded Malawian prisons put a lot of inmates at a higher risk of getting infected with various infectious diseases like TB and Covid-19. Malawi has 30 prison facilities with a capacity that has been overwhelmed with inmates hence the need to probe more on the status of health among inmates and how healthcare issues are sorted out. A cross-sectional qualitative study involving about 42 participants from three prisons (14 from each) will be conducted to assess the current health status among inmates in Malawian prisons. The main objective of this study is to assess the status of health care being provided in prisons with regard to them being at higher risk of contracting diseases. The specific objectives included the following; exploring the common diseases affecting inmates, interventions put in place to treat and prevent the common diseases, assess the quality of the services delivered to inmates and also to discuss possible challenges faced in accessing quality healthcare. The study will be conducted in southern region Prisons in Malawi: Zomba Maximum, Chichiri and Domasi prisons. Participants involved will include prison officers and inmates that are willing to take part. The information gathered will disseminated at Kamuzu University of Health sciences (KUHES) research dissemination seminar during the 2022/23 academic year. The final report will be submitted to relevant authorities including the research supervisor, College of Medicine Research Committee (COMREC) and the KUHES Library.1.1 Introduction and Background Globally, provision of healthcare services to prison inmates poses a range of challenges which results to poor quality healthcare for the inmates especially in developing countries. A lack of both financial and human resources has led to a system of task-sharing in the prisons to support healthcare services. There are 30 prison facilities in Malawi with a capacity of 7,000 inmates, but there are over 14,000 inmates currently being held nationwide. An operational toolkit was put in place to provide information on comprehensive medical services through a three-phase model, where prisoners are screened upon entry, their stay in prison and when they exit. Healthcare in prisons is managed by the Malawi Prison Health Services (MPHS). This toolkit was designed to be used as a practical tool to assist the MPHS in the scale up of a minimum package of health services as recommended by Southern African Development Community (SADC) in prisons across Malawi. The components of the prison healthcare package are screening services, therapeutic services and referral services between the prison healthcare service and the local Ministry of Health which is required to ensure continuity of care for more complicated cases and those needing hospital admissions. Major morbidities presenting within the prison context which are screened for at entry, stay and at exit include HIV, TB, STIs, malnutrition and mental health problems. Hepatitis B vaccination is also offered to all prisoners. In addition, malaria, diarrheal infections and skin diseases present more commonly due to the high levels of congestion within the cells. Medical and psychological services for victims of physical and sexual violence is also recognized as an integral part of the package of care.1.2. Justification of the study Good health and well-being for all is one of sustainable development goals which aims at ensuring healthy lives and promoting wellbeing for all ages by the year 2030. Prisoners being a vulnerable population, due to overcrowding and being confined in one place and may not have a say on matters that are of concern to them. Therefore, it is important they have good health and good health services so that Malawi can move towards equitable access to quality healthcare. This can be achieved by assessing their state of health to check how they are faring so that if they are lagging behind, changes be made to improve their health. In addition, many studies on the healthcare of prisoners on specific diseases such as HIV and TB have been done such as the ‘Prisoners’ Access to HIV Services in Southern Malawi’ published on the 28th of April 2021, and in 2012 a survey on the Surveillance of Tuberculosis in Malawian Prisons was done but few studies on the overall healthcare system in prisons have been done.This study aims at generally assessing the overall status of health in Malawian prisons which may review various factors that are of concern to prisoners as far as health is concerned that may have been neglected. 1.3 Objectives of the study 1.3.1 Broad objectives The study intends to assess the status of healthcare among inmates in Malawian prisons. 1.3.2 Specific objectives  To identify common diseases in prisons  To establish methods on how diseases are prevented and managed  To assess the quality of healthcare delivery in Malawi prisons  To investigate challenges of providing healthcare services in Malawi prisons  To examines interventions that have/had been put in place to prevent and control diseases 1.3 Scope and Limitations This study focuses on the status of healthcare of prison inmates at Zomba, Chichiri and Domasi prisons. The study includes southern region prisons because of proximity, since they are close to Blantyre and this may entail the researchers not travelling long distance to collect data. The study excludes other prison because, the study has limited funds, including other prisons could have escalated the cost of conducting the study. Also, being student researchers, as such novices at research, including prisons from other regions could result into failing to manage time with equally other important academic activities. 1.4 Significance of the Study It is hoped that the results of this study may help come up with an understanding of the status of the healthcare system in prisons and hopefully some intervention in what is lacking on the health provision. The study may also contribute to literature on the topic under study.