Womens Health in Prison

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• Womens Health in Prison

• Correcting gender inequity in prison health -
• April 2009

Lars Moller Health in Prisons Project World
Health Organization Regional Office for Europe
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WHO Regional Office for Europe
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Member States HIPP

• 39 Member States are actively involved
• 17 from Western Europe
• Andorra, Austria, Belgium, Denmark, Finland,
  France,
• Greece, Iceland, Ireland, Malta, Netherlands,
  Norway,
• Portugal, Spain, Sweden, Switzerland, United
  Kingdom
• 13 from Central Europe
• Albania, Croatia, Czech Republic, Estonia,
  Hungary,
• Lithuania, Latvia, Moldova, Poland, Romania,
  Serbia,
• Slovakia, Slovenia
• 9 from Eastern Europe
• Azerbaijan, Belarus, Georgia, Kazakhstan,
  Kyrgyzstan,
• Russian Federation, Tajikistan, Ukraine,
  Uzbekistan

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International partners

• Pompidou Group, Council of Europe
• AIDS Foundation East-West
• WHO Collaborating Centre for Promoting Prison
  Health,
• Department of Health, England and Wales
• The Prison Health Expert Group of The Northern
  Dimension
• Partnership in Public Health and Social
  Well-being
• International Centre for Prison Studies, Kings
  College, London
• International Committee of the Red Cross
• European Monitoring Centre for Drugs and Drug
  Addiction
• United Nations Office on Drugs and Crime
• KNCV Tuberculosis Foundation
• Sainsbury Centre for Mental Health, United
  Kingdom
• American Public Health Association

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Why Womens Health in Prison?

• HIPP Member States asked for focus on women in
  prison already during annual conference and
  network meeting 2005
• WHO Gender Mainstreaming Strategy
  ? implement actions to ensure that gender
  equality and health equity are incorporated
  into WHOs work
• Women prisoners needs are too often not
  adequately addressed by prison policies and
  procedures

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As prison sentences have been designed for men
and by men, women are always an exception. It is
a challenge to find special solutions to the
needs of imprisoned women. Sonja
Kurten-Vartio, 2007
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Development of declaration background paper
Round-table
Kyiv conference womens health in
prisondiscussion draft declaration

• Consultation period for drafts of declaration and
  background paper

Drafting background paper by HIPP
Launch of Publication
2526 June 2008
13 November 2008
April 2009
Spring 2008
JulyOctober 2008
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Objectives of Kyiv Declaration

• To raise awareness of the current situation of
  the health of and health care provided for women
  in prisons
• To call for marked improvements in the current
  situation

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Why a Declaration?

• To make a strong statement based on several
  publications during the last years by
• - United Nations Office on Drugs and Crime
• - Quaker United Nations Office
• - Quaker Council for European Affairs
• 2. To do UNODC/WHO recommendations to Member
  States

highlighting the need for action
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Main conclusions from the evidence

• Women in prison have more and different health
  needs compared with their male counterparts
• Current arrangements are failing to meet the
  basic and health needs of women prisoners, and
  are far short of what is required by human
  rights, accepted international recommendations
  and social justice
• Unacceptable gaps and deficiencies still
  exist in many countries

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Women and womens health in prison current
situation (1)

• Women constitute a small proportion of the prison
  population (median level in European countries
  4.4)
• Majority of women prisoners offences are
  non-violent, property-related or drug-related
• In many countries, the number of women held in
  pre-trial detention is equivalent to or higher
  than the number of convicted women in prison
• Because of the small numbers of women prisoners,
  countries generally have a limited number of
  facilities for them.

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Women and womens health in prison current
situation (2)

• Many women in prison are mothers and usually the
  primary or sole carer for their children
• In most European countries children can stay with
  their mothers in prison 3 years is the most
  common age limit
• 80 of women prisoners have an identifiable
  mental health problem
• Two-thirds of women prisoners suffer from a
  substance related disorder (mostly drug
  dependency).

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Women and womens health in prison current
situation (3)

• The prevalence of HIV and other sexually
  transmitted diseases among women prisoners is
  often higher than among male prisoners
• Women prisoners are more likely to self-harm and
  commit suicide than male prisoners
• Women prisoners are three times more likely then
  male prisoners to report having experienced
  physical or sexual abuse prior to their
  imprisonment
• Women prisoners have more health problems than
  male prisoners and they have specific health care
  needs.

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Current gaps and deficiencies

• Specific needs of women not always taken into
  account
• Prison policies and programmes seldom tailored to
  womens needs
• Mental illnesses infrequently addressed
• Deficiencies in the provision of staff training
• Lack of an effective system of prison inspection
  with a confidential complaint system
• Pre-release interventions often do not take place
• Continuity of care not guaranteed.

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What should be done?

• Important principles
• Pre-trial detention and imprisonment should be
  considered as a last resort
• Gender-sensitive needs of women and variations in
  needs must be recognized
• Mental illness, in particular substance use
  disorders and PTSD should be specifically
  addressed
• Childrens best interest must be paramount.

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Key health services for women in prison

• Comprehensive and detailed screening
• Individualized care, treatment and development
  plan
• Adequate primary health care
• Specialist health care tailored to womens needs
• Adequately planned pre-release preparations.

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Thank you!

• Contact details
• Website http//www.euro.who.int/prisons
• Email LMO_at_ euro.who.int