Prison health situation and health rights of young people incarcerated in sub-Saharan African prisons and detention centres: a scoping review of extant literature

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.

Prisoners’ access to HIV services in southern Malawi: a cross-sectional mixed methods study

“…Our study found that female prisoners were having less access to general medical care and HIV services than men. Similar findings were reported in several sub-Saharan African countries [ 10 ]. A study conducted in Ghana found that female prisoners reported poor access to quality healthcare and that their perceptions were influenced by marital status, educational background, and occupation [ 19 ].…”

“…Imprisoned people are frequently re-incarcerated after release, cycling between prison and the general community [ 10 ]. As potential carriers of transmissible diseases they pose risks to themselves, their immediate families and the wider community, with detrimental effects on public health [ 7 , 11 , 12 ].…”

Prison health during the COVID-19 era in Africa

“…In Sub-Saharan Africa, different age groups are not allocated separate confinement and a part of the hidden prison population which have been deprived of the basic needs of the prison resource allocation includes the elderly [ 5 ]. Therefore, they are often incarcerated, with other inmates, which have placed them in systemic abuse and neglect [ 6 ]. They are adversely affected considering the congested sleeping area, poor hygiene, and sanitation, poor quality of food and water.…”

“…This ruthless environmental condition serves as an enclosed system of respiratory, gastrointestinal diseases, tuberculosis, and malaria [ 5 ]. Many inmates have various kinds of pre-existing disease conditions [ 7 ] (like diabetes, hypertension, and chronic respiratory diseases among others) due to the poor and life-threatening circumstances in the prisons. Therefore, any possible confirmed case of COVID-19 will lead to an outnumbered series of deaths among inmates during jail terms or even before litigation.…”

“…Access to medical care and immunization are often under restriction by the prison workers who do not understand the importance of professional healthcare service [ 5 ]. However, due to the various forms of morbidities in prisons which may weaken inmate’s immune system, there is a higher possibility of severe illness due to COVID-19 [ 6 ]. Considerations for rehabilitation and reintegration of vulnerable groups including children, women, and the elderly with mental problems should be made to keep them out of prison [ 3 ] Does this mean that the health of inmates is not considered important if they are excluded from COVID-19 response?…”