Responding to Inmates' Health Needs in Zambia: A Policy Analysis

Abstract Introduction{Fazel, 2011 #25}Worldwide, the rates of infectious and non-infectious diseases in prisons is generally higher than that of the general population. Although Zambia has adopted international and local guidelines to address prisoners’ health, the disease burden remains high in Zambian prisons. This study therefore explored barriers to translation and implementation of the legislative acts and guidelines that deal with health for inmates in correctional facilities. MethodsThis was a case study. Data was gathered through key informant interviews with stakeholders supporting inmates’ health in Zambia. These included the Ministry of Home Affairs, Ministry of Health (MoH), Ministry of Justice, Zambia Correctional Service, NGOs and UN agencies. The policy triangle was used to guide data collection, organization and analysis. Data was analysed using thematic analysis. Nvivo software version 12 was used for data coding. ResultsContext: There was political will and commitment to address inmate’s health in Zambia but was constrained by inadequate resources, infrastructure and trained Health Care Workers. Actors: Many key actors were not aware of key policy documents and guidelines addressing inmates’ health in Zambia. Coordination among partners was poor and efforts were underway to address lack of coordination in providing good health services to inmates. The role of the Ministry of health, as the lead partner, was emphasised going forward. Process: It was revealed that the policy development and implementation process was not consultative. There was weak inter-ministerial collaboration and lack of completion of the domestication process of the international guidelines, and this resulted in poor coordination and implementation of legal provision on inmates’ health.ConclusionDespite the existence of key legal and policy guidelines to address prisoners’ health in Zambia, there remain several barriers to implementation. These include lack of resources, lack of awareness and poor coordination among partners working in this sector. It will be important for the Ministry of Health to provide leadership and resources to raise awareness about prisoners’ health and a policy provision to support this process. Resources and infrastructure will be key to addressing the current challenges related to providing quality care for inmates in Zambia.