Prison health services across ten central prisons in Cameroon

Authors

  • Jürgen Noeske Independent Consultant, Yaoundé
  • Norbert Francis Ndi Focal Point for the Global Fund Grant for Prisons, Ministry of Justice, Yaoundé
  • Fabrice Honoré Minkoa Nga Office of Disease Control, Penitentiary Administration, Ministry of Justice, Yaoundé
  • Gérald Mely NGO JAPPSO, Yaoundé
  • Christopher Kuaban Faculty of Health Sciences, University of Bamenda

DOI:

https://doi.org/10.4081/jphia.2023.2600

Keywords:

Cameroon, prison, health services, assessment

Abstract

In 2021, Cameroon held approximately 26,300 inmates in 84 prisons. The Ministry of Justice manages health services in prisons. Conclusive data concerning health care in prisons are lacking. Herein, we present the results of an assessment of health care provision and delivery in 10 central prisons. We adopted mixed methods, including document review, observations, interviews with the Ministry of Justice and prison facility officials, and inmate focus group discussions (FGDs). The 6 building blocks of the World Health Organization's health system framework guided the data collection. Moreover, we collected data on imprisonment conditions. Ministerial authorisation and verbal informed consent were obtained for all activities. There were a total of 17,126 inmates, with the prison populations ranging from 353 inmates to 4,576 inmates. The majority of prisons were characterised by huge overcrowding (mean 301%). The 10 central prisons operated infirmaries with insufficient space and equipment. Compared with the civilian health sector, the numeric ratio of paramedical personnel/inmates was favourable (1:3.4 vs. 1:0.5 p. 1,000 pop, respectively). Recent admissions were screened for the coronavirus disease 2019, tuberculosis (TB), and human immunodeficiency virus (HIV). Moreover, the inmates were diagnosed for current pathologies and lesions. For the treatment of chronic diseases and medical emergencies, the prison health services bridged service gaps on a case‑by‑case basis through informal arrangements with the civilian health sector. The service quality control was limited to those performed by the TB and HIV/acquired immune deficiency syndrome control programmes. Health data was collected and transmitted with a multitude of data collection tools, without standardisation and systematic verification. The primarily reported problems comprised the scarcity of resources and the absence of an effective oversight of resource management and service quality performance entailing governance problems. Participants in FDGs esteemed the quality of treatment as poor unless paid for in cash, and denounced severe difficulties for access to care outside the prisons when required. For meeting the standard minimum rules for the treatment of inmates, prison health care in Cameroon should fill the crucial gaps involving imprisonment conditions, access to health services, and accountability. Regarding chronic underfunding, intensifying collaboration with the civil health sector may partially address the problem.

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References

Council of Europe. Committee of ministers. Recommendation no. R (98) 71 of the committee of ministers to member states concerning the ethical and organisational aspects of health care in prison (adopted by the committee of ministers on 8 April 1998 at the 627th meeting of the ministers' deputies). Available from: https://rm.coe.int/09000016804fb13c. Accessed 2022 Aug 27.

Human Rights Watch Prison Project. Ending the abusive treatment of inmates. Sept 1999. Available from: https//:www.hrw.org/legacy/advocacy/prisons/index.htm. Accessed 2022 Aug 28.

World Health Organisation. Health in prisons. A WHO guide to the essentials in prison health. Copenhagen 2007 (EUR/07/5063925). Available from: https://apps.who.int/iris/handle/10665/107829. Accessed 2022 Aug 28.

Cords O, Martinez L, Warren JL, O'Marr JM, Walter KS, Cohen T, Zheng J, Ko AI, Croda J and Andrews JR: Incidence and prevalence of tuberculosis in incarcerated populations: A systematic review and meta‑analysis. Lancet Public Health 6: e300‑e308, 2021.

Telisinghe L, Charalambous S, Topp SM, Herce ME, Hoffmann CJ, Barron P, Schouten EJ, Jahn A, Zachariah R, Harries AD, et al: HIV and tuberculosis in prisons in sub‑Saharan Africa. Lancet 388: 1215‑1227, 2016.

Topp SM, Sharma A, Moonga CN, Chileshe C, Magwende G and Henostroza G: Evaluation of a health system strengthening initiative in the Zambian prison system. BMJ Glob Health 3: e000614, 2018.

Mhlanga‑Gunda R, Motsomi‑Moshoeshoe N and Plugge E: Challenges in ensuring robust research and reporting of health outcomes in sub‑Saharan African prisons. Lancet Glob Health 8: e25‑e26, 2020.

The World Bank. GDP (current US$)‑Cameroon. Available from: https://data.worldbank.org/indicator/NY.GDP.MKTP. CD?locations=CM. Accessed 2022 Aug 24.

Republic of Cameroon. Ministry of Public Health. Health Sector Strategy 2016-2027. Yaoundé 2016 (ed. Ministry of Health). Available from: https://www.minsante.cm/site/?q=fr/content/strat%C3%A9gie-sectorielle‑de‑sant%C3%A9‑2016‑2027‑1. Accessed 2022 Aug 26.

World Health Organization. Monitoring the building blocks of health systems: A handbook of indicators and their measurement strategies. Geneva 2010. (WHO‑MBhSS_2010‑full‑web.pdf). Available from: https://apps.who.int/iris/bitstream/handle/10665/258734/9789241564052‑eng.pdf. Accessed 2022 Aug 22.

Braun V and Clarke V: Using thematic analysis in psychology. Qual Res Psychol 3: 77‑101, 2006.

Braun V and Clarke V: Thematic analysis. In: Cooper H, Camic PM, Long DL, Panter AT, Rindskopf D and Sher KJ: (eds.), APA handbook of research methods in psychology, Vol. 2. Research designs: Quantitative, qualitative, neuropsychological, and biological, pp57‑71, 2012. American Psychological Association. doi:10.1037/13620‑004.

Présidence de la République. Décret N 2012/389 du 18 Sept. 2012 portant organisation de Ministère de la Justice. Yaoundé, 2012.

Noeske J, Ndi NF and Mbondi Mfondih S: Controlling TB in prisons against confinement conditions‑a lost case? An experience from Cameroon. Int J Tuberc Lung Dis 15: 223‑237, 2011.

United Nations Standard Minimum Rules for the Treatment of Inmates. Available from: http://www.undoc.org/documents/commissions/CCPCJ/CCCCJ_Session/CCCPC_24/resolutions/L6_Rev1/ECN152015_L&Rev1_e_V1503585.pdf. Accessed 2022 Aug 25.

Loh C: Infrastrucural Dev't Impress human rights team. Cameroon Tribune 48: 6, 2021.

Beng Elingui MT: Les enjeux de la coopération internationale en milieu carcéral au Cameroun dans un contexte de développement durable. Master thesis. International Relations Institute of Cameroon. The University of Yaoundé II. Yaoundé (polycopy), 2020.

Demoures B, Nkodo‑Nkodo E and Mbam‑Mbam L: Primary health in a prison environment, the Cameroonian experience. Sante 8: 212‑216, 1998.

Bounoungou RN: La réforme du système pénitentiaire camerounais: Entre héritage colonial et traditions culturelles. Droit. Université de Grenoble, 2012. Available from: https://www.editions‑harmattan.fr/index.asp?navig=catalogue&sr=7. Accessed 2022 Aug 31.

Sando H: Derrière les murs, l'enfer : l'univers carcéral en question. Douala 2005 (ed. Catholic Relief Services).

Voufo GR: Les pouvoirs publics Camerounais et la sante des detenus: Le cas des prisons de Dschang et de Mantoum, 1960‑1992. Master thesis. Univ. of Dschang, (polycopy), 2010.

World Justice Project. Cameroon_2021 WJP Rule of Law Index Country Press Release.pdf. Available from: https://worldjusticeproject.org/sites/default/files/documents/Cameroon_2021%20WJP%20Rule%20of%20Law%20Index%20Country%20Press%20Release.pdf. Accessed 2022 Aug 28.

Ukor N, Adebayo Adebesi Y, Alaran A and Alumuku IM: Healthcare in the prisons: The Case of Sub‑Saharan Africa. June 2021. In book: Casebook on Advocacy in Public Health (pp183‑193). Publisher: World Federation of Public Health Associations, ISBN: 978‑84‑09‑27984‑5. Accessed 2022 Sep 02.

Van Hout MC and Mhlanga‑Gunda R: Contemporary women prisoners health experiences, unique prison health care needs and health care outcomes in sub Saharan Africa: A scoping review of extant literature. BMC Int Health Hum Rights 18: 31, 2018.

Nweze VN, Anosike UG, Ogunwusi JF, Adebisi YA and Lucero‑Prisno DF III: Prison health during the COVID‑19 era in Africa. Public Health in Practice 2: 100083, 2021.

World Health Organisation. Service availability and readiness assessment. Available from: https://www.who.int/data/data‑collection‑tools/service‑availability‑and‑readiness‑assessment‑(sara) Accessed 2022 Sep 02.

Sacks E, Morrow M, Story WT, Shelley KD, Shanklin D, Rahimtoola M, Rosales A, Ibe O and Sarriot E: Beyond the building blocks: Integrating community roles into health systems frameworks to achieve health for all. BMJ Global Health 3:e001384, 2019.

Published

03-08-2023

How to Cite

Noeske, J., Ndi, N. F., Minkoa Nga, F. H., Mely, G., & Kuaban, C. (2023). Prison health services across ten central prisons in Cameroon. Journal of Public Health in Africa, 14(11). https://doi.org/10.4081/jphia.2023.2600

Issue

Section

Original Articles