将促进健康和福祉列入爱尔兰监狱议程————爱尔兰监狱促进健康工作的复杂性

C. MacNamara, P. Mannix-McNamara
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引用次数: 10

摘要

监狱人口面临严重的健康不平等和社会排斥(卫生部,2002年)。囚犯一旦被监禁,患精神疾病的风险就会增加,感染传染病的风险也会增加(世卫组织,2008年)。囚犯的健康状况一般较差,因为监禁对个人健康有负面影响(世卫组织,2008年)。然而,监狱环境提供了一个独特的机会,可以针对入狱前获得保健服务的经验可能非常有限的人群实施有针对性的健康促进举措。世界卫生组织认识到在监狱中促进健康的必要性。监狱卫生项目(HIPP)证明了这一点,该项目旨在支持成员国改善监狱卫生和医疗保健,并促进监狱卫生与国家和国际公共卫生系统之间的联系。然而,在实践中,HIPP的实施是复杂的。鉴于《爱尔兰国家健康促进战略》没有提及监狱环境,本文审查了在全球和爱尔兰监狱促进健康方面所面临的挑战。本文采用定性研究设计,对爱尔兰监狱政策的12位主要人物进行了半结构化访谈,讨论了爱尔兰监狱健康促进干预措施的必要性。本文还讨论了组织文化对监狱工作人员参与促进囚犯健康的态度的影响,并探讨了监狱环境中缺乏促进健康倡议的国家政策和资金所造成的问题。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Placing the promotion of health and well being on the Irish prison agenda - the complexity of health promotion in Irish prisons
The prison population experiences significant health inequality and social exclusion (Department of Health 2002). Once incarcerated, prisoners are at increased risk of mental illness and have higher exposure to communicable diseases (WHO 2008). Prisoners generally have poorer health because imprisonment negatively impacts upon the health of the individual (WHO 2008). However, the prison setting offers a unique opportunity to implement targeted health promotion initiatives with a population that may have had very limited experience of accessing health services prior to incarceration. The World Health Organisation recognises the need for health promotion in prisons. This is evidenced in the Health in Prisons Project (HIPP), the aim of which is to support member states in improving health and health care in prisons, and to facilitate the links between prison health and public health systems at both national and international levels. In practice however, implementation of the HIPP is complex. This paper examines the challenges in promoting health in prisons globally and in Irish prisons specifically, given that the prison setting is omitted from the Irish National Health Promotion Strategy. Based on a qualitative research design that incorporated semi-structured interviews with a purposive sample of twelve leading figures in prison policy in Ireland, this paper discusses the need for health promotion interventions in Irish prisons. The paper also discusses the influence of organisational culture on attitudes of prison staff towards engaging in health promotion with prisoners and explores the problems posed by lack of national policy and funding for health promotion initiatives in the prison setting.
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