Barriers to translation of the legislative acts on health for inmates in correctional centres: a case study of Mukobeko maximum prison and Lusaka central correctional centre

Abstract

Worldwide the rates of infectious and non-infectious diseases in prisons is generally higher than that of the general population. Apart from the international guidelines, Zambia has developed local legal frameworks that deal with prisoners‟ health. Despite these provisions, the disease burden has remained higher in Zambian prisons. This study therefore explored barriers to translation and implementation of the Legislative Acts that deal with health for inmates in correctional facilities. The study utilised qualitative method. Data was gathered through Key Informants Interviews with the Ministry of Home Affairs, the Ministry of Health (MoH), the Ministry of Justice, the Zambia Correctional Service, USAID DISCOVER Health, CIDRZ, PRISCCA, UNODC as well as review of key Policy documents. The policy triangle was used to guide data collection. Data was analysed using thematic analysis and Nvivo 12. There are legal documents that provide for inmates healthcare. Context analysis revealed political will to address inmate‟s health. However, analysis further noted resource constraints, inadequate health facilities and man power. Analysis of Actors revealed that some were not aware of legal documents addressing inmates‟ health. It was at the health workers discretion on how they treated or visited inmate. ZCS took up the major responsibility on inmate‟s health yet the Health Directorate established in 2004 with the purpose of supplementing MoH is not funded. This has made it difficult for ZCS to implement legal provisions on inmate‟s health. Nevertheless, a group called PHAC was formed and it is committed to providing healthcare and to coordinate all health related activities in correctional facilities unfortunately is has no legal standing and it is not funded. Finally, process analysis showed that top down approach in formation of legal documents, weak inter-ministerial collaboration and lack of completion of domestication process of the international guidelines had resulted in poor implementation of legal provision on inmates‟ health. Most of the major legal documents on health have provided for inmates‟ health, nevertheless, not all partners were involved in their formulation and were not aware of them. The study further highlighted financial constraint that had also contributed to the implementation challenge. Consequently, disease burden in correctional facilities has remained higher than in the general population. Keyword: legal framework, inmates/prisoners, Health, Collaboration