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Study of Health Care Provision, Existing Drug Services and Strategies Operating in Prisons in Ten Countries From Central and Eastern Europe

NCJ Number
Morag MacDonald
Date Published
195 pages
This review of health services offered in 2 sample prisons in each of 10 countries in Central and Eastern Europe focuses on services to drug-dependent inmates and compares the state of health services in these prisons to the current Council of Europe and World Health Organization guidelines.
The countries involved in the study were Bulgaria, Czech Republic, Estonia, Hungary, Latvia, Lithuania, Poland, Romania, Slovakia, and Slovenia. The author visited at least two prisons in each of these countries and interviewed representatives of key nongovernmental organizations (NGOs) involved in treating drug addiction in each of the countries. Two primary problems are facing the prison administrations of all 10 countries. First, there is an increasingly high number of problematic drug users in prisons. Some of these inmates continue to use drugs while in prison, and some inject their drugs. Second, there is a high incidence of hepatitis and, in some countries, HIV among inmates. These problems are aggravated by wide-scale prison overcrowding. Bullying, forced sex, and self-harm are other inmate behaviors that increase the demand on health care services. The study identified a range of good practices and new initiatives within the sample prisons in both health care in general and specific services for drug abusers. These initiatives are provided by the prison administrations or NGOs or by the prison administrations in partnership with NGOs. Overall, there is little uniformity in health care across prisons in each country, and there is a lack of national standards for inmate health care. The author recommends greater multidisciplinary health care training and operations, which are generally lacking. 76 references and an appended checklist for prison health care services