Reproductive health care of women inmates: a case study of Lang'ata maximum women's prison

Abstract

A woman's health and nutritional status is both a national and an individual welfare concern. This is because it affects the next generation, through its impact on her children, as well as her productivity at the household level and in the wider economy. When mothers are malnourished or sickly, or when they receive inadequate prenatal and delivery care, their children face a higher risk of disease and premature death The study was designed to investigate what forms of reproductive health care interventions are offered to women inmates at Lang'ata Maximum Women's Prison. More specifically, the researcher sought to describe the availability and utilization of reproductive health services at the prison and assess and determine the quality of reproductive health care services there in. It was also imperative for the study to identify , gaps in the delivery of reproductive health services at the prison. Conditions in African prisons are life threatening and a potential health hazard to prison population. Morbidity and mortality rates are high and health status is worse in prisons than in the general community. By 2001, Kenya had a prison population of 40,000 inmates made up of convicts on remand and those who had been sentenced to serve time. in particular, there has been a dramatic growth in women's prison population in Kenya against non-growing facilities to match the same. It is no secret, as evidenced by the .regular reports in the media, that the state of Kenyan Prisons is deplorable, and that the prisons arc congested beyond their holding capacity. The sight of inmates gives a picture (Ifa dejected, deprived, neglected, if not almost forgotten, lot. The research focused on women inmates within the reproductive age of 15-49years. There were three different categories of women inmates, namely; pregnant, lactating and other general inmates. Information from the field was collected by use of interview schedules and use of interview guides for the key informants. An observation check list was used to assess the equipments available within the prison clinic. Data analysis was done using SPSS. Research questions were adequaely answered through summaries in the form of percentages and frequency tables. The study revealed that a few reproductive health interventions were being availed to the inmates. These were pre-natal, post-natal care, treatment of STIs and HIV/AIDS, immunization programmes for children and health information. A healthy woman requires an all round care provision. It is however interesting to note that out the iuterviews conducted, the major ity of inmates were somehow contented with the services since they indicated the services were average. The qual ity of reproductive health care is way below the internationally/nationally recognized standards. Women constitute a special category of vulnerable prisoners. Facilities like delivery kits are lacking and nurses handle all cases that require medical attention. These include but not limited to emergencies like deliveries which are ordinarily referred to Kenyatta National Hospital. There are too few staff to meet physical health needs. The time allocated for clinic visits is rather too short to have all clients given ample time for diagnosis. Everything is then handled in a hurry and quality of service is questionable. This often results in long delays in obtaining medical attention. The infirmary in the prison served both the inmates and the staff therein. This overstretched the facility in terms of staff and drugs to the detriment of the inmates. The key informants informed the study that there is no medical officer based at the prison and their visits were unpredictable. In standard practice, Medical Officers are supposed to diagnose and prescribe drugs for patients. Lack of Medical Officers implies that patients are treated by nurses who the researcher found on duty through out the study period. Among the recommendations proposed by the study are establishment of a Comprehensive Female Health Care System, development of programmes of sanitary education including being open to NGOs and well wishers as well as encouraging private/ mobile clinics.