Assessing Preventive Health Care Among Incarcerated Women in a Swiss Prison


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A Master's thesis.
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Master (thesis) (master)
Assessing Preventive Health Care Among Incarcerated Women in a Swiss Prison
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Université de Lausanne, Faculté de biologie et médecine
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Background: Women inmates are considered as a vulnerable population with health and social difficulties. Therefore, incarceration should be a chance to offer global health care including prevention according to the principle of equivalence and considering Nelson Mandela rules, which state that costs must be assumed by the state. Actually, it is not the case in Switzerland and a participation to medical costs when financial situation permits is required. Considering that prevention in women inmates is not quantified as far as we know, the objective of the study is to assess preventive health care and to define enabling and limiting factors that modulate access to preventive health care on women in a swiss prison.
Methods: We analysed data from the Groupe Interfacultaire Prison Santé Inégalités, which assess physical and mental health of sixty women incarcerated at la Tuilière between February and November 2017 (Lonay, Vaud). Data were collected either by a hetero-administrated questionnaire or from medical files. Based on the Swiss recommendations on preventive medicine edited by the EviPrev program, we assessed the rate of cancers, cardiovasculars and sexual transmitted infections screening on eligible women inmates and whether factors were predicting sexual transmitted infections and cardiovascular screening.
Results: No prevention was neither proposed nor conducted for breast and colon cancers, whereas about a third (27.1%) of eligible women were proposed cervix cancer screening by a Papanicolaou test. Once proposed, the majority (84.6%) accepted the test. Regarding cardiovascular diseases, preventive health care depended on cardiovascular risks. All eligible women (100.0%) were screened for obesity and hypertension, whereas almost half (47.1%) were screened for diabetes and a third (30.8%) for dyslipidaemia. The rate of sexual transmitted infections screening was heterogeneous with 78.0% screened for tuberculosis, 45.6% for HIV, 39.6% for HCV, 35.1% for HBV, 5.0% for chlamydia, gonorrhea and syphilis.
Conclusion: The study highlighted the heterogeneity in prevention screening. Indeed, screening tests for hypertension, obesity and tuberculosis are well integrated in the medical system, whereas cancers, diabetes, dyslipidaemia and infectious diseases definitely required improvement despite Swiss recommendations on preventive medicine guidelines.
Incarcerated women, prison, preventive health care, screening
Create date
07/09/2020 11:09
Last modification date
18/02/2021 7:29
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