Rahmah Amala, Blogg James, Silitonga Nurlan, Aman Muqowimul, Michael Power Robert
Amala Rahmah is based at HIV Cooperation Program for Indonesia, Jakarta, Indonesia.
Int J Prison Health. 2014;10(4):252-61. doi: 10.1108/IJPH-08-2013-0038.
Indonesian law provides prisoners with basic rights, including access to education, health care and nutrition. Yet, structural and institutional limitations, notably overcrowding and under-resourcing, prohibits penal institutions from fulfilling these commitments for female prisoners. The purpose of this paper is to explore their health concerns.
DESIGN/METHODOLOGY/APPROACH: Six prisons and one detention centre were researched, comprising: female prisoners (n=69); clinical officers (six); clinic heads (seven); wardens (seven); heads of prisons (seven); and a Directorate representative. Data were collected through observation, focus group discussions, in-depth interviews and a semi-structured questionnaire. Raw data were transcribed and analysed thematically, adopting the General Principles of Grounded Theory.
Both "formal" and "informal" health-coping strategies were dependent upon a range of factors which determined access to treatment, medicines and other items procured both inside and outside of the prison, as well as referral services. Informal systems of support existed for women, especially in regard to pregnancy and raising of babies born in detention. Systems that maintain harmony within cell blocks were identified as an important informal coping strategy.
ORIGINALITY/VALUE: This research is important in informing policy and practice. There is a clear need for gender-sensitive legislative frameworks, penal policies and prison rules to ensure women's needs are addressed. The identified coping strategies were considered viable, but do not replace the need for a health system providing women prisoners with levels of care as available in the community, including commensurate budgeting, personnel, access and referral to more specialised external health services.
印度尼西亚法律赋予囚犯基本权利，包括接受教育、医疗保健和营养的权利。然而，结构和制度上的限制，尤其是过度拥挤和资源不足，使刑罚机构无法履行对女囚犯的这些承诺。本文旨在探讨她们的健康问题。
设计/方法/途径：对六所监狱和一个拘留中心进行了研究，包括：女囚犯（69人）；临床官员（6人）；诊所负责人（7人）；典狱长（7人）；监狱负责人（7人）；以及一名局代表。通过观察、焦点小组讨论、深入访谈和半结构化问卷收集数据。原始数据被转录并采用扎根理论的一般原则进行主题分析。
“正式”和“非正式”的健康应对策略都取决于一系列因素，这些因素决定了在监狱内外获得治疗、药品和其他物品的机会，以及转诊服务。为女性存在非正式的支持系统，特别是在怀孕和抚养在拘留期间出生的婴儿方面。维持牢房区和谐的系统被确定为一种重要的非正式应对策略。
原创性/价值：这项研究对于为政策和实践提供信息很重要。显然需要对性别问题敏感的立法框架、刑罚政策和监狱规则，以确保满足女性的需求。所确定的应对策略被认为是可行的，但并不能取代建立一个为女囚犯提供社区同等水平护理的卫生系统的必要性，包括相应的预算、人员配备、获得和转诊到更专业的外部卫生服务。
