The Study On Health Supply And Health Needs In Re-education Centers In Western China.

Background and ObjectivesBy the end of 2005,over 9 million people were held in every kind of penal institutions throughout the world,however,those who experienced a prison life in a year would be 4-6 times than that figure because of high rate of turnover.Prisoners usually have bad health compared to general population,the low social-economic status,criminal/legislation procedures and custody are main reasons.Re-education through labour is a special political system of CHina,re-education centers are designed to held minor criminals for 1-3 years.Chinese government attaches great importance to thehealth of every kind of prisoners including those in re-education centers.Effective measures having been taken to protect and promote prisoners' health.In China,health services are provided by Justice Department rather than Health Department inside the government.Since 1970's,western countries recognized that prisoners having the rights of to-be healthy and that good prisoners' health is part of good social public health,they concerned more and more about the prisoner's health issues,carded out many researches in various aspects.However,few such researches had been done in China.The main purpose of study are to describe health status and health delivery system of Re-education system,to analyze health utilization,and to raise suggestion for decision makers to improve prisoners' health.Methods This study is designed to be a describing one.Data resources includes existed literature and policy documents,data collected through questionnaire prepared for prisoners,data collected through questionnaire prepared for institutions and key informants interview.Considering social economic development level and geographical distribution,12 reeducation centers in Guangxi,Chongqing and Yunnan provinces were selected, 1721 prisoners and 75 key informants were interviewed.The field works for data collection were conduceted from July 20 to August 8,2007 by experts and students of Shandong University.Both qualitative and quantitative methods are employed for data analysis.The study took into full account the specialty of the prisoners,privacies and other rights were greatly protected.Main resultsThere are 348 re-education centers in China,remaining more than 200,000 people at a point of time since the year 2000.Policemen manage every aspects of prisoners' life inside re-education centers.Before they came into re-education centers,prisoners had high incidence of high-risk behaviours,such as smoking,drinking and drug abuse,sexual and tattoo.1,721 surveryed inmates including 94.8%smokers,54.9%having drinking habits,91.8% had experienced drug addiction,84%have more than two sexual partners.Among 1,721 inmates,638(37%) thind that their health state be "good" or "very good",their average score of self-estimate of health status is 6.2.Rates of TB,AIDS, hepatitis,sexually transmitted diseases are high among prisoners.Health expenditure of each re-education center was 715000 RMB yuan in 2005, accounting for 3.1%of total expenditure of the center.For each prisoner,health expenditure was 373 RMB yuan including 165 yuan for medical expenditure.Ministry of Justice had identified health regulations for prisoners,including physical check,health education,out-patients and in-patients,etc.Public health sector provides supports to re-education centers.Health services in re-education centers have several characteristics,including being mandatory,non-independence,free of charge,low level and quality,etc.Factors that impact provision of health services include:not being priority,rules and regulations, health status of inmates,financial level,costs and prices,etc. 81%of the inmates had received doctors' diagnosis or treatment,an average of 5.1 times each year for each prisoner.75%of the inmates told that they had access to health services when needed.SuggestionsThe government should make it clear that inmates have the right of access to health services,fully aware that prison be a good opportunity for disease control.Health Sector and Justice Sector should responsible for prisoners' health.The study suggest that to improve capacity of providing more and better health services to prisoners,a scientific collaboration relationship be established between Justice and Health sector inside the government,to regulate health institution and health workers in Re-education,and to control TB,HIV,Hepatitis inside the wall. The study also suggest further research works be conducted by health-background experts.