Health needs and risky behaviours among inmates in the largest prison of eastern Nepal

• DOI: https://doi.org/10.1108/IJPH-10-2017-0049
• Pages: 254-267
• Date: 17 December 2018
• Published date: 17 December 2018
• Author: Gambhir Shrestha,Rashmi Mulmi,Deepak Kumar Yadav,Dharanidhar Baral,Birendra Kumar Yadav,Avaniendra Chakravartty,Paras Kumar Pokharel,Nidesh Sapkota
• Subject Matter: Health & social care,Criminology & forensic psychology,Prisoner health,Sociology,Sociology of crime & law,Public policy & environmental management,Policing,Criminal justice

Health needs and risky behaviours

among inmates in the largest prison

of eastern Nepal

Gambhir Shrestha, Rashmi Mulmi, Deepak Kumar Yadav, Dharanidhar Baral,

Birendra Kumar Yadav, Avaniendra Chakravartty, Paras Kumar Pokharel and Nidesh Sapkota

Abstract

Purpose –The purpose of this paper is to assess the health status and risky behaviours of inmates in Nepal.

Design/methodology/approach –This cross-sectional study was conducted in Jhumka Regional

Prison, the largest male p rison in eastern Nepal fr om September 2014 to August 2 015. Data were

collected through face-to-face interviews from 434 randomly selected incarcerated participants using

semi-structured questionnaires.

Findings –The mean age of 434 participants was 35.7 years (SD 13.3). The majority (84 per cent) had at

least one current health problem, of which the commonest were respiratory (50 per cent), skin (38 per cent)

and digestive (26 per cent). Alcohol (73 per cent) and cigarettes (71 per cent) were the most commonly used

substances prior to imprisonment. Approximately, 27 and 11 per cent reported illicit drug use and injectable

drug use prior to incarceration, respectively. A total of 204 inmates reported having intercourse with

sex workers. Of these, 49 per cent did not use a condom in their last intercourse with a sex worker.

Research limitations/implications –This paper illustrates that a wide range of physical and mental health

problems exist among incarcerated people in Nepal. The study may lack generalisability, however, as it was

conducted in a single male prison.

Practical implications –The paper suggests a need for medical, psychiatric and substance abuse care in

correctional settings to improve the health status of the prison population. It is also important to develop

screening policies for blood-borne viral and other infectious diseases in the prison.

Originality/value –This is the first study of its kind drawn from prisons in Nepal.

Keywords Substance abuse, Nepal, Health policy, Health need, Prisoners’health status,

Risky behaviours

Paper type Research paper

Introduction

The Moscow declaration on “prison health as a part of public health”strongly recommends that

prison and public health care should be closely linked (WHO, 2003). The prevalence of infectious

diseases, chronic diseases, mental disorders, blood-borne viruses (BBV ) and sexually

transmitted diseases are much higher in prison populations than in the general population

(WHO, 2003; Kazi et al., 2010; Simooya, 2010; Baillargeon et al., 2000; Binswanger et al., 2009;

Indig and Wales, 2010; Esposito, 2010; Shrestha et al., 2017). The prison population is

comprised of members from marginalised communities including people with poor and

untreated health conditions and those who engage in high-risk behaviours such as injecting

drugs, tattooing and commercial sex work (Fazel et al., 2006). The chances of prisoners

transmitting HIV infections is significantly high because they are often involved in risky activities,

such as tattooing, or in drug-related activities involving needles (Jürgens et al., 2011).

Prisoners might pr eviously have had l imited access to he alth services due t o educational,

social and economic disadvantages (Watson et al., 2004). Incarceration exposes prisoners to

Received 30 October 2017

Revised 10 January 2018

27 January 2018

31 January 2018

Accepted 5 February 2018

The authors express the

gratitude to Jail Superintendent of

Jhumka Prison (Ganesh Adhikary),

auxiliary health workers

(Yam Prasad Gautam and

Dinesh Neupane) and other prison

staff members for providing

necessary information and for

helping the authors during the

interactions with the inmates.

The authors would also like to

thank Dr Rabin Gautam,

Dr Puja Sharma and Kanchan

Thapa for helping the authors edit

this manuscript. Again, the authors

are thankful to all the inmates who

helped the authors and

participated in the study.

The authors affiliations can be

found at the end of this article.

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INTERNATIONALJOURNAL OF PRISONER HEALTH

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VOL. 14 NO. 4 2018, pp. 254-267, © Emerald Publishing Limited, ISSN 1744-9200 DOI 10.1108/IJPH-10-2017-0049