Using performance and theatre arts in HIV interventions and HIV programming in sub-Saharan Africa: A scoping review of extant literature

To raise awareness and knowledge of the human immunodeficiency virus (HIV); information, education and communication (IEC) strategies are needed. Entertainment education (EE) uses performing arts and theatre, as form of HIV programming, and is increasingly utilised in sub-Saharan Africa (SSA), a region impacted by a generalised HIV epidemic. A scoping review was conducted mapping and describing extant performance and theatre arts literature in HIV programming in the region. 27 records (between 1999-2019) were charted and thematically analysed. Performance theatre as a health education and promotion strategy in HIV programming was reported in South Africa, Botswana, Mozambique, Namibia, Swaziland, Uganda, Malawi, Lesotho, Zambia, Nigeria and Tanzania. This innovative strategy raised awareness, enhanced knowledge and corrected community myths; was transformative in changing cultural views and attitudes’; and enhancing behaviour change. This review highlights the potential for continued use of innovative performance and theatre arts in HIV interventions and HIV programming in SSA

Prison health situation and health rights of young people incarcerated in sub-Saharan African prisons and detention centres: A scoping review of extant literature

BACKGROUND: Treatment and special protection of the rights of incarcerated young people in prisons are mandated under the Sustainable Development Goals (SDG), as well as under United Nations (UN) human rights instruments. METHODS: A scoping review mapped what is currently known about prison conditions and health situation of detained and incarcerated young people in sub-Saharan African (SSA) prisons. A systematic search collected and reviewed all available and relevant published and grey literature. Following application of exclusion measures, 54 records remained, which represented 37 of the 49 SSA countries. These records were charted and thematically analysed. RESULTS: The ages of children and adolescents held in SSA prisons ranged from 12 to 18 years. Three main themes were generated during the charting exercise; the prison environment for young people; availability and accessibility of basic necessities and navigating the prison system for health care and outside continuum of care. CONCLUSIONS: The review highlights the grave and continuing deplorable situation of young people held in SSA prisons. The violation of international human rights norms is observed in the systemic abuse and detention of young people with adults. Basic needs are not met in relation to sanitation, ventilation, safe spaces, protection from physical and sexual violence, clothing, food and access to HIV and medical care

Preventing child sexual abuse before it occurs: Examining the scale and nature of secondary public health prevention approaches

Preventing child sexual abuse requires comprehensive multi-agency criminal justice and public health approaches. Yet, marginal attention has been given to secondary prevention strategies that target ‘at risk’ populations. Thus, we carried out a scoping review examining secondary prevention interventions for people at risk of sexual offending by considering their effectiveness, challenges, and barriers. We identified N = 43 sources and completed a qualitative analysis. Our appraisal found five themes: a) essential features needed for secondary prevention programmes (plus summary of interventions); b) barriers to examining, implementing, and accessing secondary prevention programmes; c) methodological limitations; d) the ethical justification; and e) economic benefits for preventing abuse before it occurs. Over the last two decades sources report greater public tolerance to the notion of tackling child sexual abuse using public health prevention approaches. Thus, we call for policy makers to embrace this positive shift and invest resources to further examine this area

Prison conditions and standards of health care for women and their children incarcerated in Zimbabwean prisons

Purpose The Sub Saharan (SSA) region remains at the epicentre of the HIV epidemic and disproportionately affecting women, girls and prisoners. Women in prison are a minority group and their special health needs relating to gender sensitivity, reproductive health, their children, and HIV/AIDs are frequently neglected. Design/methodology/approach A qualitative study using focus group discussions and key informant interviews explored the perspectives of women in prison, correctional officers, correctional health professionals, and non-governmental organisations around prison conditions and standards of health care whilst incarcerated in a large female prison in Zimbabwe. Narratives were transcribed and analysed using thematic analysis. Findings Three key themes emerged: ‘Sanitation and hygiene in the prison’; ‘Nutrition for women and children’ and ‘Prison based health services and health care’. Divergence or agreement across perspectives around adequate standards of sanitation, hygiene, quality and adequacy of food, special diets for those with health conditions, access to healthcare in prison and the continuum of care across incarceration and community are presented. Practical implications Understanding prison environmental cultures which shape correctional staff understanding and responsiveness to women in prison, environmental health conditions and access to healthcare is vital to improve conditions and continuum of care in Zimbabwe. Originality/value Policy and technical guidance continues to emphasise the need for research in SSA prisons to garner insight into the experiences of women and their children, with a particular emphasis on the prison environment for them, their health outcomes and healthcare continuum. Our unique study responded to this need

‘Mankind owes to the child the best that it has to give’: Prison conditions and the health situation and rights of circumstantial children incarcerated in Sub Saharan African prisons.

Background: In recent times, sub-Saharan African (SSA) prisons have seen a substantial increase in women prisoners, including those incarcerated with children. Methods: A scoping review mapped what is currently known about the health situation and unique rights violations of children incarcerated with their mothers in SSA prisons. A systematic search collected and reviewed all available and relevant published and grey literature (2000-2018). Following application of exclusion measures, 64 records remained, which represented 27 of the 49 SSA countries. These records were charted and thematically analysed. Results: Four main themes were generated as follows: 1) the prison physical environment; 2) food availability, adequacy and quality; 3) provision of basic necessities and 4) availability and accessibility of health services for incarcerated children. Conclusions: The review highlights the grave situation of children incarcerated with their mothers in SSA prisons, underpinned by the lack of basic necessities, inadequate hygiene, sanitation and safe drinking water, exposure to diseases in overcrowded cells, inadequate nutrition, lack of provision of clothing and bedding, and difficulties accessing paediatric care. Reported paediatric morbidity and mortality associated with such prison conditions is deeply concerning and contrary to international mandates for the rights of the child, right to health and standards of care

Ethical guidance for health research in prisons in low- and middle-income countries: a scoping review

Objectives: this study examined the extent, range and nature of the published literature, prison policies and technical guidance relating to the ethical conduct of health research in prisons in low- and middle-income countries (LMICs).Study design: scoping Review.Methods: we adhered to the five stages of the scoping review iterative process: identifying the research question, identifying relevant studies, study selection, charting the data, and collating, summarizing and content analysis of polices. Disagreements around allocation of content were resolved through team discussion. We also appraised the quality of the included articles.Results: we included nine records that examined the ethical aspects of the conduct of health research in prisons in LMICs; eight of these were peer-reviewed publications, and one was a toolkit. Despite the unique vulnerabilities of this group, we could find no comprehensive guidelines on the ethical conduct of health research in prisons in LMICs.Conclusions: the majority of the world's imprisoned populations are in LMICs, and they have considerable health needs. Research plays an important role in addressing these needs and in so doing, will contribute to the achievement of the Sustainable Development Goals. With regards to health research, imprisoned people in LMICs are 'left behind'; there is a lack of clear, prison-focused guidance and oversight to ensure high quality ethical health research so necessary in LMICs. There is an urgent need for prison health experts to work with health research ethics experts and custodial practitioners for procedural issues in the development of prison-specific ethical guidance for health research in LMICs aligned with international standards.</p

Empowering Zimbabwean women prisoners’ right to health and equivalence of care in the prison system, using Forum Theatre.

Background: The HIV epidemic in the Sub Saharan (SSA) region disproportionately affects women and girls and is further concentrated amongst prisoners. Given the male dominated prison environment, women’s health needs are frequently ill resourced. This research investigated the health inequalities of Zimbabwean women prisoners. Methods: Using multi-stakeholder qualitative and theatre performance-based practice as research methodology, within an art-based research approach, we examined the extent to which prison Forum Theatre validated prior research findings, fostered dialogic communication, and fuelled discourse to generate solutions to women prisoner rights to health and equivalence of care. Results: Analysis found five themes: female vulnerabilities and rejecting the criminal identity; group solidarity against prison security protocols and rights to confidential health care; prisoner peer hierarchies and threat to well-being; challenging the prison system; and multiple perspectives beyond the performance. Conclusions Forum theatre offers an innovative medium to empower women prisoners and actualize sexual health rights based approaches in prisons in Zimbabwe, and Africa using a transformative sustainable development approach

Ethical guidance for health research in prisons in low and middle-income countries: a scoping review

Objectives: This study examined the extent, range and nature of the published literature, prison policies and technical guidance relating to the ethical conduct of health research in prisons in low and middle-income countries (LMICs). Study Design: Scoping Review. Methods: We adhered to the five stages of the scoping review iterative process: identifying the research question, identifying relevant studies, study selection, charting the data, and collating, summarizing and content analysis of polices. Disagreements around allocation of content were resolved through team discussion. We also appraised the quality of the included papers. Results: We included nine records that examined the ethical aspects of the conduct of health research in prisons in LMICs; eight of these were peer-reviewed publications and one was a toolkit. Despite the unique vulnerabilities of this group, we could find no comprehensive guidelines on the ethical conduct of health research in prisons in LMICs. Conclusions: The majority of the world’s imprisoned populations are in LMICs and they have considerable health needs. Research plays an important role in addressing these needs and in so doing, will contribute to the achievement of the Sustainable Development Goals. With regards to health research, imprisoned people in LMICs are ‘left behind’; there is a lack of clear, prison-focused guidance and oversight to ensure high quality ethical health research so necessary in LMICs. There is an urgent need for prison health experts to work with health research ethics experts and custodial practitioners for procedural issues in the development of prison specific ethical guidance for health research in LMICs aligned with international standards