NDPHS EXPERT GROUP ON PRIMARY HEALTH AND PRISON HEALTH CARE SYSTEMS Activities to implement goal 6 NDPHS CSR Meeting, April 19-20, 2012, Helsinki

“Improving the system of medical and social measures aimed at creating adequate reproductive behaviour among women prisoners” Developed and Submitted by - Federal Research Institute for Health Care Organization and Information of MoH&SD of RF and Foundation for overcoming the demographic crisis The overall objective of the project: Support for improving the system of medical and social measures aimed at adequate reproductive behaviour among women prisoners Specific activities of the project: Development of methodological approaches that promote positive reproductive choice of women, held in custody Improving health and social care services in maintenance and education of infants born in the FPS institutions to prevent child abandonment. Establishment of centres for adaptation of women who came out of prison, and gave birth in custody

Capacity Building, Knowledge Transfer and Best Practice in Working with Populations Most At Risk from Blood-Borne Virus Infections in Prison and Post-Prison Settings in Baltic and Nordic Countries” A systematic and evidence-based programme of work lasting 3 years will be undertaken and will consist of 5 main strands: 1) improving of the caring environment of prison and development of the through care processes for prisoners 2) working with prison staff to promote a healthy environment and healthy relationships 3) working with prisoners to promote health literacy and reduce harmful behaviours 4) developing after-care, advocacy and supportive links with families and community-based services and groups to improve post-prison outcomes. 5) setting up learning exchanges and forums to encourage the transfer of knowledge concerning best practice Anticipated Outcomes: Increased capacity of Baltic and Nordic NGOs working with IDUs/CSWs affected by or at risk from BBV,Strengthened relationships among Baltic and Nordic civil organisations, including state-NGO relations, Enhanced knowledge and expertise among groups, individuals and organisations within Baltic and Nordic countries for working with IDUs/CSWs affected by or at risk from BBV

“Development of the effective model of preventive education and reintegration of young inmates in the Russian Federation” Developed and Submitted by AFEW in coordination with ILO Moscow Office. Project Goal: The proposed twelve-month project seeks to develop and pilot comprehensive and effective model of health preventive education and reintegration of young offenders (18-25 y.o.) in St. Petersburg city of the Russian Federation The objectives to reach this goal are to: A) Develop an effective system of psycho-social support to young offenders in the correctional facilities (colonies) on the issues of their health and responsible and risk-free life style. B)Strengthen capacity of penal service staff at the correctional facilities for adolescents and local social service employees working with young offenders in providing adequate and coordinated HIV prevention and reintegration services for (former) young offenders; C) Support institutionalization and further promotion of the developed model

“Development of the effective model of preventive education and reintegration of young inmates in the Russian Federation” -continiation- The specific outputs will include but not be limited to: Series of 4 trainings for at least 60 at-risk youth; Series of 4 trainings for at least 40 penal staff; Series of special training sessions such as bray-ring games conducted for at least 60 at-risk youth; 500 copies of information materials for penal staff; One comprehensive training curriculum on HIV, STI, TB prevention, treatment adherence, healthy life-style promotion among young offenders staying at the correctional facilities; One public discussion for the total of 50 participants that will draw public and media attention to the issues of at-risk youth and young offenders within the current justice system reform including the formal presentation of the developed model and materials to the top management of the Federal Penal Service (FPS) and other authorities and stakeholders

Stewardship of Prison Health Policy guidance for Member States of the WHO European Region on the provision of health services in prisons What a good modern prison health service should look like and what it should provide; How to ensure close ties and co-operation between MoJ and MoH nationally, and prisons and public health services locally, no matter what model for the provision of prison health serv The need to prevent the isolation of prison health services from public health services; The need to combat the lack of awareness which often exists in society and among many health policy makers, of the status of health in prisons and its public health significance.

Stewardship of Prison Health Background: prison health in health governance The need for guidance on the Stewardship of Prison Health The evolution of prison health services – a short history The current situation The underpinning principles of prison health provision Models for providing prison health services Case studies of the MoJ (or MoI) model: Case Studies of the MoH model: Norway, France and England Case Studies of two countries in transition to MoH model: Spain and Scotland conclusions from the case studies Recommendations

Stewardship of Prison Health main conclusions from this work A good prison health service can be provided by either the Ministry of Justice or the Ministry of Health, but both need to be aware of the health needs, the resources and skilled staff required to deliver it; Ministries (MoH and MoJ) have to be closely involved with the stewardship of prison health, which has to be seen as part of the stewardship of health as a whole; The whole field is far from static and as new needs arise and more health technology and treatment options become available, there is good sense in exchanging experiences, agreeing best practice and learning from each other.

Stewardship of Prison Health main conclusions from this work Member States with a shortage of resources and whose services may be thought of as struggling to provide an equivalent service should be encouraged to acknowledge this issue, and to plan to address and improve the situation as soon as possible. Indeed this issue, when identified by a Member State could be part of Regional discussions on the development of basic health services for socially marginalised groups, as well as being in the interest of human rights and public health. The isolation of prison health services from general health services still exists in many countries, and is therefore still likely to cause and exacerbate public health problems; all Member States should therefore review their arrangements, and where necessary initiate a dialogue that leads to close cooperation between the Ministry of Justice and Ministry of Health Ministries in all countries