WHO minimum public health data set on prison health Dr Lars Moller Dr Lisa Schölin Ms Julie Brummer WHO Consultant, Alcohol and Illicit Drugs Division of Noncommunicable Diseases and Life-Course

Outline The WHO Minimum public health dataset for prison health Preliminary findings – key data on drugs Next steps

Background Risk factors for ill health are higher in the prison population compared to the general population. Most diseases have a higher prevalence than in the general population There are significant differences between the health systems in prison and in the civilian system.

Minimum public health dataset Lack of comprehensive, consistent and reliable public health data on prison populations and their health needs across the WHO European Region WHO European Region the only region with a prison health programme The minimum public health dataset for prison health sets out to obtain national data on key areas of prison health Data collection commenced October 2016

Indicator set – 7 domains Population demographics (7 indicators) E.g. total number of prisoners, number of female prisoners Prison health systems (21 indicators) E.g. government ministry responsible for prison health, health workforce statistics Risk factors for diseases (10 indicators) E.g. Risk factor prevalence (smoking, obesity, drug and alcohol use), testing protocols Disease screening (24 indicators) E.g. testing protocols, % tested and number of cases (E.g. HIV, Hep B & C, TB), availability of mental health disorder screening Prevention of communicable and non-communicable diseases (14 indicators) E.g. availability of disease prevention programmes such as needle exchange, availability of drug-free units Treatment of communicable and non-communicable diseases (7 indicators) E.g. numbers in treatment for opioid addiction, HIV and Hep C, availability of mental health support Mortality data (4 indicators) E.g. total number of deaths, number of <18 deaths, number of deaths by suicide The database will comprise approximately 85 indicators of prison health

Project funding and partners Project funding is provided by the Finnish Government Survey developed with assistance of: WHO/Europe Health In Prisons Programme (HIPP) HIPP Steering Group (Public Health England/WHO Collaborating Centre, European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), United Nations Office on Drugs and Crime (UNODC), AIDS Foundation East-West (AFEW), and representatives from Switzerland, Netherlands, Spain and Slovenia) European Centre for Disease Prevention and Control (ECDC) Council of Europe European Commission Collaboration regarding indicator set design and data collection to avoid overlap and ensure consistency in indicator definitions and key figures

Preliminary results

Participating Member States 41 Member States (MS) have submitted data    

Screening

Mandatory testing* *For all or parts of prison population

Data for prevalence of drug use 7 (19%) of MS have data on number of prisoners screened for illicit drug use 6 (16%) MS have data on current injecting drug use 8 (22%) have data on ever injecting drug use The majority of member states are lacking data on prevalence of drug use, as well as number of prisoners screened

Availability of infectious diseases data *missing data not included

Healthcare services

Harm reduction Needle/syringe exchange programs for injecting drug users available in 7 (19%) of MS Disinfectants for syringes, razors, tattoo equipment available in 15 (41%) of MS

Prevention Condoms available in 78% of MS Free of charge in 86% of these MS Lubricants available in 35% of MS Free of charge in 92% of these MS National guidelines on prevention of post-release drug-related death exist in 43% of MS

Treatment for HIV and Hep C 62% of MS have data on number of prisoners under antiretroviral treatment 33% of MS have data on number of prisoners under antiviral treatment for Hep C

Availability of drugs treatment

Next steps

Data All data will be made available on the Global Health Observatory (11 December 2017) Country profiles for each participating Member State, including key indicators (December 2017)

Continued work The submitted data indicate a lack of information for many indicators in majority of Member States Lack of data presents an opportunity to call for improving data collection and monitoring systems in Member States

Thank you for your attention mollerl@who.int scholinlis@who.int brummerj@who.int