DIRECTORATE OF PRISONS HEALTH SERVICES KENYA PRISONS SERVICE DIRECTORATE OF PRISONS HEALTH SERVICES

Cohort I – January to July 2011 LeHHO Team Members Cohort I – January to July 2011 1. Dr. John Kibosia – Director of Prison health services 2. Dr. Charles Isiaho - Ag. Director of Health services Cohort II – June to December 2011m 34,w Mrs. Mary Chepkonga – ACP, Head of ACU (KPS AIDS Control Unit) Dr. Eileen Koske – In charge, Langata Women Prison Health Services

Background Kenya Prisons Service Prisons Service in Kenya has been in existence since 1911. The services is mandated through Act of Parliament to fulfill the main role of;- Containing and keeping offenders in safe custody Rehabilitation and reformation of offenders Facilitation of administration of justice by producing offenders in courts of justice Training of young offenders in Borstal institutions and Youth Corrective Training Centres Provision of facilities for children aged 4 years and below accompanying their mothers to prison Recruitment, training and development of suitable human resource for the provision of service.

Directorate of Prisons Health Service Background Cont. Directorate of Prisons Health Service Until 5 years ago, all prisoners who needed medical attention were referred to Ministry of Health facilities. In late 2006 the government decided to create the Directorate of Health with the mandate of promoting the inmates staff and the environment they occupy is healthy. The Directorate has now been incorporated into the prison structure.

Mission Mission of the Directorate of Health services To provide quality healthcare to prison community through preventive, curative & referral services

Health challenges addressed by the LeHHO teams Cohort I To Provide basic dental services in 5 principal prisons Cohort II To provide TB screening to 80% of all prisoners in the Langata Women’s prison.

Situation as of January 2011 before LeHHO training All prisoners who needed dental care services were transported to the nearest MOH facility that had dental services. To be able to do this the following was needed; - Provision of vehicles for transportation - Provision of security to escort the prisoners - Finances to take care of the fuel costs and also the pay for the services in the respective hospitals.

Measurable result 5 principal prisons will offer dental services by 30th July 2011

Justification KMTC students carried out a study in 2010 in 3 maximum prisons in Kenya on healthcare needs. The study revealed that: - 70% of referral cases were dental related. - 90 % of these could be treated with basic dental equipments within the prisons health facilities

Obstacles Funding Equipment Personnel Infrastructure Challenge How will we provide dental health services in 5 principal prisons in the light of in-adequate funding for health services, lack of equipment, shortage of staff and lack of dental equipments.

Priority actions Recruitment of staff by the KPS 2. Secondment of staff by MoH 3. Procurement of basic dental equipments by KPS 4. Request for support from MoH and Partners to purchase/provide the dental services equipments.

Resource mobilization matrix Name of the stakeholder Specific request made Outcome International Medical Corps ( IMC) Restorative dental kits 5 boxes of assorted kits were provided Ministry of Medical Services ( MoMs) Secondment of staff Provison of medical supplies ( consumables) 2 Oral health staff seconded to Nairobi West and Kamiti Prisons MoM committed to continuous supply of these consumables Dr. Ronald from Switzerland ( private practioner , dental surgeon) Dental Extraction Kits Provided kits for Embu and Kakamega principal prisons Ministry of Home Affairs Extraction Kits Provided Kits for Kodiaga, Nyeri, Embu, Nairobi West, P.S.T.C Kenya Prisons Under the Ministry of Home Affairs Recruitment 5 Oral health officer were recruited.

Achievements as of July 2011(end of LeHHo training) Dental services were offered in the 5 principal prisons namely; Nyeri, Kodiaga, Embu, Nairobi west and Shimo la Tewa. In-addition this services were extended to the Prison Service training college (P.S.T.C) This interventions have helped the prison services to save on; Manpower needed for security of prisoners and cost of dental services outside prison health facilities.

Current situation after July 2011 The scope for provision of Dental health services has been expanded to ; - Kakamega - Kamiti - Naivasha prisons 2. Using the concept of the challenge model, we have expanded to other specialized health services; - Ear Nose and Throat (ENT) services at; the P.S.T.C, Borstal Juvenile Prisons at Shikusa and Shimo la Tewa 3. Minor Surgical procedures have been introduced to all the 40 prison health facilities country wide.

Conclusion The Directorate of Prison Health Services have helped to; Decongest the public health facilities Provide Primary Healthcare ( PHC) to host communities who are not bale to access health services due to the distances from the healthcare facilities. It is possible to provide the prisons community with internationally accepted health care services

ACKNOWLEDGEMENT The Commissioner Of Prisons Ministry of Medical Services Ministry of Home Affairs Development Partners Strathmore Business School USAID and MSH / LMS

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