title: The health of female prisoners in Indonesia.
abstract: OBJECTIVE
  Indonesian law provides prisoners with basic rights, including access to education, health care and nutrition. Yet, structural and institutional limitations, notably overcrowding and under-resourcing, prohibits penal institutions from fulfilling these commitments for female prisoners. The purpose of this paper is to explore their health concerns.
  
  
  METHODS
  Six prisons and one detention centre were researched, comprising: female prisoners (n=69); clinical officers (six); clinic heads (seven); wardens (seven); heads of prisons (seven); and a Directorate representative. Data were collected through observation, focus group discussions, in-depth interviews and a semi-structured questionnaire. Raw data were transcribed and analysed thematically, adopting the General Principles of Grounded Theory.
  
  
  RESULTS
  Both "formal" and "informal" health-coping strategies were dependent upon a range of factors which determined access to treatment, medicines and other items procured both inside and outside of the prison, as well as referral services. Informal systems of support existed for women, especially in regard to pregnancy and raising of babies born in detention. Systems that maintain harmony within cell blocks were identified as an important informal coping strategy.
  
  
  CONCLUSIONS
  This research is important in informing policy and practice. There is a clear need for gender-sensitive legislative frameworks, penal policies and prison rules to ensure women's needs are addressed. The identified coping strategies were considered viable, but do not replace the need for a health system providing women prisoners with levels of care as available in the community, including commensurate budgeting, personnel, access and referral to more specialised external health services.
authors.affiliation: Amala Rahmah is based at HIV Cooperation Program for Indonesia, Jakarta, Indonesia.
authors.forename: Amala
authors.initials: A
authors.lastname: Rahmah
authors.forename: James
authors.initials: J
authors.lastname: Blogg
authors.forename: Nurlan
authors.initials: N
authors.lastname: Silitonga
authors.forename: Muqowimul
authors.initials: M
authors.lastname: Aman
authors.forename: Robert
authors.initials: R
authors.lastname: Michael Power
mesh_terms: D000223:Adaptation, Psychological; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility / Q000458:organization & administration* / Q000592:standards; D006304:Health Status; D006801:Humans; D007214:Indonesia; D008427:Maternal Health Services / Q000458:organization & administration; D010342:Patient Acceptance of Health Care; D011329:Prisoners; D011330:Prisons; D016387:Women's Health
keywords: Health in prison; Health policy; Human rights; Offender health; Overcrowding; Prisoners