Determinants of access to primary healthcare for formerly incarcerated women transitioning into the community: a systematic review
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Heidelberg Institute of Global Health, Heidelberg University Hospital, Germany
Swiss Tropical and Public Health Institute, Switzerland
Public Health Institute, Faculty of Health, Liverpool John Moores University, United Kingdom
Department of Health and Social Work, Frankfurt University of Applied Sciences, Germany
Publication date: 2023-04-27
Popul. Med. 2023;5(Supplement):A1356
Background and Objectives: Women and girls are becoming the fastest growing segment of the global prison population. Women with a history of incarceration experience markedly poorer health and social vulnerability compared to both their male counterparts and women in the general population. Drawing on the patient-centered access to healthcare model, we conducted a systematic review of the literature to answer the following questions: 1) what are the determinants for primary healthcare use among formerly incarcerated women transitioning into the community? 2) What are the challenges and opportunities for access to primary healthcare? Methods: Following the PRISMA guidelines, we applied relevant search terms in five databases, according to the Population, Concept, and Context framework. No restriction for country or language were made. Findings: 180 studies were retrieved for full-text screening, from which 23 studies were identified as eligible for inclusion. Several themes were identified, including: trends of healthcare utilization, compared to the general population; women’s perception of their health and healthcare needs; the impact of health on coping and functioning after release; barriers to primary and preventive care; expectations and experiences of general practitioner care; quality and continuity of healthcare upon release, and stigma and perceived discrimination in the healthcare system. Finally, we report interventions that were designed to improve access to health care among formerly-incarcerated women population. To summarize the findings, we map identified determinants of access to care to the five dimensions of the access to healthcare model, and to the corresponding populations abilities to illustrate pathways in which access to primary healthcare for women transitioning from prison into the community can be affected. Conclusions: Women with a history of incarceration have unique health experiences shaped by structural determinants of health during and after incarceration. We suggest areas of priority for future research and practice.
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