Women Behind Bars: A Qualitative Study of Gender-Sensitive Health Care Experiences in a Model Prison in Northeastern Thailand

Abstract

This study addresses the growing concern that women prisoners face unique health needs in correctional settings originally designed for men, where gender-sensitive health care remains limited despite international standards such as the Bangkok Rules. This qualitative descriptive study is a part of the larger project entitled “Health Services for Women in Prison.” It aimed to explore the perspectives of women prisoners on prison health services, with a particular emphasis on gender-sensitive care in line with the Bangkok Rules and the principle of “Prison Health is Public Health.” The study, conducted between December 2022 and June 2024, explored the perspectives of 39 women prisoners and prison public health volunteers in a model prison in northeastern Thailand. Data were collected through in-depth interviews, observations, and document reviews and analyzed using qualitative content analysis. Two major themes emerged. First, participants perceived prison health services as adequate and responsive, highlighting accessibility, timeliness, and comprehensive coverage. Second, several gender-sensitive needs remained unmet, including the demand for pelvic examinations by female doctors, earlier cervical cancer screening, mental health promotion, and peer support networks. Despite the positive perception of prison health services, these gaps underscore the continuous challenges in providing gender-specific care.

The findings highlight the need for policy measures to strengthen reproductive health guidelines, systematically allocate resources, and institutionalize peer support within prison health systems. Nurses play a crucial role in ensuring privacy, trust, and trauma-informed care while coordinating with multidisciplinary teams to implement the Bangkok Rules and uphold the principle of “Prison Health is Public Health.”