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This paper presents an actor-based conceptualization of the increasing oscillatory pattern of prison overcrowding in Colombia. The research proposes a dynamic hypothesis that explains that unintended behavioural pattern as a result of delayed balance feedback loops shaped by decision-making processes of actors that intend to control crime. This system matches a well-known systemic archetype that explains those persistent oscillations. The paper also introduces a simulation model for testing that dynamic hypothesis and for delivering concrete courses of action. This work illustrates the relevance for policymakers to understand the dynamic complexity of social systems as the outcome of the agency of actors who take action to defend their own interests. Such actions ultimately form a complex web of interactions that drive the performance of such systems with unintended consequences. In particular, the construction of explicit models provides better chances of devising policies that consider the system-level implications of those interactions.

This work uses system dynamics modelling. First, the paper presents a conceptual model anchored in operational thinking, which refers to the identification of actors and decisions, and the manner in which those decisions ultimately build the respective social system in which the oscillatory pattern emerges. Second, it identifies key feedback structures that result from those chains of decisions. Finally, the paper introduces a simulation model for suggesting policy implications for decisionmakers.

The increasing oscillatory pattern that prison overcrowding in Colombia has displayed over the last 20 years is the outcome of a wide variety of laws that increase sanctions on criminal conducts, a phenomenon known as “legislative inflation”. Such reactions against crime are propelled and sustained by society and policymakers as the result of static and linear thinking that simply delivers “more punishment” of crime – harsher legislation and longer prison terms – which ultimately boosts long-term prison overcrowding and further cycles of crime control and overcrowding. Such actions create permanent negative feedback loops that involve various material and information delays, which – coupled with the reinforcing feedback loops – explain the previously mentioned behavioural pattern. Through a system dynamics simulation model, this paper tests and explains the proposed dynamic hypothesis and shows how policymakers can enhance and develop their dynamic understanding to explore and design effective policies intended to tackle prison overcrowding.

This paper presents a practical and concrete case that bridges the fields of criminal policy and prison management through systems thinking. It uses the case of prison overcrowding in Colombia to demonstrate the relevance of incorporating systemic thinking into the cognitive portfolio of policymakers if they aspire to improve complex systems.

Criminal policy and prison management are different fields that typically belong to different traditions (law and criminal psychology for the former, public administration for the latter). The work presented here bridges those perspectives under a single engineering and systemic perspective that answers questions in both fields and serves as a unifying framework for designing more coherent criminal policies that meet the practical requirements and restrictions that prison management implies.

The smart building concept has gained prominence in the construction sector during the past decade. In the United Arab Emirates, although smart building technology has been widely adopted in different building sectors, no empirical studies have examined the applicability of the smart buildings concept in prison facilities. The current study aims to understand the current status of prison buildings in the UAE and the challenges faced by the prison industry to implement new smart technology.

This study involved a semi-structured interview consisting of 14 participants who were interviewed face-to-face about their opinion about the objectives of the study. The interviewees were experts from the prison and construction industry of the UAE working at the top management level. Mind-maps were created from the thematic data using Nvivo software.

The results demonstrated that among current issues prevailing in prisons, overcrowding was regarded as the most severe issue. Additionally, in most cases, there is no systemic classification of inmates. Concerning the potential challenges in the implementation of smart technologies in the prison buildings, being too old and outdated of prison buildings are a significant concern, followed by a substantial gap in the approval system of budget to purchase new smart technology.

The findings of this study are of vital importance and help to identify potential challenges involved in the implementation of smart technologies in prison buildings that should be taken into consideration before selecting any new smart technology.

The purpose of this paper is to explore the influence of health system factors on access to a quality healthcare among prisoners in Ghana.

Data were gathered using different qualitative methods (interviews and participant observation) with staff of the James Camp Prison, Accra. Findings were analyzed using a framework method for the thematic analysis of the semi-structured interview data; and interpreted with the theoretical perspective of health systems thinking and innovation.

The study concludes that health system factors such as inadequate funding for health services, lack of skilled personnel and a paucity of essential medical supplies and drugs negatively affected the quality of healthcare provided to inmates.

The limited facilities available and the sample size (healthcare workers and prison administrators) impeded the achievement of varied views on the topic.

The paper recommends the need for health policy makers and authorities of the Ghana Prison Service to collaborate and coordinate in a unified way to undertake policy analysis in an effort to reform the prisons healthcare system.

The national health insurance scheme was found to be the financing option for prisoners’ access to free healthcare with supplementation from the Ghana Prison Service. The study recommends that policy makers and healthcare stakeholders should understand and appreciate the reality that the provision of a quality healthcare for prisoners is part of the entire system of healthcare service delivery in Ghana and as such should be given the needed attention.

This is one of few studies conducted on male only prisoners/prison in the context of Ghana. It recommends the need for an integrated approach to ensure that the entire healthcare system achieves set objectives in response to the primary healthcare concept.

This paper seeks to understand relationships between prison healthcare and integrated care systems (ICS), including how these affect the delivery of new healthcare interventions. It also aims to understand how closer integration between prison and ICS could improve cross system working between community and prison healthcare teams, and highlights challenges that exist to integration between prison healthcare and ICS.

The study uses evidence from research on the implementation of a pilot study to establish telemedicine secondary care appointments between prisons and an acute trust in one English region (a cross-system intervention). Qualitative interview data were collected from prison (n = 12) and community (n = 8) healthcare staff related to the experience of implementing a cross-system telemedicine initiative. Thematic analysis was undertaken on interview data, guided by an implementation theory and framework.

The research found four main themes related to the closer integration between prison healthcare and ICS: (1) Recognition of prison health as a priority; (2) Finding a way to reconcile networks and finances between community and prison commissioning; (3) Awareness of prison service influence on NHS healthcare planning and delivery; and (4) Shared investment in prison health can lead to benefits.

This is the first article to provide research evidence to support or challenge the integration of specialist health and justice (H&J) commissioning into local population health.

Prisons in the sub-Saharan African region face unprecedented challenges during the COVID-19 pandemic. In Malawi, the first prison system case of COVID-19 was notified in July 2020. While prison settings were included in the second domestic COVID-19 response plan within the Law Enforcement cluster (National COVID-19 preparedness and response plan, July–December 2020), they were initially not included in the K157bn (US$210m) COVID-19 fund. The purpose of the study was to assess prison preparedness, prevention and control of COVID-19 in Malawi..

A multi-method situation assessment of the COVID-19 response and human rights assurance of prisoners and staff was conducted in a large prison complex in Malawi. Qualitative research underpinned by the Empirical Phenomenological Psychological (EPP) framework consisted of interviews with key informants such as prison health personnel, senior prison staff, penal and judicial policymakers, government and civil society organisations (n = 14) and focus group discussions with consenting male (n = 48) and female prisoners (n = 48) and prison wardens (n = 24). Prison site visits were supported by detailed observations based on the World Health Organisation Checklist for COVID-19 in prisons (n = 9). Data were collected and analysed thematically using the EPP stepwise approach and triangulated based on Bronfenbrenner’s model conceptualising COVID-19 as a multi-level event disrupting the prison eco-system.

The results are presented as MICRO-MESO level individual and community experiences of incarceration during COVID-19 spanning several themes: awareness raising and knowledge of COVID-19 in prisons; prison congestion and the impossibility of social distancing; lack of adequate ventilation, hygiene and sanitation and provisions and correct use of personal protective equipment; MESO-MACRO level interplay between the prison community of prisoners and staff and judicial policy impacts; medical system COVID-19 response, infrastructure and access to health care; COVID-19 detection and quarantine measures and prisoner access to the outside world.

This unique situation assessment of the Malawian prison system response to mitigate COVID-19 illustrates the dynamics at the micro-level whereby prisoners rely on the state and have restricted agency in protecting themselves from disease. This is due to severe structural inadequacies based on low resource allocation to prisons leading to a compromised ability to prevent and treat disease; an infirm and congested infrastructure and bottlenecks in the judicial system fuelling a continued influx of remand detainees leading to high overcapacity. Multi-pronged interventions involving key stakeholders, with prison management and line Ministry as coordinators are warranted to optimise COVID-19 interventions and future disease outbreaks in the Malawian prison system.

Mental illness affects the majority of prisoners. Mental health issues are beginning to take a central position in the development of prison health services, reflecting this burden of disease. This change in focus is not before time. But prison mental health services cannot exist in isolation. Public health systems should lead provision of care for patients with acute and severe illness. A whole prison approach to health and, specifically, mental health will offer the greatest likelihood that offenders will thrive, benefit from imprisonment, and lead law‐abiding lives after release. Public awareness of the scale and commitment of prisons to mental health and illness, and understanding of prisons’ role in society, are necessary developments that would protect and enhance public mental health, as well as creating a healthier and safer society. This article draws on recent reviews, information and statements to set out a public health agenda for mental health in prisons.

Overcrowding in prisons has a negative impact on health care and consequently the international standards insist that accommodation for prisoners must include sufficient space. Despite this, the article shows that overcrowded prison systems, defined as those holding more prisoners than they are intended to accommodate, are to be found in every part of the world; indeed, almost 70% are overcrowded, and many others are overcrowded in some prisons. Moreover, overcrowding is not just widespread; it is often severe, with many prison systems having levels of occupancy that far exceed the official capacity. Furthermore, the official capacities of prisons often allow insufficient space per prisoner, so that there is in fact overcrowding even in prison systems where the prison population is lower than the officially stated capacity. Again, prison populations continue to rise, often without parallel increases in the space available. It is suggested that attempts to improve prison health should include strategies to reduce prison populations and eliminate overcrowding.

This review integrates and builds linkages among existing theoretical and empirical literature from across disciplines to further broaden our understanding of the relationship between inequality, imprisonment, and health for black men. The review examines the health impact of prisons through an ecological theoretical perspective to understand how factors at multiple levels of the social ecology interact with prisons to potentially contribute to deleterious health effects and the exacerbation of race/ethnic health disparities.

This review finds that there are documented health disparities between inmates and non-inmates, but the casual mechanisms explaining this relationship are not well-understood. Prisons may interact with other societal systems – such as the family (microsystem), education, and healthcare systems (meso/exosystems), and systems of racial oppression (macrosystem) – to influence individual and population health.

The review also finds that research needs to move the discussion of the race effects in health and crime/justice disparities beyond the mere documentation of such differences toward a better understanding of their causes and effects at the level of individuals, communities, and other social ecologies.