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Over 30 million people spend time in prisons and other closed settings each year. These populations remain one of the most marginalised and excluded groups when it comes to accessing and realising their sexual and reproductive health rights.

Those who are young, and/or disabled, and/or HIV positive, and/or female, experience even greater challenges and discrimination. 

Globally, the prevalence of HIV, sexually transmitted infections, hepatitis B and C and tuberculosis in prison populations can be up to 50 times as high as it is in the general population.

Prison health services provided are often substandard and under-funded, characterised by chronic staff shortages, poor nutrition, and a lack of essential medications. 

Project focus: Promoting human rights and health in prisons

VSO peer educator JK in Zimbabwe ©VSO/Cynthia Matonhodze

JK found a fresh sense of purpose as a volunteer peer educator in prison, and a new lease of life upon his release.

We work across four countries in Southern Africa – eSwatini, Malawi, Zambia and Zimbabwe – to improve the health and wellbeing of highly vulnerable, marginalised and neglected prison populations.

Our innovative approach includes working directly with prisoner volunteers, as well as advocating for policy reform and holding authorities to account to ensure that quality health services are available and accessible. 

Developing peer support groups 

Peer support groups provide invaluable services to fellow prisoners, including: 

  • raising awareness of communicable diseases and better hygiene practices; 
  • cell-based care for those who have been discharged from prison hospital but are still unwell; 
  • psychosocial support; 
  • antiretroviral adherence and nutrition advice. 

Volunteers are at the heart of this peer support model. We’ve trained over 400 volunteer peer educators and counsellors, equipping them with the skills they need to form groups and provide effective advice and support to their fellow inmates. 

Raising awareness 

Alongside peer support groups, we work to increase prisoners’ awareness of their sexual and reproductive health rights, through accessible and engaging novel approaches. Our pilot project in partnership with Tackle Africa uses football coaching to raise awareness amongst both prisoners and staff. 

Holding authorities to account 

As well as supporting prison-based volunteers directly, we work closely with authorities and prison staff to advocate for accessible health services. We empower inmates to understand their right to healthcare, and challenge the relevant authorities when these rights aren’t being met. 

Other areas of our work supporting healthy communities