Who are Prison Healthcare Service Users in Northwestern Ethiopia? And what factors are associated with use? A cross sectional study

Abstract Background: Studies on inmates’ Health Care Service (HCS) utilization are scarce and findings about the factors associated with HCS utilization are inconsistent. Studies over inmates’ use of HCS and associated factors are unavailable in Ethiopia. The present study, therefore, examined inmates’ HCS utilizations and associated factors in Northwestern Ethiopia. Methods: The study employed institution-based cross sectional research design and data is collected using questionnaire from 422 inmates in three prisons. The questionnaire collects data about prisoners’ demography, imprisonment related information and HCS utilization. Descriptive statistical techniques as well as bivariate and multiple logistic regressions were used to analyse the data. Results:The study found that 72.5%, 66.1% and 13.3% of the inmates, respectively, use medical services, guidance and counseling services and psychiatric services. Inmates with primary education (AOR=2.256, p<0.05, 95% CI= 1.155, 4.408), with secondary education (AOR= 1.955, p<0.05, 95% CI=1.012, 3.779), know the availability of the services (AOR=8.103, p<0.01, 95% CI= 4.405, 14.903) were more likely to use medical services. Inmates with accused status (AOR=.386, p<0.05, 95% CI= .183, .811) were less likely to use medical services than inmates with convict status. Divorced marital status (AOR= 7.015, p<0.05, 95% CI=1.524, 32.290) and knowledge of the service availability (AOR= 4.169, p<0.01, 95% CI=2.224, 7.817) are associated with high guidance and counseling service use. An increase in the length of stay in the prison is associated with a decrease in psychiatry service use (AOR= .455, p<0.01, 95% CI=.311, .665) while knowledge of service availability is associated with higher odds of psychiatry service use (AOR= 29.028, p<0.01, 95% CI= 12.363, 68.159). Conclusions: There are high medical care service utilizations while low mental health care service utilizations in among inmates in Northwestern Ethiopia. Based on the results of the study, it can be recommended that there is a critical need for nationwide study to better understand inmates HCS utilization and immediate health care service promotion and education measures need to be in place.