The purpose of the study was to evaluate the health care of children living with their mothers in prison. No previous studies on this topic have been conducted in Italy.
Italian law allows female prisoners to keep their babies with them until the age of 3 years in specific nest areas. Currently, there are 15 nest areas in Italian prisons, 2804 female inmates, 64 prisoners with children aged <3 years and 64 children.1 Our study was performed in the female detention centre of Roma‐Rebibbia, Rome, Italy.
From 2003 to 2005, 150 children were admitted, with 211 accesses in all (table 1).
Table 1 Demographics of children and morphological parameters on admission.
| Age in months, mean (median) | 9.79 (9.40) |
| Age in months, n (%) | |
| <1 | 15 (7) |
| 2–12 | 110 (52) |
| 13–24 | 54 (26) |
| 25–36 | 29 (14) |
| Unknown | 3 (1) |
| Sex, n (%) | |
| Male | 80 (53.3) |
| Female | 70 (46.7) |
| Place of birth, n (%) | |
| Italy | 133 (88.67) |
| European union | 8 (5.33) |
| East European States | 5 (3.33) |
| South America | 1 (0.67) |
| Unknown | 3 (2) |
| Race or ethnicity, n (%) | |
| East European | 101 (67.33) |
| Italian | 6 (4) |
| European union | 6 (4) |
| South American | 5 (3.33) |
| African | 2 (1.33) |
| Unknown | 30 (20) |
| Mean birthweight in g, | 2800 |
| Weight in centile, n (%) | |
| <10 | 38 (18.01) |
| 10–25 | 34 (16.11) |
| >25 | 72 (34.12) |
| Unknown | 67 (31.75) |
The low mean age and body weight on admission suggest that these children represent a vulnerable group with particular healthcare needs. Inadequate housing and food, poor information about previous medical care, lack of screening at birth and of an adequate immunisation are some challenges of these families. Socioeconomic, cultural and linguistic barriers thwart these children from accessing basic healthcare services.
Children received good assistance inside the prison. Several medical examinations were conducted by paediatricians, doctors on call and other specialists. Children required medical care out of prison in case of severe diseases. Causes of hospitalisation were similar in inmates and non‐inmates. After the stay in prison, 11% of children evaluated for a period >3 months showed a catch‐up growth.
A small percentage of children had an adequate immunisation status before entering the prison. During their stay, the immune status of 21 (14%) children was adjusted (table 2).
Table 2 Children examinations, reasons for hospitalisation and immunisation status.
| Admissions | |
| 1 | 105 (70) |
| 2 | 33 (22) |
| 3 | 8 (5.33) |
| 4 | 4 (2.66) |
| Total children | 150 (100) |
| Total admissions | 211 |
| Examinations in prison | |
| Paediatrician | 981 (42.85) |
| Doctor on call | 1282 (56) |
| Other specialist | 26 (1.15) |
| Total | 2289 (100) |
| Emergency room | 8 |
| Hospitalisation | 24 |
| Immunisation status | |
| Adequate | 21 (14) |
| Unknown | 81 (54) |
| Inadequate | 48 (32) |
| Adequate after prison | 42 (28) |
| Vaccination in prison | |
| Hexavalent | |
| 1 dose | 17 (11.33) |
| 2 doses | 3 (2) |
| 3 doses | 1 (0.67) |
| MMR | 2 (1.33) |
Values are n or n (%).
Hexavalent, DTAP‐IPV‐HIb‐HBV
There should be a balance between the possible damage of separating children from their mothers and the potential harm to children kept in prison. Parental contact is fundamental for the child and must be guaranteed inside the prison as a constitutional principle. The mother and baby relationship can promote prisoners' rehabilitation to the community. The choice to separate mothers and children is rarely justified; it often took place because of the inadequacy of the detention centre.2
However, in Roma‐Rebibbia Female Detention Centre, that the general health of these children is paramount. The high number of medical examinations is probably because of the availability of medical assistance 24 h a day. Catch‐up growth depends on the improved intake of more nourishing food and the continuous medical assistance. The low percentage of children whose immune status was adjusted is probably a result of the short duration of their stay in prison of most of the children.
Further data are warranted in order to understand the complex conditions of this population and improve health promotion. Our proposals are the introduction of a computerised paediatric clinical diary on a national scale; more attention to be paid to on healthcare promotion by providing healthcare educational programmes; and optimisation of the immunisation programme in accordance with the recommended schedule for healthy infants and children.3
Prison may act as a gateway to facilitate the health and general well‐being of these babies. A civil society is one that cares for its babies.
Footnotes
Competing interests: None declared.
References
- 1.Ministero della giustizia Pianeta carcere. Dipartimento dell'Amministrazione penitenziaria‐Ufficio per lo sviluppo e la gestione del sistema informativo automatizzato‐sezione statistica. (Ministry of justice. Detention centre. ) http://www.giustizia.it/pcarcere/attualita/indice.htm (accessed 13 Nov 2006)
- 2.Dillner L. Keeping babies in prison. BMJ 1992304932–933. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 3.American Academy of Pediatrics 2003 Red book: report of the committee on the infectious diseases. 26th edn. Elk Grove Village, IL: American Academy of Pediatrics, 2003141