Abstract
OBJECTIVE To analyze the influence from context characteristics in the control of tuberculosis in prisons, and the influence from the program implementation degrees in observed effects.METHODS A multiple case study, with a qualitative approach, conducted in the prison systems of two Brazilian states in 2011 and 2012. Two prisons were analyzed in each state, and a prison hospital was analyzed in one of them. The data were submitted to a content analysis, which was based on external, political-organizational, implementation, and effect dimensions. Contextual factors and the ones in the program organization were correlated. The independent variable was the program implementation degree and the dependent one, the effects from the Tuberculosis Control Program in prisons.RESULTS The context with the highest sociodemographic vulnerability, the highest incidence rate of tuberculosis, and the smallest amount of available resources were associated with the low implementation degree of the program. The results from tuberculosis treatment in the prison system were better where the program had already been partially implemented than in the case with low implementation degree in both cases.CONCLUSIONS The implementation degree and its contexts – external and political-organizational dimensions – simultaneously contribute to the effects that are observed in the control of tuberculosis in analyzed prisons.
Highlights
The implementation degree and its contexts – external and political-organizational dimensions – simultaneously contribute to the effects that are observed in the control of tuberculosis in analyzed prisons
The actions aiming to control tuberculosis (TB) in the Brazilian prison system were standardized by Brazilian National Prison System Health Care Plan, in 2003, and by the recommendations from Brazilian National Tuberculosis Control Program, in 2010
The integration among penitentiary and health care management bodies at federal, state, and municipal levels is fundamental for the development of actions with established purposes by professionals who are motivated and qualified to promote early diagnose and successful treatment.17,a The Municipal Health Care Offices of cities housing prisons contribute to the conduction of complementary exams, more complex actions, and health care to inmates
Summary
The actions aiming to control tuberculosis (TB) in the Brazilian prison system were standardized by Brazilian National Prison System Health Care Plan, in 2003, and by the recommendations from Brazilian National Tuberculosis Control Program, in 2010. Each federated unit plans and executes their Plano Operativo Estadual (POE – State Operation Plans) for Prison Health Care. There may be different ways to organize and manage the actions. The integration among penitentiary and health care management bodies at federal, state, and municipal levels is fundamental for the development of actions with established purposes by professionals who are motivated and qualified to promote early diagnose and successful treatment.17,a The Municipal Health Care Offices of cities housing prisons contribute to the conduction of complementary exams, more complex actions, and health care to inmates. Educational measures and measures to improve environmental conditions are required to control the disease in prisons.b
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