John Vincent E. Lacuesta, RN, MPH

Accessibility and Availability of Healthcare Services in Jail Facilities among Persons Deprived of Liberty (PDL) in Dumaguete City, Philippines

Introduction

Accessibility and availability of healthcare services in jail facilities among persons deprived of liberty (pdl) in dumaguete city, philippines. Investigate healthcare access & availability for Persons Deprived of Liberty in Dumaguete City jails. Understand influencing factors like age, sex, and perceived needs for better prison health.

Abstract

Background. Access to prison healthcare and healthcare equity remains poorly understood in the Philippines. With Philippine jail health systems subjected to budgetary restrictions, optimization of efficient mechanisms in healthcare delivery is warranted. This makes understanding how PDLs’ utilization to healthcare services more relavant and of high importance. Objectives. This study sought to determine healthcare accessibility and explored what influences healthcare access by Persons Deprived of Liberty (PDLs). Additionally, the study looked into whether healthcare was equally accessible to different PDL subgroups. Methods. A descriptive-correlational design was employed in recruiting 261 PDLs utilizing stratified random sampling in two jail facilities in Dumaguete City from May to June 2023. Data on healthcare accessibility and availability from self-report survey questionnaires were analyzed using SPSS version 25. Results. Hierarchical linear regression analysis shows that, collectively, predisposing factors (age, sex) F=200.82, enabling resources (availability of health services) F=52.52, and perceived needs (physical activities, sleep, diet, and mental health) F=30.24 significantly predict healthcare accessibility, having the availability of healthcare services as the strongest predictor with an R2 change of 43.7% followed by percieved needs (3.9%) and predisposing factor (1.4%), respectively. Furthermore, ordinal logistic regression analysis shows that healthcare by age groups 18-34 (OR=0.379) and 35-54 (OR=0.449) are less likely to be available and accessed than those aged 55 and above. Additionally, availability and accessibility of healthcare are less likely for males (OR=0.24) than females while PDLs with average physical activities (OR=0.87), good (OR=50.7) to average sleep (OR=27.4), and average mental health (OR=0.35) have higher odds of availing and accessing healthcare than their poor counterparts. Conclusion. These findings indicate that PDLs tend to access healthcare services based predominantly on availability rather than their desired needs warranting strategies that allow catering to a wide range of health needs in PDL subgroups which ultimately lead to better prison health outcomes.

Review

This study addresses a critically important and under-researched area concerning healthcare access and availability for Persons Deprived of Liberty (PDL) in Philippine jail facilities, offering valuable insights into a vulnerable population often overlooked in health equity discussions. The background clearly establishes the research gap and the urgency for understanding healthcare utilization within a resource-constrained system. The objectives are well-defined, aiming to not only determine accessibility but also to explore influencing factors and subgroup disparities. The methodological approach, employing a descriptive-correlational design with stratified random sampling across two facilities and utilizing robust statistical analyses like hierarchical linear regression and ordinal logistic regression, appears sound and appropriate for achieving the stated objectives. The findings presented are compelling and highly relevant. The identification of healthcare service availability as the strongest predictor of accessibility, significantly outweighing perceived needs, highlights a fundamental structural challenge within the system. Furthermore, the detailed subgroup analysis revealing disparities based on age, sex, physical activities, sleep, and mental health status provides crucial empirical data that can inform targeted interventions. For instance, the finding that younger PDLs and males are less likely to access care than their older and female counterparts, respectively, prompts further inquiry into the underlying reasons and potential barriers specific to these groups. While the R-squared change values provide a clear measure of predictive strength, a deeper qualitative understanding of *why* certain disparities exist (e.g., stoicism in males, limited awareness among younger PDLs) would further strengthen the practical implications. Overall, this study makes a significant contribution to the nascent body of literature on prison health in the Philippines. Its findings strongly advocate for a shift towards more proactive and needs-based healthcare provision rather than solely relying on the current, likely limited, availability. The identified disparities underscore the necessity for tailored health strategies that cater to the diverse health profiles and unique challenges of different PDL subgroups. This research provides a solid foundation for policy recommendations aimed at improving healthcare equity, optimizing resource allocation, and ultimately enhancing health outcomes for PDLs in the Philippines, warranting further investigation into implementation strategies and the long-term impact of such interventions.

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