As a setting, prisons offer a unique opportunity to invest in the health of disadvantaged and marginalised populations and address health inequalities and social exclusion – thereby achieving sustainable improvements in well-being for offenders and their families and in turn, helping to reduce rates of re-offending. This article draws on English and French experiences and doctoral research to advocate a shift from a pathogenic model towards a salutogenic model of health as a helpful way to address inequalities and thus, by promoting joined-up working across justice and wider systems, impact positively beyond ‘health’ for the effective resettlement of prisoners. The paper utilises examples from horticulture to further argue the powerful role of nature in the prison setting in mediating aspects of culture particularly relating to processes of socialisation. Critical success lies in bridging across systems and a commitment to joined-up working at all levels across and beyond prison.

Purpose: In the context of current prison safety and reform, the purpose of this paper is to discuss findings of an impact evaluation of a horticultural programme delivered in 12 prisons in North West England. Design/methodology/approach: The programme was evaluated using quantitative and qualitative methods, including Green Gym© questionnaires, the Warwick Edinburgh Mental Wellbeing Scale (WEMWBS) and Biographic-Narrative Interpretive Method interviews. Findings: Against a backdrop of high rates of suicide, self-harm and poor mental health, the horticultural programme studied proved beneficial to prisoner participants, the most marked effect was on mental health and wellbeing. In addition to data related to the original mental health outcome indicators, the study revealed multiple layers of “added value” related to mental health arising from horticultural work in a prison setting. Research limitations/implications: The main research limitations were the limited completion of follow-on questionnaires due to prisoners being released and the inability to conduct longitudinal data collection post-release. There was also concern about response bias and lack of resource to compare with the experience of prisoners not participating in the programme. Social implications: Positive impacts on prisoners’ mental health and wellbeing included increased confidence, social interactions with staff and other prisoners and gaining skills and qualifications and work experience, increasing potential for post-release employment. Originality/value: Benefits of horticulture work on health are well established. However, to date, there is little research concerning the effects this work may have on mental wellbeing of prisoners both within prisons and more so upon their release back into the community.

The health needs of women in sub-Saharan African prisons are both neglected and poorly understood. Outside South Africa, little research exists on African prison health; what is available tends to be gender-blind and concerned with disease prevention rather than with health promotion. While Vetten ( 2008 Vetten L (2008) ‘The imprisonment of women in Africa’ in J Sarkin (Ed) (2008) Human Rights in African Prisons, Cape Town: Human Sciences Research Council (HSRC) Press. [Google Scholar] ) has raised this concern previously, a comprehensive overview of women's health and health promotion in African jails is clearly absent. Available evidence shows that the conditions in African prisons are harmful to health, justifying a need for a health promoting prisons agenda rooted in the needs of sub-Saharan Africa. Women prisoners have significant mental and physical health needs, and international conventions on health care are not being respected globally. The health promoting prison concept has considerable attention in the Global North, with a commitment to equivalence of health care, gender sensitivity and to prisoners’ social as well as health needs. This article provides an opportunity for critical reflection on women's health in prison, shows the lack of research in this area, questions the suitability of the health promoting prisons’ agenda for sub-Saharan Africa, draws on our limited experience of the women's prison in Lusaka, Zambia, and produces recommendations to tackle women's health and wellbeing needs within the criminal justice systems of sub-Saharan Africa.

Purpose: This paper reports on insights from an evaluation of Birth Companions (BC) (a UK-based charity) perinatal support in two prison settings in England. The initiative involved the provision of group and/or one-to-one perinatal support and training women prisoners as peer supporters. Design/methodology/approach: A mixed-methods study was undertaken that involved observations of support groups and peer support supervision sessions (n = 9); audio recorded interviews (n = 33) with prison and health-care staff, women in prison, peer supporters and BC staff; analysis of existing routinely collected data by BC and notes undertaken during regular meetings (n = 10) with the BC Project Manager. Thematic analysis was undertaken supported by MAXQDA qualitative data analysis software. Findings: BC provided instrumental/practical support, emotional support, information support, signposting to services and advocating for women to the prison concerning their perinatal needs and rights. Key themes revealed that support had an impact on the lives of perinatal women by creating a safe place characterised by meaningful interactions and women-centred approaches that facilitated access to wider care and support. The service made a difference by empowering women and providing added value for peer supporters, prison, health-care and BC staff. Key enablers and strategies for the care of perinatal women and the delivery of perinatal support are also detailed. Originality/value: Through longitudinal data and the involvement of a range of stakeholders, this study evidences the subtleties of support provided by BC and the potential it has to make a difference to perinatal women in prison and those volunteering or working within the prison system.