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A human rights assessment of menopausal women's access to age- and gender-sensitive nondiscriminatory health care in prison.

IMPORTANCE AND OBJECTIVE: Women represent about 6% of the global prison population of 11 million. The female prison population has increased significantly in the past decade. Where attention is devoted to women's unique sexual and reproductive health needs in prison, this is largely focused on menstruation management and ante/postnatal care. There is no explicit guidance regarding imprisoned menopausal women's health care in the United Nations normative standards of detention (Mandela Rules, Bangkok Rules). A human rights assessment of menopausal women's access to age- and gender-sensitive nondiscriminatory health care in prison since 2010 was conducted.

METHODS: Arksey and O'Malley's scoping review methodology was adhered to. A systematic search was conducted using detailed MeSH terms on CINAHL, MEDLINE, PubMed, ProQuest Central, PsycInfo, Scopus, and the Web of Science. All published materials in the English language in the time frame of 2010-2022 were collated (n = 268). Fourteen duplicates were removed. Two hundred thirty-four were excluded after title and abstract screening, with five records remaining. Hand searching yielded an additional 11 records. Sixteen records were charted and analyzed thematically using a human rights lens. Themes were the following: environmental conditions and menopausal sequelae, gender-sensitive nondiscriminatory free health care, evidence-based age/gender-sensitive prison health policies, and medical insensitivity and incompetencies in menopausal care.

DISCUSSION AND CONCLUSION: Menopausal women have the right to the underlying environmental determinants of health in prison and rights to nondiscrimination and equivalence of care, essential medicines, medical care and treatment, preventive health services, and participation in the generation of prison policies and support initiatives. The lack of visibility regarding their health needs in policies and healthcare provisions is reflected in the realities of life in prison, with glaring gaps in the practical medical and lifestyle supports of menopause. Further research is warranted to inform evidence-based prison reforms to improve the quality of life of older women in prison.

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