Women’s healthcare needs and access across the incarceration pathway in Israel: a qualitative study

Background: Within punitive, under-resourced, and male-dominated incarceration systems, the healthcare needs of incarcerated women are often overlooked and inadequately addressed. This study aimed to explore the healthcare needs and access to care among formerly incarcerated women in Israel. Methods: We employed an exploratory-descriptive qualitative design, and interviews were conducted with eighteen formerly incarcerated women, purposively recruited from the Prisoner Rehabilitation Authority in Israel. Data were analyzed inductively using thematic analysis. Results: We group our findings into three overarching themes, representing the time-points illustrated by the participants: before incarceration, during incarceration, and after release from prison. Our themes illustrate the complex physical and mental health needs of formerly incarcerated women in Israel, perceived impact of incarceration on health, challenges faced by women with disabilities, discontinuity of care across stages of incarceration, mistrust in the prison medical system, systemic barriers to accessing timely and appropriate healthcare, and post-release support. Conclusions: This study emphasizes the urgent need for a trauma-informed, gender-responsive, and continuity-based approach to healthcare within carceral settings. Our findings support the need for integration of prison health services into the national health system and call for system-wide, cross-sectoral, and human rights-based policy frameworks that promote prevention, rehabilitation, and adequate mental and physical healthcare in prison. Integrating prison healthcare within the broader national health system is crucial for reducing health inequalities by improving continuity of care, transparency, and the effective sharing and reporting of health information.