Abstract

The Irish Red Cross Global Hub for Community-Based Health in Detention (CBHinD) was established in 2022 through an MoU with the ICRC and IFRC. Recognised by WHO (Europe) Health in Prisons Project (HIPP) as best practice, it is based on a multidisciplinary, peer-led "whole prison approach" (WHO, 2007). Originating in Irish prisons over 15 years ago, the programme empowers trained prisoner volunteers to deliver preventive health initiatives within formal prison health systems.

Replicated in Australian (ARC 2018) and Norwegian prisons (NRC 2020; 2022), with training support from the Irish Red Cross, Irish Prison Service (IPS), and Education and Training Board, the programme follows an Action Research framework (UWO 2023).

Key peer-led initiatives include:

• HIV/HCV testing advocacy, resulting in high participation and detection of undiagnosed HCV cases (Bannion et al 2016; Crowley et al 2018; IRC 2017).

• Latent TB testing support, enabling curative treatment for those at risk of developing active TB (Phillips 2022).

• Weapons amnesties, reducing violent incidents by over 50% post-intervention (Abiodun et al 2015; UWO 2015).

• Lifestyle change programmes, supporting inmates with NCDs like type II diabetes to improve health and reduce medication use.

• Mental health support, facilitated by volunteers and psychologists, showed statistically significant improvements in inmate wellbeing using the Warwick-Edinburgh Scale (IPS 2019; UWO 2023).

Participants also reported increased self-esteem and personal development, aiding reintegration and health behaviour transfer post-release (Marron et al 2022; Greene et al 2017). These benefits have been mirrored in international adaptations of the programme.

Volunteers played a crucial role during the COVID-19 pandemic, particularly in preparedness and vaccine advocacy, achieving 79% compliance (UWO 2023).

This paper presents an overview of the CBHinD initiative and its growing global replication as a model for community-driven, cost-effective prison health reform.