Narratives of incarcerated women in a Prison in Malawi: a qualitative study

Abstract

Background

In Malawi, women in prisons make up 2.7% of the total prison population. However, the experiences of women incarcerated are not well documented in the literature. We aim to describe the experiences of women incarcerated in a Malawian prison facility. We will concentrate on the qualitative findings that highlight the unique perspectives of these women, including those in which they are imprisoned alongside their children, as well as the larger implications for child welfare and prison policy.

Methods

A qualitative approach using descriptive study design was used to explore the experiences of incarcerated women in prisons in Malawi. In-depth interviews were conducted with seven incarcerated women (n = 7). The interviews followed a semi-structured interview guide, and the data were analyzed manually using thematic analysis.

Results

The following four themes emerged from the data: the burden of conviction, prison as a traumatic environment, health insecurity and perceptions regarding release from prison. Participants reported that being convicted caused significant psychosocial stress. The incarcerated women stated that they are subjected to inhumane and degrading treatment. The prison conditions are poor. The nutrition is inadequate for both incarcerated women and their children. Incarcerated women look forward to their release, citing that they have been transformed and are optimistic about their new lives. Prison living made them calmer and more patient. Others express concern that the stigma of incarceration will inhibit their ability to reconnect with the community upon release.

Conclusion

Understanding women’s experiences in Malawian prisons can inform policy and improve standards of living for incarcerated women in Malawian prisons.

Introduction

Globally, incarcerated women are a minority within the prison population worldwide; they represent between 2% and 9% of a nation’s prison population [1]. Globally, the number of incarcerated women has increased more in recent decades when compared to male incarcerated persons [1]. The percentage of female incarcerated persons in America was 8.4% in 2017, which is the largest female prison population in the world [2]. The prison population in Malawi as of October 2022 was 16,366 incarcerated individuals, and 1.1% were female [3]. The Malawi prison facilities face significant overcrowding, often exceeding their designed capacities, which exacerbates issues related to healthcare, sanitation, and access to basic necessities [4, 5]. This overcrowding leads to a challenging environment that affects the well-being of all women in prisons, contributing to serious health issues and a high risk of mortality [6]. Additionally, incarcerated persons in Malawi face human rights violations due to poor infrastructure and inhumane treatment of incarcerated people [7].

Globally, incarcerated women face higher physical and mental health challenges than their male counterparts, including depression, self-harm, suicidal ideation, and suicide attempts [8]. They face obstacles like separation, grief, loss, behavioral issues, stigma, and stress [9, 10]. In Malawi, incarcerated women are permitted to have their children live with them in prison. However, this arrangement is limited to children under the age of five [11]. This policy aims to support the early development of children during their formative years. There is no specific limit on the duration as long as the child remains under this age threshold. The practice of allowing children to stay with their mothers in prison is not without its challenges [12]. There are concerns about the psychological and physical well-being of both mothers and children in such an environment. Moreover, the lack of proper facilities and support systems exacerbates these issues [12].

Incarcerated women in Malawi range widely in age, and many are young adults [11]. A significant number are in their 20s and 30s, though older women and minors may also be present. The incarcerated women reflect the diverse ethnic makeup of Malawi, with the Chewa, Yao, and Lomwe being among the most prominent groups. Women in Malawi’s prisons are incarcerated for a variety of offenses, including theft and robbery, drug-related offenses, domestic violence and homicide, sometimes as a result of self-defense or abuse, economic crimes, often linked to poverty or lack of access to resources [11]. Many incarcerated women are single, though some are married or in relationships. The stigma associated with incarceration can complicate their relationships with family and partners [11]. A significant portion of incarcerated women are mothers. They often face unique challenges, as many may have young children who are left without adequate care or support during their imprisonment. There is essentially limited studies on the experiences of incarcerated women in Malawi’s urban prisons. Gadama et al. [13] reported on the health and needs of incarcerated women and their children in Malawi. This qualitative study is aimed at exploring the lived experiences of incarcerated women in Malawian prison.

Methodology

Study approach and design

This study utilized a qualitative, descriptive research approach. The approach was ideal in this study because it offers a comprehensive summary of the phenomena where there is a dearth of knowledge within a particular subject; it also addresses the ‘who, what, and where’ of participants’ experiences [14].

Study setting and population

This study was conducted at a prison facility in urban settings in the Central region of Malawi. Prisons in Malawi generally accommodate both men and women, although they are typically housed in separate areas within the facilities. The security levels vary, with some prisons designated as minimum security and others as maximum security, depending on the nature of the offenses committed by the incarcerated individuals and the facility’s capacity. Our study setting was designed as minimum security. The study population comprised incarcerated women who had been given prison sentences. The prison warden advertised verbally about the study to the groups of women at the facility. Women interested in participating in the study presented themselves to the warden, who then arranged a meeting with the researchers. The inclusion criteria were as follows: willingness to participate in the study, physical and mental conditions that ensure that participation is freely consented to, and coherent answers. The seven incarcerated women, two of them with children, participated in a study with socio-demographic and legal characteristics illustrated in Table 1. They were invited to an interview and informed about study objectives.

Table 1 Socio-demographic and legal characteristics of incarcerated women

Ethical considerations

All methods were performed in accordance with the relevant guidelines and regulations. Clearance from the national prison authorities was sought so as to have access to the prison. Ethical approval for the study was obtained from the Ethics Committee, Malawi’s National Health Sciences Research Commission (NHSRC), with reference number 22/03/288. All participants were fully informed about the study and signed a written informed consent and that they participated voluntarily. To ensure confidentiality, participants were assigned codes, and names were not used in the study. Participants were allowed to ask questions and could withdraw at any time. The decision to participate, or decline to participate, in the study had no impact on their sentence or treatment, and confidentiality was maintained through identification numbers on interviews, documents, and notes. Participants were offered refreshments as a way to compensate for the time spent during the interviews.

Data collection procedure

In May 2023, data was collected through in-depth interviews using a semi-structured interview guide. The guide included demographic questions and open-ended questions (supplemental material). This tool was created to collect information on knowledge, perceptions, behaviors, and experiences related to HIV/TB within prisons. We also examined issues of violence in prisons, including whether participants had ever witnessed physical, emotional, or sexual violence. The interviews were conducted in a room away from prison guards’ hearing distance, with a prison staff member monitoring the process. The interviews were audio-recorded in Chichewa and lasted 45–60 min.

Data analysis

The data analysis was conducted manually, guided by the thematic analysis. E.N listened to the recorded interviews and then transcribed them verbatim. All the interviews and transcripts were checked for accuracy against the original audiotapes. Transcripts were translated into English and translated back into Chichewa by two independent translators to ensure content consistency. E.N and research assistants coded each transcript independently. To ensure scientific rigour, a quality framework in thematic analysis was guided by Braun and Clarke [15]. This involved several key steps as follows:

• Reading and re-reading the transcription, individually and in pairs, to note early ideas;

• Coding in a systematic and logical manner and paying attention to interesting concepts and ideas within the data;

• Organizing codes into corresponding groups using an iterative process. Topics raised were grouped under potential thematic categories that were often renamed when a more appropriate title emerged. The ideas and issues that emerged were grouped into categories and further grouped into themes;

• Refining and reviewing these themes by E.N, examining the coherence of patterns across these themes and developing a thematic map;

• Final clear defining and naming of themes with data extracts representing and articulating the essence of these and overall analysis.

Trustworthiness of data

The study used four criteria for data trustworthiness: credibility, dependability, confirmability, and transferability [16]. Peer debriefing and member checking were employed to promote credibility, manage interviewer bias, and ensure conceptual clarity during data analysis and manuscript writing. Some of the participants and the research team gathered to review the research findings. Trustworthiness was achieved through the inclusion of participants’ verbatim narratives, and dependability was achieved through detailed reporting of study processes. Transferability was ensured through thick descriptive narratives, and confirmability was established through field notes, transcripts, and a reflexive diary kept by EN. All decisions agreed upon during peer debriefing were documented.

Results

The following themes emerged from the analysis of the participants’ narratives: (1) The burden of conviction; (2) Prison as a traumatic environment; (3) Health insecurity and (4) Perceptions towards prison release. Themes and sub-themes are presented in Table 2:

Table 2 Themes and subthemes

The burden of conviction

The participants’ accounts show that being convicted caused feelings of guilt, regret, desperation and anxiety:

‘…When I was convicted, I couldn’t take it, I could not believe…’(Participant #2).

‘…When I went to prison, I had a one-year-old child, regret and sadness were the order of the day, I felt very embarrassed about what I had done…’ (Participant# 6).

One of the major pains for the incarcerated women was separation from their families:

“…I felt sorry for my children when they came to see me here in prison; when they left, I cried and wondered who would look after them…” (Participant #7).

‘…. You think of your family and lack of care for your children…’ you cry the whole day …’(participant #6).

The mothers were also aware that they would be separated from their children when convicted; this feeling caused intense stress among them:

‘…The feeling of staying away from your children really hurts, as I don’t know who is taking care of them…’ (Participant #7).

‘…We are aware that children think about their mothers and we also miss them so much. Why are our children left behind and how will they survive? We are here for a year without seeing our children…’ (Participant 6).

The female incarcerated persons generally report that institutional adjustment is more difficult:

‘…It’s not easy to accept and adjust to the fact that you have been convicted and must live behind bars…’ (Participant #1).

‘…Staying inside the prison ruins all your plans; you don’t have time to see your children or family and can’t conduct any business. You are a type of person who constantly pleads. Life is really difficult on this planet…’ (Participant #2).

Prison as a traumatic environment

The interviewees lamented ill treatment in prison. An important finding of the study was the perceived mistreatment imposed by prison staff.

‘…When the prison wardens are in a bad mood, they shout at us, we feel bad, it hurts. They scream “What do you expect! That’s prison life. You understand…’ (Participant # 2).

‘…The prison wardens treat us as if we are nothing or trash, they tell us that we are useless …’(Participant # 5).

‘… Life is tough in prison; I used to cry every day and night. I regard myself as worthless when I think of the inhumane treatment inflicted on me. It is as if I’m not a human being, but rather an animal…’ (Participant #7).

The incarcerated women have had a negative experience with regards to the punishments the security personnel give them for minor offenses committed within the prison walls. The incarcerated women regard such punishments as unbearable and more like torture.

“Sometimes they tell us to jump like frogs for long hours over a long distance. Thus, the following day we are unable to walk properly because we have developed sores.…’ (Participant #2).

‘…When one inmate is wrong, they punish all of us. They call it ‘one for all’ punishment; the warden commands us to kneel down the whole day, from morning up to afternoon, imagine just kneeling down all these hours…’ (Participant #7).

‘…Sometimes they instruct us to carry firewood all day long. Other days, the prison wardens pour water on the ground and ask us to roll on the muddy ground. We roll the entire day under the observation of the prison officials. To be frank, one–for-all punishment is very unfair…’ (Participant #3).

Some of the incarcerated women were intending to commit suicide in order to escape inhumane treatment:

‘…Sometimes we think of committing suicide just to escape ill treatments. It really hurts how we are being treated. Imagine that sometimes we cry the whole day for many consecutive days. As a result, some of us lose weight enormously …’ (Participant #5).

‘… You even think of finding the worst means of getting rid of this torture. For example, suicide gets into our minds quickly so that we should no longer feel pain. Of course, torture has to come to an end…’ (Participant #4).

Some of the participants stated that they are ill-treated regularly:

‘…When a month goes by without actually ill-treating us, we wonder and praise God. When we see the wardens’ carrying pails of water approaching us, we get scared and know for sure that they are going to punish us severely…’ (Participant #5).

‘…We suffer overwhelming anxiety here… day-to-day life is really terrible in prison…’ (Participant #2).

The agony of being imprisoned encompassed husband abandonment and lack of support for children:

‘… My family suffers while I am here; for example, as I am behind the walls, my spouse is suffering too. My husband is not actually sleeping at home. He found a girlfriend in town; he spends about two weeks there, leaving my children alone at home. I was also disappointed when my husband’s girlfriend visited me here during the early days of my sentence. …’(Participant #7).

“…My family does not come to visit me here, … My husband has abandoned me; he has turned his back on me. …” (Participant #1).

Women in prison experience challenges in caring for their under-five children who live with them in prison. The study participants reported being denied access to timely medical care for their sick children:

‘… Healthcare access for children is a problem here: the children need to receive medical attention when they are ill. Sadly, what happens here is the opposite; when the child is sick, he/she is not referred to the hospital within a week. The prison officials allow us to bring our babies to the health facility when the condition gets worse …’(Participant # 6).

The prison conditions and diet for the children were described as horrible and hazardous for the physical and mental development of the minors. The following verbatim quotes illustrate this:

‘…The cells are over capacity; indeed, they are very full. We feel rib-aches when getting up in the morning due to overcrowding. Our children who are also living with us here experience the same. It is excessively hot in the cells, therefore children cry all night…’ (Participant #3).

“…Besides, the children are not well fed here, so they are not growing well. Look at them…” (Participant #4).

‘…The food is inadequate for the children and breastfeeding mothers. We live by God’s grace; the diet is very poor here….We receive inadequate meals and a fixed allotment for the duration of our incarceration. We are provided food once a day; children receive the same food. A portion of food is set aside for the child to consume before bedtime with the assistance of a few of the incarcerated women. However, the food is not nourishing for the child.’(Participant #6).

Health insecurity

According to the participants’ views, incarcerated women had access to health screening while in prison. This has benefited them because they are aware of their health status.

‘…. On the other hand, we are grateful as we are released from prison free from the diseases we have had before. I testify that I got here without knowing my HIV and cervical cancer status. When I arrived here, I was screened for cancer and discovered that my cervix had some problems. So, I was treated here in the prison...’ (Participant #2).

‘…It is necessary when you visit and screen us for various diseases. When we are in our respective homes, we take it for granted; we don’t get to the hospitals to have our bodies screened for diseases. Here, we are forced to get tested. As such, we are treated for several diseases that are brought into the prison by our fellow incarcerated women . (Participant #6).

One of the major challenges in prison was access to clean water; inadequate water for washing, cooking, and toilets was also reported. Due to water scarcity, incarcerated women were struggling to get water. So long queues emerged, that fighting among incarcerated individuals ignited.

‘…Sometimes we do not have sufficient water and yet everyone would like to bathe.” There are 30 incarcerated women here, so it’s difficult to have enough water to meet our needs as sometimes the taps run dry. Furthermore, toilets need water to be cleansed. (Participant #1)

‘…We fight for basic necessities such as water; imagine one tap supplying water for a good number of women in prison ; really, we fight among ourselves to have water. (Participant #5)

Participants indicate that the management of menstrual periods is problematic in prison. At times, well-wishers provide sanitary pads to incarcerated women, helping to improve their lives:

‘…Our lives become so tough during menstrual periods. It’s not easy to get sanitary pads behind bars. At times, well-wishers provide us with sanitary pads, or we use linen. (Participants #6)

‘…We lack soap tablets to clean children’s nappies and sanitary linen. If women who have under-five children here had soap, the children would have good personal hygiene. Furthermore, nappies that are washed with soap smell.’ (Participants #5).

Perceptions towards prison release

The study found divergent perspectives regarding incarcerated women’s release from prison. Some incarcerated women look forward to their release, citing that they have been transformed and are optimistic about their new lives. Prison living made them calmer and more patient.

‘…Also, I have learned how to control my emotions and anger. If released, I will not be involved in fights again as I will be able to control my temper…’ (Participant #4).

‘…Prison taught me patience and taught me to look at life from a different point of view. It made me realize that there’s a lot going on out here. Patience and teaching me to appreciate the little things…’ (Participant #7).

Furthermore, some of the participants reported that their spiritual well-being had been transformed for the better as a result of being imprisoned; they perceive themselves as reformed individuals.

‘…Prior to my arrest, I was not praying to God, but now I have known God. I will continue to pray forever, indeed, I have become a better person…’ (Participant #5).

Alternatively, some of the participants perceived that their prison experiences could result in social isolation and stigma in their communities. According to their accounts, they may be considered criminals and will not be accepted by society.

‘…I doubt if my community would welcome me; they might discriminate against me. I think people would regard me as a criminal. Perhaps even my friends would shun me. (Participant #7)

‘…I believe the first week following my release from prison, I will remain indoors at home, looking outside the environment through the window as if I’m still in prison. I shall be thinking that the prison warden is still guarding me…’ (Participant #1).

Discussion

This study reveals complex experiences of incarcerated women, including psychological discomfort, guilt, regret, and anxiety, and separation from families. Evidence has shown that the negative impact of being imprisoned, particularly separation from their families, is more painful among women than men and has a greater effect on children [17]. Studies have shown that many incarcerated women are plagued by concerns about their children [18]. In this study, two participants were living with their children, who were under five years old. These women had additional concerns, such as delays in accessing children’s health care, poor diets, and infants’ well-being. Similar findings were reported in prisons in studies elsewhere [19,20,21]. Dietary deficiency and prison conditions have a major impact on the incarcerated women’s health and the physical and mental development of their children [22, 23]. In this study, participants reported that they were served inadequate food and the same ration throughout their jail term. Children are fed on nsima (thick porridge) and boiled beans daily. Participants with children described setting aside a portion of food for the child to eat before going to bed. This reflects difficulties in prison that require extra attention, such as child nutrition management. Evidence suggests that prisons in sub-Saharan Africa generally do not have a special budget for the children living with their mothers in prison [1]. Ackermann [24] argues that the true impact of female detention is felt by children who are imprisoned with their mothers. It is therefore important that such women receive sufficient nutrition so as to breastfeed adequately in order to prevent child malnutrition and adhere to their ART regime if living with HIV [13].

Narratives from participants indicate there is inhumane treatment and unjustified punishment given to incarcerated women by some prison wardens. This closely relates to research findings in Africa about prison personnel mistreatment [20]. Furthermore, the Malawi Inspectorate of Prisons’ most recent inspection of prisons in March 2018 uncovered serious human rights violations relating to inhumane treatment imposed on incarcerated people in Malawi [7]. Nevertheless, Boal [25] and Chiwandikwa et al. [26] argue that the inhuman treatment of incarcerated persons is an injustice so common that people rarely “see” or “hear” it. This contradicts the United Nations standard minimum rules for the treatment of incarcerated individuals. Regulations clearly state that no person under any form of detention or imprisonment shall be subjected to torture or cruelty, inhuman or degrading treatment, or punishment [27]. The minimum standards further portray that no circumstance whatever may be invoked as a justification for torture or other cruel, inhuman, or degrading treatment or punishment [27].

Participants’ narratives in this study further expose incarcerated women’s suicidal ideation in order to escape inhumane and degrading treatment. Suicidal behavior is a fatal act that represents the person’s desire to die [28]. It includes suicidal ideation, suicide planning, suicide attempts, and suicide completion [29]. It has been pointed out that incarcerated persons have long been recognized as a vulnerable population at greater risk of suicide behavior than the general population [30]. Evidence suggests that the risk of suicide for females is amplified compared to male incarcerated individuals; incarcerated women are at least nine times more likely to die from suicide compared to the general female population [31]. The prison environment is harsh; this can be overwhelming to some incarcerated persons and would lead to an increased risk of suicidal behavior [28, 30,31,32,33,34,35]. Despite the fact that suicidal behaviors are common in correctional institutions, less attention has been paid to this public health problem, especially in middle- and low-income countries [33]. We therefore recommend that the correction facilities deliver an appropriate mental health screening to diagnose and treat incarcerated persons with suicidal behavior.

According to the participants, incarcerated women have had access to health screening. This is good for them because they are aware of their health status. This study underscores that, despite the difficulties of living in a closed setting, access to health care is better in prison than when they are in their communities. Similar results have been reported in the literature [1]. Like in other studies, this study exposes that for many women, this appeared to be their first point of contact with health screening for HIV and cervical cancer [1, 36]. This finding would be a reflection of the limited resources in the community and is not necessarily an endorsement of the quality of the prison health care services.

It was not easy for incarcerated women to access water. It was stated that the availability of running water for washing, cooking, bathing, and toilets was difficult. As a result, fighting erupted among them in the queue as they were under intense pressure to get water. Shortages of water were also reported in this study in Malawian Central Prisons [13]. Participants lamented that the management of menstrual periods is problematic in prison. Sometimes well-wishers bring in sanitary pads, thus making their lives at least a little better. Gadama et al. [13] identified that there is a strong reliance on donors (faith-based organizations, well-wishers and non-governmental organizations) to provide female sanitary wear, clothes, cleaning products, nutrition, and health support.

Participants reported divergent perspectives regarding incarcerated women’s release from prison. Some incarcerated women look forward to their release, citing that they have been transformed and are optimistic about a new life. Prison life shaped them to be calm, stronger, and more patient. Similar findings were reported by Maier and Ricciardelli [37]. On the other hand, some of the participants perceived that they could be socially isolated and stigmatized, potentially causing societal rejection. There is evidence that individuals with a history of incarceration are burdened with a criminal record, no matter how minor the offense is, and face significant challenges reintegrating into communities [38].

Strengths and limitations

Our research provides insight into the realities of incarcerated women in Malawi’s urban prison setting. It constitutes an important contribution to Malawian and sub-Saharan Africa (SSA) prison literature. There is very little incarceration literature for incarcerated women available in Malawi. One limitation is that the sample was limited to one prison and seven participants. This is because incarcerated women in this region are housed here. Another limitation pertains to the data collection method, as participants may not have been completely honest due to the surveillance and potential punishment they faced in that environment. Consequently, they might not have fully disclosed their experiences. Nevertheless, the findings offer valuable insights into the experiences of women in Malawi’s prisons.

Conclusion

This study provides light on issues facing incarcerated women’s experiences, which may be applicable not only to Malawi but also to other prisons with similar conditions in SSA. It invites further discussion and research about nutrition deficiencies in Malawian prisons. Additionally, it underpins the need for further research in relation to the needs of children of incarcerated women throughout the SSA region and beyond. Notwithstanding improvements in prison conditions, inhuman and degrading incarcerated individual treatment, and health-care provision for children under the age of five, one could argue for alternatives to incarceration for mothers with children under the age of five who have committed small and non-violent offenses. Custodial sentences for young women and mothers with children under the age of five, in particular, should be avoided until absolutely necessary. This can be accomplished through the design and implementation of prison reform programs.