This is a follow-up report to previous examinations of the health care provisions in the Poland, Hungary, and Czech prison systems in 2001. The follow-up study included visits to three prisons in each country, including both male and female prisons, and focused on a broad-based review of the provision of health care and the response to drug addiction. Data included statistical information from prison service headquarters, interviews and focus groups, and direct observations. The common problems plaguing each of the three prison systems are overcrowding, the autonomy of the prison from the prison headquarters, foreign prisoners, and budget constraints. An analysis of the activities of inmates and the availability of work for inmates was conducted. The availability of work for prisoners varied in each country, but generally the opportunity for prisoners to work had decreased since 1989, reflecting the economic conditions of the countries. Despite this decrease in prisoner work, a wide range of educational, vocational, and cultural activities were provided to inmates in each country. Another area of analysis was the degree to which each prison system engaged in anti-bullying strategies and self-harm and suicide prevention programs. The report reviews the anti-bullying strategies in each country and then reports that the incidence of self-harm among prisoners had decreased over the past 10 years. Next, the prison health care systems were examined, with a focus on confidentiality issues, access to doctors, weekend medical coverage, equivalence of care in prison versus in the community, cleanliness and hygiene, and food in prison. The issues that emerged as possibly problematic included issues of confidentiality, the frequency of showers, and the availability of food. Prevention and harm reduction strategies in prisons were examined in terms of drug use, sex, and communicable diseases in prisons. In all the prison systems examined, drugs were considered a marginal problem and in all three systems attempts are being made to comply with the Council of Europe’s prison health care rules. Prevention and harm reduction efforts must be improved in all three systems. Examinations were also made of the provision of through care for prisoners leaving confinement and of prison staff shortages, training, and welfare. References