Capability-Based Framework for Incarcerated Women's Health: Building on Amartya Sen Approach

The Capability Approach (CA) offers a useful way to evaluate prison health that goes beyond service provision or patient satisfaction. Researchers have applied it in public health, prison health, and criminal justice, but rarely to the health of incarcerated women. This paper begins to fill that gap. It proposes a gender-responsive, rights-based capability framework to evaluate women’s real freedom to achieve good health. The research question is: how can the Capability Approach help evaluate and strengthen incarcerated women’s health freedoms? The paper uses a targeted narrative synthesis and a conceptual framework analysis, following Jabareen (2009). This method combines theoretical clarification, purposive selection of capability domains, and a critique of conventional indicators. This review argues that we should assess incarcerated women’s well-being through two lenses: capabilities, the real freedoms to reach valued states of health, and functionings, what women actually achieve with dignity and autonomy. Drawing on international reports and qualitative studies, the paper suggests that standard indicators may understate how institutional constraints, coercion, stigma, and unequal conditions restrict women’s agency. In some settings, reported satisfaction may simply reflect adaptation to deprivation rather than genuinely adequate care. These are interpretive claims drawn from the literature, not new findings from this study, and they still need empirical testing. As a preliminary conceptual proposal, the paper sets out six capability domains, presented in Table 1, without claiming to define a universal set; the abstract illustrates four of them , bodily integrity, reproductive autonomy, psychosocial well-being, and health-related agency , and examines their link with concrete functioning such as dignified menstrual care or respectful maternity services. This preliminary framework helps structure a rights-based, gender-responsive model of prison health. It can serve as a starting point for empirical research and for evaluating reforms in low- and middle-income settings.