The Quality Department monitors high priority matters such as permissions; functioning of physical infrastructure and medical equipment; personnel qualifications; sanitation, hygiene and epidemiology watching regime; implementation of the National Recommendations (the Guidelines) and Standards (the Protocols); nosocomial (hospital-acquired) infection control; maintenance of medical documents including statistics and referrals. The Order of the Minister of Health no. 01-25/n dated 19 June 2013 “on determining classification of medical interventions and approving minimum requirements for primary healthcare institutions” establishes minimum requirements to be met by primary healthcare institutions. It should be noted that the requirements envisaged by Order no. 01-25/n apply to and are mandatory for only those primary healthcare institutions that are involved in the Insurance Program for All; however, it would certainly be a step forward if some of the standards established by the mentioned Order were implemented also in the penitentiary healthcare system with a view of meeting the principle of equivalency of penitentiary healthcare services. The scope of the Order may be extended to cover the penitentiary healthcare system except certain issues that are specific to the prison setting, which should be regulated separately such as special rules for sterilization, use of safe boxes and appropriate containers to collect sharp objects and syringes, disinfection and sterilization of medical tools, items and materials for multiple usage. Requirements of maintaining medical and statistical information should also be articulated separately. Government Resolution no. 359 dated 13 February 2014 “on approving Technical Regulations for High-Risk Medical Activities” regulates high-risk medical activities. Such activities that are also implemented in the penitentiary setting are related to infectious diseases such as tuberculosis, hepatitis and HIV/AIDS. The monitoring results have shown that the requirements established by the said Government Resolution are not fully observed in the penitentiary system. Problems remain in terms of proper management of medical waste, control of the disinfection and sterilization process and lack of ventilation equipment in manipulation rooms. In consideration of all the above mentioned, the Public Defender addressed the Minister of Corrections with the recommendation to take all measures to enhance a mechanism for controlling the implementation of civilian healthcare standards in the penitentiary system; introduce an effective system for statistical data collection and analysis; pay more attention to statistical analysis results in designing the penitentiary healthcare action plan; effectively manage the procurement process and evaluate its cost-effectiveness and to assess the quality of penitentiary healthcare services using pre-determined and relevant indicators. According to the response of the Ministry of Corrections, Primary health care model has been successfully operating in all the institutions of the peniNATIONAL PREVENTIVE MECHANISM (NPM), 2015 107

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