For every £1 spent on a sexual health self-sampling service in an open prison setting, a potential social value of £4.14 was created, demonstrating both direct return on investment and wider social value of providing such a service to prisoners.
The sexual health self-sampling service in an open prison generated a social return on investment ratio of £4.14 for every £1 spent.
Approximately one-third of the total value created by the self-sampling service was categorised as monetarily returnable.
A substantial portion of the social value generated by the self-sampling service was non-monetary in nature, including improved mental well-being.
The study applied a unique combined methodological approach using Health Impact Assessment (HIA) and Social Return on Investment (SROI) frameworks in tandem.
The sexual health of the male prison population is characterised as often being among the poorest in a country.
The combined HIA and SROI framework was found to be feasible for illustrating both direct return on investment and the social value of prison health services.
This research suggests that providing a sexual health self-testing service inside an open prison in Wales generates significant value — both financial and social — that far exceeds its cost. For every £1 spent running the programme, approximately £4.14 worth of value was created. This value came from two sources: about one-third (£1,517.95) represented tangible, money-saving outcomes (such as earlier treatment of infections reducing downstream healthcare costs), while the remaining two-thirds (£3,260.40) represented harder-to-quantify benefits like improved mental well-being among prisoners who used the service. The researchers gathered this information by consulting multiple groups of stakeholders — including prisoners and staff — through workshops, interviews, and questionnaires. The study also tested a new way of evaluating health programmes by combining two existing analytical tools — Health Impact Assessment (HIA) and Social Return on Investment (SROI) — at the same time. This approach allowed the researchers to capture a broader picture of the programme's worth than either method could provide alone, including both practical health outcomes and wider social benefits. The authors note that the findings are based on a small sample, so the specific numbers should be interpreted cautiously, but the overall approach appears promising. This research suggests that investing in sexual health services for people in prison can be cost-effective and socially valuable, even when accounting for only the immediate and direct benefits. It also offers a potential model for how similar programmes in other prison settings could be evaluated in a more comprehensive way, helping policymakers and health services make the case for funding such interventions.
Ashton K, Challenger A, Craddock C, Clemens T, Williams J, Kempton O, et al.. (2024). Self-administered sexual health testing in an open prison setting: a pilot health impact assessment and social return on investment analysis.. International journal of prison health. https://doi.org/10.1108/IJOPH-03-2024-0011