Medical Check-up of Prisoners and the Role of Medical Superintendents in India

Healthcare in India’s prisons is a crucial yet often overlooked aspect of public health and human rights. Every prisoner, irrespective of their crime, has a fundamental right to health under Article 21 of the Constitution of India. This includes access to comprehensive medical check-ups, treatment for chronic and infectious diseases, and mental health services.

However, overcrowding, resource constraints, and administrative challenges often prevent effective healthcare delivery in prisons. At the heart of this system is the Medical Superintendent or prison doctor, who is responsible not only for clinical care but also for managing prison health services.

Legal and Institutional Framework

Prison healthcare in India is governed primarily by:

• Indian Prison Act, 1894 – mandates a medical officer for every prison, though many provisions are outdated.
• Model Prison Manual, 2016 – issued by the Ministry of Home Affairs, it provides detailed guidelines for healthcare, sanitation, diet, and communicable disease control.
• Supreme Court Judgments – landmark cases like Inhuman Conditions in 1382 Prisons v. State of Assam (2016) have reinforced the states’ duty to improve prison healthcare.
• International Standards – the United Nations Standard Minimum Rules for the Treatment of Prisoners (Nelson Mandela Rules) emphasize healthcare comparable to that available in the community.

Types of Prisons in India

Prisons in India include:

• Central Prisons
• District Prisons
• Sub-Jails
• Women Jails
• Borstal Schools
• Open Prisons

Open Prisons, established first in Rajasthan in 1953, focus on rehabilitation rather than confinement. They operate with minimal security, emphasizing reintegration into society, in line with Gandhian principles and international human rights standards.

Authority Responsible for Prisoner Medical Check-ups

The Medical Officer or Medical Superintendent is responsible for:

• Conducting medical examinations at the time of admission.
• Recording chronic illnesses, mental health conditions, or signs of torture.
• Referring cases to government hospitals when necessary and ensuring proper medical reports are prepared.
• Performing regular health check-ups for prisoners with chronic conditions like HIV, tuberculosis, or psychiatric illnesses.

Routine check-ups are vital to detect infectious and chronic diseases early, reduce the spread of infections, and prevent medical complications.

Importance of Regular Medical Check-ups

Prisons often have overcrowded and unhygienic conditions, making prisoners susceptible to:

• Communicable diseases: Tuberculosis, HIV/AIDS, hepatitis
• Non-communicable diseases: Diabetes, hypertension, cardiovascular disorders
• Mental health issues: Depression, anxiety, psychosis, suicidal tendencies

Regular screening helps in early detection, preventive care, and ongoing monitoring of health conditions. It also assists in detecting signs of drug withdrawal, physical abuse, or mental health deterioration.

Responsibilities of the Medical Superintendent

The Medical Superintendent holds a central role in prison healthcare, including:

• Clinical duties: Initial and routine medical examinations, treatment, and referrals.
• Administrative duties: Managing medical staff, pharmacy, supplies, and maintaining accurate health records.
• Health education: Awareness programs on hygiene, nutrition, and disease prevention.
• Mental health management: Screening for psychological disorders, arranging counseling, and suicide prevention.
• Specialized care: Geriatric, female, and juvenile prisoner care, including prenatal and postnatal attention for women.

Management of Diseases in Prisons

Communicable Diseases

The Medical Superintendent oversees:

• Screening and isolation of infected prisoners
• Vaccination campaigns
• Implementation of programs like the Revised National Tuberculosis Control Programme (RNTCP)

Non-Communicable Diseases

Regular monitoring and treatment of chronic conditions such as:

• Diabetes and hypertension
• Cardiovascular and respiratory diseases
• Age-related illnesses in elderly prisoners

Legal and Judicial Oversight

The law mandates hospitals, doctors, and police to provide proper medical care to prisoners. Key provisions include:

• Section 54, CrPC: Mandatory medical examination of arrested individuals
• Section 166 & 330, IPC: Penalizing negligence or mistreatment
• Supreme Court directives in cases like DK Basu v. State of West Bengal mandate medical examinations to prevent custodial abuse

Courts also intervene in cases of medical negligence or denial of healthcare, ensuring compliance with constitutional rights.

Challenges in Indian Prison Healthcare

Despite legal frameworks, prisons face:

• Chronic understaffing
• Limited medical infrastructure and outdated equipment
• Scarcity of mental health professionals
• Bureaucratic delays in referrals to external hospitals
• Inconsistent health record-keeping

These challenges result in preventable deaths and highlight the urgent need for systemic reforms.

Conclusion

Prison healthcare is essential for upholding the right to life and human dignity under Article 21. The Medical Superintendent plays a pivotal role in bridging gaps between policy and practice. Strengthening this role through policy reform, increased funding, specialized training, and interdepartmental coordination is crucial to creating a humane and effective correctional system in India.

Ensuring prisoners’ health is not only a matter of human rights but also a public health imperative, given that prisoners eventually return to the general population.

Incase, You wish to discuss, and talk on any such matter that, ‘You may need help with’. Feel free to contact us.  Our team at  www.legalwellbeing.in shall be happy to assist.

Sourced and References:

1. Ndindeng AN. Mental health and well-being in prisons and places of detention. Int J Prison Health. 2024; ahead of print. doi:10.1108/IJOPH-07-2024-0035.

2. Shekhawat BS, Swami R, Meena V. Pattern of illness in prisoners admitted in a tertiary care hospital of South Eastern Rajasthan. J Indian Acad Forensic Med. 2023;45(2):105–108. doi:10.48165/jiafm.2023.45.2.1.

3. Shiney S, Yesudas KF, Sumesh B. Psychiatric morbidity among prisoners in South India: a cross-sectional study. Kerala J Psychiatry. 2023;36(2):115–21. doi:10.30834/KJP.36.2.2023.399.

4. Shankardass, R. D. Punishment & the Prison: Indian Perspectives. Sage Focus, 2000.

5. Rao, K. S. Open Jail System and Reformation, Prison J., Vol. 103, No. 1, 2022, pp. 5–19.

6. Citizens for Justice & Peace (CJP). A Prison Without Bars, 2021 report on Sanganer Open Jail.

7. The Print. Open Prisons Reduce Recidivism: Rajasthan Model Analysis, 12 Sep 2023.

8. Bhalla, Vineet. Open-air prisons are a humane solution to overcrowded jails – so why doesn’t India use them more?, 21 Dec 2024.

9. Kapoor, S. Medical Professional Liability in Prisons, Indian Journal of Medical Ethics & Law, 2022, pp. 10–30.

10. Das, M. Hospital Obligations in Custody Cases, Criminal Law Journal of India, 2023, pp. 75–95.

11. Dolla CK, Dhanraj B, Malaisamy M. Burden of pulmonary tuberculosis in modern prison: a cross-sectional prevalence survey from South India. Indian J Tuberc. 2019;66(1):189–92.

12. Mehta, S. Legal Duties of Prison Doctors, Indian Journal of Gender Law, 2022, pp. 45–66.

13. Mareeswaran N, Goplakrishnan S, Faizal O. A review on prisoners health: a neglected group. Int J Community Med Public Health. 2019;6(8):3639–3643. doi:10.18203/2394-6040.ijcmph20193501.

14. Rathod SM, Thakre SS, Jadhao A, et al. A cross-sectional study on health status of convicted prisoners in a central jail of central India. J Community Health Manag. 2023;10(1):32–36. doi:10.18231/j.jchm.2023.007.

15. Health status of the prisoners in a central jail of South India. PubMed. 2014;300 life-term inmates—9.6% acute URTI, 84% anemia. PMID:24379498.

16. Singh S, Udwadia FR, Boyd JW. Doctors in India need human rights training to advocate for prison reform. Health Hum Rights J. 2021;23(1):e2021008.

17. Mehta, S. Sexual Violence in Custody: Medical and Legal Implications, Indian J. Gender Law, Vol. 5, 2022, pp. 45–66.

18. Banerjee, R. Police Custodial Health: A Rights Framework, NLU J., 2023, pp. 150–175.

19. DK Basu v. State of West Bengal, AIR 1997 SC 610.

20. Chatterjee, T., Bose, A. Suicide & Mental Health in Indian Prisons, Asian J. Criminol., 2021, pp. 77–94.

21. Status of tuberculosis services in Indian prisons. Infect Dis Poverty. 2017;6:76. Screening in 157 prisons: 50% entry, 60% periodic; 19% TB symptoms, 8% smear-positive. PMID:28179148.

22. Thekkumkara T et al. Feasibility testing of a peer support programme for prisoners with common mental disorders and substance use. Crim Behav Ment Health. 2023;33(5):379–389.

23. Tripathy S, Behera D, Negi S, et al. Burden of depression and its predictors among prisoners in a central jail of Odisha, India. Indian J Psychiatry. 2022;64:295–300. PMID:35859554.

24. Singh A, Lall B, Panigrahi BK, et al. Deep learning for automated screening of tuberculosis from Indian chest X-rays. arXiv. 2020.2011.09778.

25. Kulkarni M, Golechha S, Raj R, et al. Predicting treatment adherence of tuberculosis patients at scale. arXiv. 2022.2211.02943.

26. Sharma, R. Implementation of Prison Manual Guidelines, Indian Journal of Criminology, 2021, pp. 112–130.

27. Goswami, A. K., Gautam, R. Prison Manuals and Health Delivery, International Journal of Health Sciences, 2023, Vol. 6, S6.

28. Reingle Gonzalez JM, Connell NM. Mental health of prisoners: identifying barriers to mental health treatment and medication continuity. Am J Public Health. 2014;104(12):2328–2334.

29. PMID24379498: Health status in South India central jail—URTI, anemia, ascariasis data.

30. Gajardo P, Riquelme V, Vicencio D. Optimal control of diseases in prison populations through screening policies of new inmates. arXiv. 2020.2011.00293.

31. Patel, V. Rethinking Parole: A Comparative Model, Delhi L. Rev., Vol. 4, 2020, pp. 112–134.

32. Project 39A, NLU Delhi. What Numbers Don’t Tell Us, 2022.

33. National Crime Records Bureau. Prison Statistics India 2023: Vacancy rates: 36% of sanctioned medical staff unfilled; 1,879 deaths in custody (185 unnatural), overcrowding at 130%.

34. Das, M. Section 482 and Custodial Abuse, Indian Journal of Constitutional Law, 2022, pp. 100–120.

35. Shree, B. S. Abuse of Power in Prison Systems, National Criminal Law Journal, 2020, pp. 91–101.

36. Gupta, A. K. Judicial Oversight and Custodial Health under Article 21, NLU Delhi Law Review, 2019, pp. 90–112.

37. Parmanand Katara v. Union of India, AIR 1989 SC 2039.

38. Das, M. Judicial Review of Prison Health Systems, Indian Journal of Constitutional Law, Vol. 6, No. 1, 2023, pp. 20–40.

39. L. Muruganantham v. State of Tamil Nadu & Others, SLP (C) No. 1785 of 2023 (SC).

40. R. Ramalingam v. Principal Secretary to Government (W.P.(MD).No.2024/2025), Madras High Court.

41. Mr. X vs State Of Himachal Pradesh Cr. MP(M) No.669 of 2024.

42. Mareeswaran N et al. Mental illness and general health problems among inmates in Indian prisons: a review. IJCM&PH. 2019;6(8):3639–3643.

43. Joshi, N. Medical Officer’s Role in Prison Admissions, Indian Penal Policy Journal, 2022, pp. 55–70.

44. WHO. Global prison health governance and health equity: a critical lack of evidence. Am J Public Health. 2020;110(3):371–377.

45. Raghuvanshi S, Nikam SS, Karne M, et al. Unmasking inequity: socio-economic determinants and gender disparities in Maharashtra and India’s health outcomes. arXiv. 2025.2506.08206.