People with Disabilities in India: From Commitment to Outcomes

NGOs, both quantitative and qualitative, and interactions with the Indian disability community
and officials dealing with disability matters in various sectors.
4. The report concludes that it will take a multi-faceted approach for disabled people
to realize their full individual potential and to maximize their social and economic
contribution to society. Strengthening preventive and curative health care services, ensuring
inclusion in education, and increasing the participation of disabled in the workplace will be
essential. Also critical will be improvements in available information on disability and reducing
stigma about disability. Efforts to minimize disability (e.g. immunization, early detection, better
outreach for rehabilitation) will be critical, but more effective efforts to ensure inclusion of
disabled in basic services (e.g. inclusive education, health, social protection programs) will also
be required. In some areas, this will require more public resources, but the fiscal impacts of even
significant proportional increases will be negligible and fiscally supportable.
5. Although improvements are needed in a number of areas, interventions will need to
be prioritized and sequenced if the agenda for promotion inclusion of people with
disabilities is to be realized. India’s implementation capacity is generally weak in a number of
areas of service delivery which are most critical to improving the situation of disabled people, and
it is not realistic to expect that all the actions needed by many public and non-public actors can be
taken all at once. It is important therefore to decide the most critical interventions and “get the
basics right” first. Obvious priorities include: (i) preventive care, both for mothers through
nutritional interventions, and infants through both nutrition and basic immunization coverage; (ii)
identifying people with disabilities as soon as possible after onset. The system needs major
improvements in this most basic function; (iii) major improvements in early intervention, which
can cost effectively transform the lives of disabled people and their families, and their
communities; and (iv) expanding the under-developed efforts to improve societal attitudes to
people with disabilities, relying on public-private partnerships that build on successful models
already operating in India.
6. The study finds that it is neither possible nor desirable for the public sector to “do it
all”. Operationalizing this insight will require stronger coordination of efforts within the public
sector, greater engagement between public and non-public actors, and mobilization of actors in
local governments and community institutions in order to address a variety of market,
government and collective action failures.
7. The report also brings out the heterogeneity of the situation of and policy options
for different groups of disabled people in India. There are substantial differences in socioeconomic
outcomes, social stigma, and access to services by disability type, with those with
mental illness and mental retardation in a particularly poor position. As with the general
population, there are also major urban/rural differences in outcomes, though the policy
implications differ in some cases from those of the general population. Gender, class and
regional variations are also significant in many cases. While the report therefore attempts an
overview of the situation of people with disabilities in India, it is also important to stress such
heterogeneity in order to explore implications for public policy. The main findings of the report
and policy options for addressing disability are summarized below.
II. Socio-economic Profile of People with Disabilities (Chapter 1)
8. While official estimates of disability are low (around 2 percent), alternative
estimates using better methods and more inclusive definitions suggest a higher incidence of
disability (4-8 percent). The 2001 census found 21.91 million PWD (2.13 percent of the
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