People with Disabilities in India: From Commitment to Outcomes

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population), while the 2002 NSS round’s disability estimate is 1.8 percent of the population. 1 The share of households estimated by NSS to have a disabled member was 8.4 and 6.1 percent in rural and urban areas respectively (though this share seems high given the number of disabled individuals and survey results on their household size). Alternative estimates from a variety of sources suggest that the actual prevalence of disability in India could be easily around 40 million people, and as high as 80-90 million if more inclusive definitions of mental illness and mental retardation in particular were used. 2 Just as importantly, the bulk of disabled people in India have mild to moderate disabilities. 9. The medical causes of impairments are rapidly changing in India - from communicable disease to non-communicable disease and accidents. Between 1990 and 2020, there is predicted to be a halving of disability due to communicable diseases, a doubling of disability due to injuries/accidents, and a more than 40 percent increase in the share of disability due to non-communicable diseases. This reflects long term trends in fertility reduction and aging, increased road congestion, poor workplace safety practices, stubbornly poor nutritional outcomes, and progress in reduction of communicable diseases. In terms of age of onset, there is “double hump” of disability onset, first shortly after birth and then in the 50-60 year old cohort. In addition, the age profile of disability onset varies sharply by category of disability. 10. For some impairments (e.g. speech and hearing), illness and disease remain major causes, while for others such as visual disability age is a major driver. For mobility disabilities, the causes are shifting from a dominance of polio to a more mixed set of causes. For several disabilities, in particular mental illness and mental retardation, the causes of disability are often unknown, indicating the major knowledge gaps in current disability research. 11. Physical and mental impairments are compounded by poor education outcomes, and children with disabilities (CWD) have very high out of school rates compared to other children. As for any other group, education is critical to expanding the life prospects of people with disabilities. Disabled people have much lower educational attainment rates, with 52 percent illiteracy against a 35 percent average for the general population. Illiteracy is high across all categories of disability, and extremely so for children with visual, multiple and mental disabilities (and for severely disabled children of all categories). Equally, the share of disabled children who are out of school is around five and a half times the general rate and around four times even that of the ST population. In even the best performing major states, a significant share of out of school children are those with disabilities: (in Kerala, 27 percent; in TN over 33 percent). Indeed, evidence from more advanced states demonstrates that CWD remain perhaps the most difficult group to bring into the educational net even where overall enrollments are very high. Across all levels of severity, CWD very rarely progress beyond primary school. This underlines the importance of getting CWD into school if India is to achieve the education MDGs. 3 1 Significantly, the two differ notably on the composition of the disabled population by type of disability. The differences are in part explained by different disability definitions in NSS and census. 2 See GoI/WHO and Dandona et al (2004) on visual and Gururaj and Isaac (2005) on mental impairments. 3 Around 90 percent of CWD who have ever attended school attend a regular rather than special school. This brings home that the choice facing most CWD is whether they are out of school or in regular school. xii
Out of school rates for CWD are high in all states and CWD account for a higher proportion of all out of school children as overall attendance rates increase Figure 1: Share of 6-13 year old CWD and all children out of school, 2005 Figure 1 60 %of cohort out of school 50 40 30 20 10 CWD All 0 AP Assam Bihar Delhi Har Jhar J&K Karn Kerala MP Maha Oris Punj Raj TN UP WB Source: SRI survey for MHRD, 2005. 12. Disabled people also have significantly lower employment rates than average, and this gap has been increasing over the past 15 years. The large majority of PWD in India are capable of productive work. Despite this fact, the employment rate of disabled population is lower (about 60 percent on average) than the general population, with the gap widening in the 1990s. 4 Controlling for other factors, having a disability reduces the probability of being employed by over 30 percent for males in rural UP and TN, though the effect is lower for women. However, those in rural areas and the better educated (those with post graduate education or vocational training) have relatively better prospects of employment relative to other disabled people. People with certain types of disabilities, e.g. hearing, speech and locomotor disabilities, and those with disability since birth also have better chances of getting a job. Mental illness and particularly mental retardation have a strong negative impact on the probability of being employed, even in cases where such disabilities are not severe. The presence of a disabled member also has impacts on the labor supply of other adult household members. Around 45 percent of households in UP and TN with a PWD report an adult missing work to care for PWD member, the bulk of these every day and on average for 2.5 hours. However, other adult men are more likely to be working in households with disabled members, due to the need to compensate for lost income. 13. A recent adverse development is the decline in the employment rate of working age disabled people, from 42.7 percent in 1991 to 37.6 percent in 2002. The fall was almost universal across the country, but the extent varies greatly across states. The gap between the disabled and general population employment rates also widened for all education levels during the 1990s, and disabled people with lowest educational attainment have fared the worst. Improving job prospects for the disabled will be critical for improving their welfare, but also ensure that the economy can benefit from full labor potential. However, public sector initiatives to date in this regard have had only very marginal impact on employment outcomes for disabled people. 4 It is important not to attribute these differentials entirely or automatically to discrimination, as many factors are at play, including lower than average educational levels and the nature of some disabilities. However, analysis in the report finds a significant unexplained element in employment participation probabilities (se Chapter 5). xiii
Page 1 and 2: PEOPLE WITH DISABILITIES IN INDIA:
Page 3 and 4: Abbreviations and Acronyms ADL ANM
Page 5 and 6: Table of Contents EXECUTIVE SUMMARY
Page 7 and 8: Figure 5.3: Employment rates of PWD
Page 9 and 10: Box 5.4: A Jobs Fair Bringing Emplo
Page 11: NGOs, both quantitative and qualita
Page 15 and 16: needs to respond more proactively t
Page 17 and 18: government strategies for promoting
Page 19 and 20: Safety Net Schemes 33. Safety nets
Page 21 and 22: 40. In early 2006, a National Polic
Page 23 and 24: should move to implement the Act’
Page 25 and 26: 54. Addressing current and future p
Page 27 and 28: disability SHGs, which has been sho
Page 29 and 30: have comparative advantage is putti
Page 31 and 32: extent of individual functioning du
Page 33 and 34: converting income into well-being o
Page 35 and 36: 21. In light of the challenges that
Page 37 and 38: not be explained by this. The major
Page 39 and 40: Table 1.2: Disability Prevalence ra
Page 41 and 42: The share of disability impact due
Page 43 and 44: • It is also important to recall
Page 45 and 46: 1.17. A second issue with obvious i
Page 47 and 48: Figure 1.9: Employment rates of PWD
Page 49 and 50: Box 1.2: Census questions on disabi
Page 51 and 52: Box 2.1: Disability in Indian mytho
Page 53 and 54: • overall, there is low acceptanc
Page 55 and 56: Table 2.2: Positive perceptions of
Page 57 and 58: different areas, as for example the
Page 59 and 60: governmental sectors drive home the
Page 61 and 62: Box 2.4: Raising awareness and chan
Page 63 and 64:
• onset of mental disabilities is
Page 65 and 66:
3.9. Locomotor disability is the ca
Page 67 and 68:
B. Prevention of Disability 3.15. A
Page 69 and 70:
3.20. The NBCP, like other vertical
Page 71 and 72:
almost three times more likely to h
Page 73 and 74:
PWDs. The scheme operates in 11 cen
Page 75 and 76:
Figure 3.4: Proportion of disabled
Page 77 and 78:
Table 3.11: Type of Service Accesse
Page 79 and 80:
Urban 1.46 North 1.40 South 1.10 Ea
Page 81 and 82:
Box 3.1: WHO’s “Ten Question Pl
Page 83 and 84:
3.51. (f) Financial barriers to acc
Page 85 and 86:
including for road accidents, and e
Page 87 and 88:
A. Indian and International Policy
Page 89 and 90:
4.9. A specific feature of SSA is a
Page 91 and 92:
• significant gender differential
Page 93 and 94:
Out of school rates for CWD are hig
Page 95 and 96:
Only around 5 percent of children w
Page 97 and 98:
4.30. (b) Financial performance of
Page 99 and 100:
only factor contributing to both po
Page 101 and 102:
The numbers of CWD identified by SS
Page 103 and 104:
IE training options. The impacts of
Page 105 and 106:
part of the authorities to increase
Page 107 and 108:
well beyond the needs of CWD alone.
Page 109 and 110:
performance in the schooling system
Page 111 and 112:
DLROs has contributed to West Benga
Page 113 and 114:
CHAPTER 5: EMPLOYMENT OF PERSONS WI
Page 115 and 116:
atios, while others such as J&K, Bi
Page 117 and 118:
Figure 5.8: Employment rates over t
Page 119 and 120:
• the relative wages of PWD to no
Page 121 and 122:
of age and disability status. Multi
Page 123 and 124:
5.23. For males in the survey, a de
Page 125 and 126:
equirement of specific post identif
Page 127 and 128:
5.34. Nonetheless, there has been u
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consistent with survey findings. Na
Page 131 and 132:
exchanges are in any event servicin
Page 133 and 134:
Source: NHFDC website reporting cum
Page 135 and 136:
Box 5.5: Good practice in NGO skill
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D. Conclusions and recommendations
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is set. In the case of SGSY, the gu
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Table 6.2: States/UTs with unemploy
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Table 6.4: Coverage of disability s
Page 145 and 146:
Table 6.6: Contributions and benefi
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6.24. Easily the largest scheme for
Page 149 and 150:
6.35. While the design of the insur
Page 151 and 152:
people. The transfer under NOAPS wa
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7.4 (a) The Persons with Disabiliti
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7.8 (ii) Sectoral policy issues in
Page 157 and 158:
• in the area of education, the p
Page 159 and 160:
awareness raising about disability
Page 161 and 162:
more formal institutions in disabil
Page 163 and 164:
7.28 There is little detailed analy
Page 165 and 166:
Table 7.2: Institutions providing b
Page 167 and 168:
systematically related to the numbe
Page 169 and 170:
• collaboration between NGOs and
Page 171 and 172:
moving to improved outcomes for PWD
Page 173 and 174:
CHAPTER 8: ACCESS FOR PEOPLE WITH D
Page 175 and 176:
Box 8.1: International and regional
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The comparison of institutional arr
Page 179 and 180:
laudable, there are concerns that m
Page 181 and 182:
ANNEX 1: COMPARING THE INCOMPARABLE
Page 183 and 184:
of prevalence estimates across the
Page 185 and 186:
person will be treated as having
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People with Disabilities in India: From Commitment to Outcomes

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