People with Disabilities in India: From Commitment to Outcomes

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first to have a disability card. In the survey, only 15 percent of PWD with moderate disability had such a card and around 21 percent of those with severe disabilities. Shortcomings in the identification and certification system (see Chapters 3 and 4) are therefore to some extent driving relatively low coverage in the social protection system. However, there also appears to be low awareness of both social pensions for disabled people and the unemployment allowance scheme, with over 60 percent of PWD in rural UP and TN not aware of the existence of either scheme and only 9 percent of them having benefited (Table 6.5). While awareness is not as low as several other PWD entitlements, lack of awareness is clearly an issue. Table 6.5: Awareness of disability certification and cash benefits, rural UP and TN, 2005 Certification as a disabled person Not aware 56.2% Aware 19.8% Benefited 20.7% Denied 3.3% Regular cash benefit to destitute or unemployed PWD Not aware 61.5% Aware 25.6% Benefited 9.0% Denied 3.9% Source: UP and TN village survey, 2005. Bank staff estimates. 6.17. (d) Conclusion on poverty alleviation and social assistance schemes: Overall, the level of coverage and financial protection provided by the range of interventions reviewed varies significantly across states. However, in nearly all cases, the combined social protection that the various poverty alleviation and social welfare programs offer to PWD appears to be rather insignificant. This is a product of low awareness among PWD of programs, weak channels for increasing demand in several cases, and in many states an apparent lack of focus on the whole area of social protection for PWD. The disability social pension appears to date to have the most effective outreach in several states. In contrast, the system of reservations under general poverty alleviation schemes has clearly failed to achieve the desired outcomes and consideration needs to be given to alternative approaches to livelihood promotion and other forms of social protection for PWD. The unemployment allowance scheme remains inadequately understood, but does not appear to play a significant role in social protection for PWD. B. Disability Insurance in India 6.18. (a) Overview of current mandatory schemes: Disability can lead to significant declines in household consumption, especially when the affected individual is a breadwinner. 162 An important instrument for addressing the risk of disability and smoothing consumption is insurance. As in the majority of countries, most disability insurance provision in India is provided publicly and in the form of a mandated benefit tied to the retirement income scheme. Only formal sector workers are covered by the mandated disability insurance schemes, although some voluntary provision exists. The schemes for public and private sector formal sector workers provide similar benefits but are financed differently (Table 6.6). 162 See for example, Gertler and Gruber (1997). -115-
Table 6.6: Contributions and benefit targets for mandated disability insurance in India Scheme Contributions Qualifying Replacement rate period Employees Pension Scheme 8.33% that also covers old age and survivor 1 month 1.52% times years of contribution X final 10 months wage with minimum Civil service pension Scheme benefit None, financed from budget directly Military pension None, financed from Scheme budget directly Source: Government of India and EPFO 250 rupees per month Immediate 1.52% X years of service X final 10 months wage with minimum 1310 rupees per month immediate Basic retirement pension plus 20% depending on rank 6.19. There are at least two problems with the current arrangements for social insurance, including disability insurance. The first is related to the small share of the formal sector. When combined, the public and private sector schemes cover less than one in ten workers in the country, and this share has not increased in recent decades. Coverage is therefore low and concentrated in the top half of the income distribution. This can be seen in Figure 6.2. Unfortunately, there is no “clean” picture of disability/serious accident insurance. However, the pension coverage is a a significant extent one proxy due to the provision for disability pensions in formal systems. The more important insurance however in coverage terms is life insurance, which is often bundled with accident/disability insurance. While coverage also remains low and concentrated in the upper ends of the distribution, penetration is notably higher overall, and not as negligible in the second and third quintiles Figure 6.2: Coverage of health, life and pension insurance, 2004 60 %of quintile covered 50 40 30 20 10 Health insurance Life insurance Pension 0 Poorest Q2 Q3 Q4 Richest Source: Palacios and Goyal, 2006., based on MoF/ADB national 2004 survey. 6.20. The second problem is related to financing. In the case of civil servants, the financing comes directly from the budget. No reserves are set aside, just as in the case of old age pensions. This is starting to change however, as a new defined contribution scheme is being phased in for new civil service hires. 163 In the case of the Employees’ Pension Scheme (EPS), the benefit is financed out of a common fund and contributions are pooled for old age and disability. Recent actuarial reports have identified an unfunded liability in the EPS signaling sustainability problems. In both cases, the premium required specifically for disability insurance coverage has not been calculated or separated. This is not surprising given that in neither EPS or the EPFO are the contributions (or lack thereof) set so as to generate long term actuarial balance. The new DC scheme that covers newly hired civil servants makes it necessary to rethink the simple - if opaque - financing arrangement for disability insurance that has operated so far. 163 The disability provisions of this new scheme have not yet been determined (see below). -116-
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PEOPLE WITH DISABILITIES IN INDIA:
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Abbreviations and Acronyms ADL ANM
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Table of Contents EXECUTIVE SUMMARY
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Figure 5.3: Employment rates of PWD
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Box 5.4: A Jobs Fair Bringing Emplo
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NGOs, both quantitative and qualita
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Out of school rates for CWD are hig
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needs to respond more proactively t
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government strategies for promoting
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Safety Net Schemes 33. Safety nets
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40. In early 2006, a National Polic
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should move to implement the Act’
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54. Addressing current and future p
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disability SHGs, which has been sho
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have comparative advantage is putti
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extent of individual functioning du
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converting income into well-being o
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21. In light of the challenges that
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not be explained by this. The major
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Table 1.2: Disability Prevalence ra
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The share of disability impact due
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• It is also important to recall
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1.17. A second issue with obvious i
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Figure 1.9: Employment rates of PWD
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Box 1.2: Census questions on disabi
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Box 2.1: Disability in Indian mytho
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• overall, there is low acceptanc
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Table 2.2: Positive perceptions of
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different areas, as for example the
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governmental sectors drive home the
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Box 2.4: Raising awareness and chan
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• onset of mental disabilities is
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3.9. Locomotor disability is the ca
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B. Prevention of Disability 3.15. A
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3.20. The NBCP, like other vertical
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almost three times more likely to h
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PWDs. The scheme operates in 11 cen
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Figure 3.4: Proportion of disabled
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Table 3.11: Type of Service Accesse
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Urban 1.46 North 1.40 South 1.10 Ea
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Box 3.1: WHO’s “Ten Question Pl
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3.51. (f) Financial barriers to acc
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including for road accidents, and e
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A. Indian and International Policy
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4.9. A specific feature of SSA is a
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• 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
Page 129 and 130: 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
Page 137 and 138: D. Conclusions and recommendations
Page 139 and 140: is set. In the case of SGSY, the gu
Page 141 and 142: Table 6.2: States/UTs with unemploy
Page 143: Table 6.4: Coverage of disability s
Page 147 and 148: 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
Page 153 and 154: 7.4 (a) The Persons with Disabiliti
Page 155 and 156: 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
Page 177 and 178: 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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