People with Disabilities in India: From Commitment to Outcomes

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insurance. The NCEUS proposal is ambitious in that it seeks to offer insurance for several major risks to 300 million informal sector workers in a span of five years. This includes disability insurance. The ultimate objective of universal coverage is shared by many developing country governments. However, such an expansion of coverage, to be achieved through voluntary participation is unprecedented in terms of international experience and experiences in India. The administrative and recordkeeping challenges alone suggest that the proposed time frame is not feasible. 6.41. In this vein, GOI (and specifically, MOLE and MOH) is in the process of building on the NCEUS approach towards a new policy that could be rolled out in stages. The first step in the sequenced expansion policy can be seen in the 2007-08 budget announcement of the Aam Aaadmi Bima Yogana (AABY). This is intended to cover around 15 million rural landless households with death and disability insurance for the breadwinner, with the premium fully subsidized on a 50/50 sharing basis by centre and states. 6.42. In time, the combined population of public sector workers, informal sector groups and some individuals could provide the volumes required for economies of scale of operation (say, in the tens of millions of contributors) and importantly therefore, consistent with low marginal costs of recordkeeping and fund management. The planned NPS scheme envisions this scale of operation and the information technology platform needed at a national level to implement it. 174 Meanwhile, the commission to expand social security is tasked with producing a financially viable proposal to extend these kinds of benefits to unorganized sector workers. A convergence of the two initiatives would seem appropriate. 6.43. (d) Summary on disability insurance : Fewer than one in ten workers in India has any kind of disability insurance coverage and the financing of existing schemes tends to be either opaque or unsustainable or both. The micro-insurance and welfare fund initiatives reveal strong underlying demand, but their diffuse nature increases administrative costs and leads to wide disparities in quality and price of services. C. Recommendations 6.44. Policies and programs should help improve awareness and targeting of safety net benefits to the poor and develop innovative approaches to extend coverage of disability insurance. 6.45. Improving the safety net. A first step in improving the poor performance of safety net programs for disabled people is familiarizing implementing officials and PRI representatives of the commitments under the PWD Act. Once such familiarization is done, the next step is for implementers to make efforts to raise awareness of schemes and PWD entitlements. In parallel, efforts need to be made in the public and non-governmental sectors to mobilize PWD themselves, so that there is more bottom-up demand on the delivery system. Formation and capacity building of PWD SHGs could be an important part of both strategies. Developing more focused efforts are also needed for specific programs, including: (i) for SGSY, targeted efforts to mobilize formation of SHGs of disabled people; (ii) for NREGS, adjustment of the national guidelines to include disabled people and efforts to identify both categories of works well suited to disabled people and processes for ensuring their adequate inclusion; and (iii) for social pensions, review of states with poor coverage, and relaxing the eligibility criteria for disability social pensions. It would also seem sensible to consider a base level of funding from the central government on disability social pensions, just as happens presently with the NOAPS scheme for destitute old age 174 See CRA document. -121-
people. The transfer under NOAPS was increased to Rs. 200 in the 2006-07 budget, and equity considerations suggest that disabled social pensioners should be treated on a similar footing. The experience of NOAPS with much higher beneficiary numbers suggests that this would be a highly affordable initiative in fiscal terms. 6.46. Expanding disability insurance. In order to address the demand that clearly exists for disability insurance, a low cost platform with standardized products and uniform regulations is likely to be the only approach that can be scaled up at the national level. Such a platform has recently been proposed under the New Pension System to deal with old age pensions for both the informal sector workers and civil servants. However, it will be necessary to have far more coordinated efforts across different arms and levels of government to link various social insurance initiatives to such a platform. Equally, the role of intermediary organizations such as MFIs, NGOs, and perhaps PRIs will be critical in improving program outreach and playing a role in contribution mobilization and claims processing if transactions costs are to be kept manageable. -122-
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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
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Out of school rates for CWD are hig
Page 95 and 96:
Only around 5 percent of children w
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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 and 144: Table 6.4: Coverage of disability s
Page 145 and 146: Table 6.6: Contributions and benefi
Page 147 and 148: 6.24. Easily the largest scheme for
Page 149: 6.35. While the design of the insur
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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