People with Disabilities in India: From Commitment to Outcomes

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practice to value (e.g. loss of pleasure from life due to severe depression, or sense of isolation due to mobility impairment). 17. (iii) Social services and people with disabilities: There are also likely to be challenges for both the market and governments in direct service provision to PWD, at least where service provision is disability-specific and not simply a factor in a PWD accessing general services. This is driven by the characteristics of the group of disabled people. First, while by no means negligible, they are a relatively small share of the population. With respect to service provision, the (still smaller) size of particular sub-groups of PWD also matters, e.g. where disability-specific aids and appliances are needed. As a result, PWD are likely to be a dispersed group for providing services. Second, PWD and the households in which they live are poorer than average, so that their appeal for the commercial sector is relatively limited (though may be higher for some segments of the market such as NGOs). Third, even where supply-side issues can be overcome (e.g. cities), there may be significant demand side issues. These could include lack of interest in services for disabled people (e.g. lower demand for schooling relative to other children), greater problems in physical access to goods and services for PWD, or simply the poverty constraints already noted. 18. When both “arms-length” relationships (market and government) fail, then people as groups may be able to take care of some types of market failures. In the case of disability, local communities may provide a service that is too difficult or expensive for the market or government to provide (e.g. this may explain some of the success of community-based rehabilitation for PWD in India and elsewhere). They can be more precise in their appraisal of the extent and consequences of a person’s impairment. Care of a PWD will not be over-provided by family or community, and is not prone to exploitation in the same way as a public program. The “insurance” in this case is implicit in the expectations of reciprocity among family members and of the community at large – both of which are very different in different cultural environments. 19. If effective household and/or community support is dependent a sense of reciprocity with the PWD, the most vulnerable PWD are those who do not have a sufficient support system within their community. This may be either because their connections to those with resources are few or weak (which may be driven by reasons such as social stigma, caste, age or gender), or because the people they can depend on (typically their family) are very poor themselves. There can thus be two weaknesses of social action – one that is driven by the absence or thinness of networks of reciprocity, and one that is driven by the limited capacity of social networks to provide support. There are reasons to expect that the lives of PWD are characterized by both these weaknesses more than average. Empirically, a typical feature of disability in all countries appears to be more limited social networks (in particular due to stigma) and higher household poverty. The effectiveness of social action in both promoting opportunities and providing basic social protection for PWD is thus likely to be unusually constrained. 20. What is the role of government in the context of community-provided care (either by informal community institutions or the family? The direction of help may be two-way. Firstly, governments may choose to help the disabled for the sake of alleviating poverty – not only for the PWD but for the entire support system if care-takers are themselves poor. Secondly, government programs for PWD may be able to use the greater and more detailed information available in the community in the identification of beneficiaries and, possibly, the extent of entitlement. -5-
21. In light of the challenges that face market, government and social action in the field of disability, what combination of interventions seem sensible for trying to address different forms of failure? There is not is simple answer to this question. Different combinations appear more appropriate for different aspects of PWD lives (e.g. employment versus education), for PWD in different settings (e.g. urban/rural), and also for people with differing types of degrees of disability. For example, government and market action may be easier in urban areas with concentrated populations of disabled people, while collective action may be more readily mobilized in rural settings among groups where social cohesion is strong. The approach also needs to take account of binding commitments of the state to PWD – e.g. where legal rights have been guaranteed to PWD. The rest of the report deals with the issues outlined above in turn. -6-
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 and 12: NGOs, both quantitative and qualita
Page 13 and 14: Out of school rates for CWD are hig
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: converting income into well-being o
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
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
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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
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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