People with Disabilities in India: From Commitment to Outcomes

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CHAPTER 1: SOCIO-ECONOMIC PROFILE OF PERSONS WITH DISABILITIES 1.1. This chapter presents a socio-economic profile of persons with disabilities in India. It is based primarily on data from the 47 th and 58 th NSS rounds and the 2001 census, but is supplemented by analysis from a dedicated survey in rural UP and TN carried out in 2005. A. Socio-economic profile of PWD 1.2. (a) Disability Prevalence: The starting point is an estimation of the total number of PWD in India. On this point, the two major official sources of data on disability differ, with the census estimate around 18 percent higher than NSS estimates. The 2001 census found 21.91 million PWD (2.13 percent of the population), while the 2002 NSS round’s disability estimate is 1.8 percent of the population, which would come to around 18.5 million (Table 1.1). The difference in aggregate estimates is in part explainable on the basis of different definitions used in the NSS and census for disabilities (see Annex 1). Both sources find disability rates to be higher among men and higher in rural than urban areas. In fact, the 58 percent share of males in total PWD estimates is worthy of further exploration. 1.3. Just as importantly in terms both of the impact of disability in the population and in terms of political economy and voice among people with disabilities, is the share of households estimated to have a member with a disability. The NSS for 2002 estimates that 8.4 percent of rural households and 6.1 percent of urban households had a member with a disability. These higher figures are important for several reasons. Firstly, the direct impacts of a disabled household member will clearly go beyond the individual with the impairment (as, for example, the chapter in impacts on non-disabled family member work participation in Chapter * indicates). Secondly, 7.8 percent of households nationally represents a significant “vote bank” which suggests that there may be more political mileage in policies to promote inclusion of disabled people than is commonly thought. Table 1.1: Disability rates from census and survey sources, early 2000s. PWD as share of… Census NSS 58th All individuals 2.13 1.8 All urban individuals NA 1.50 All urban households NA 6.1 All rural individuals NA 1.85 All rural households NA 8.4 All males 2.37 2.12 All females 1.87 1.67 Sources: Census 2001 and NSS 2002. 1.4. Looking at the prevalence of specific disability types, the divergence between census and NSS estimates are very pronounced for locomotor and visual disabilities (see Figure 1.1). While they also differ significantly for both hearing and speech disabilities, the inclusion in NSS of multiple disabilities is a factor, as speech and hearing disabilities may be more likely to combine. The locomotor and visual disability differences are however much more sharp and can -7-
not be explained by this. The major driver of the differences appears to be definitional, with the census defining visual disabilities more broadly and vice versa for movement disabilities. 12 Census and NSS sources give a divergent picture of the composition of disability Figure 1.1: Disability shares by type, census and NSS, early 2000s (% of disabled people) Figure 1.1 Multiple %of PWDpopulation Locomotor Speech Hearing Visual Census rates NSS rates Mental 0 10 20 30 40 50 60 Source: NSS, 58 th round and census, 2001. 1.5. The aggregate number of PWD in India is keenly disputed, with alternative estimates invariably higher than official ones. 13 Higher estimates are based on several arguments: • exclusion of disability categories in both NSS and census. The reliance on PWD Act categories is a limiting factor. There are numerous examples of excluded disability categories, including autism, thalassemia, haemophilia, and many learning disabilities. • the method of questioning on disability in both census and NSS which relies on a traditional “diagnostic” identification of disability by untrained interviewers, which recent work coming out of a UN expert group suggests is the method which yields the lowest disability estimates. Box 1.1 notes the various methods and issues involved. Simply asking whether or not people have a disability (and what type) has been found worldwide to yield lower bound estimates of prevalence, with a strong bias towards more serious disabilities. • disability-specific surveys which have found often substantially higher rates of disability in cases where interviewers have been far better trained on detection and probing. Examples include: a meta-analysis of mental illness incidence gives an estimated prevalence of 5.8 percent of the population based on dedicated surveys. 14 A GoI/WHO survey in the 1980s estimated visual disabilities at 1.5 percent of the population, a share that may have grown based on a national estimate of blind persons in 2000 of 18.7 million, of which 9.5 million were cataract-related and 3 million refractive error-related. 15 Naturally, different studies are subject to differences in approach and definition, but careful work by well-trained interviewers using better instruments and with reasonable definitions of disability have produced substantially higher estimates of disability prevalence than official statistics. The 12 Bhanushali (2005). GoI has recognized a number of these issues, as summarized in the 2006 Technical Advisory Committee report on Disability Statistics. 13 See Puri (2005) prepared as background material for this report, which provides a comprehensive summary of micro-studies on prevalence of different forms of disability in India. 14 Khandelwal et al. (2004). 15 Dandona et al (2001). If there is no change in the current trend of blindness, the study estimates that the number of blind persons in India would increase to 24.1 million in 2010, and to 31.6 million in 2020. -8-
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 and 34: converting income into well-being o
Page 35: 21. In light of the challenges that
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
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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
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Only around 5 percent of children w
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4.30. (b) Financial performance of
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only factor contributing to both po
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The numbers of CWD identified by SS
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IE training options. The impacts of
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part of the authorities to increase
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well beyond the needs of CWD alone.
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performance in the schooling system
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DLROs has contributed to West Benga
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CHAPTER 5: EMPLOYMENT OF PERSONS WI
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atios, while others such as J&K, Bi
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Figure 5.8: Employment rates over t
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• the relative wages of PWD to no
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of age and disability status. Multi
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5.23. For males in the survey, a de
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equirement of specific post identif
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5.34. Nonetheless, there has been u
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consistent with survey findings. Na
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exchanges are in any event servicin
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Source: NHFDC website reporting cum
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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
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Table 6.6: Contributions and benefi
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6.24. Easily the largest scheme for
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6.35. While the design of the insur
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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
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• in the area of education, the p
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awareness raising about disability
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more formal institutions in disabil
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7.28 There is little detailed analy
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Table 7.2: Institutions providing b
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systematically related to the numbe
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• collaboration between NGOs and
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moving to improved outcomes for PWD
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CHAPTER 8: ACCESS FOR PEOPLE WITH D
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Box 8.1: International and regional
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The comparison of institutional arr
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laudable, there are concerns that m
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ANNEX 1: COMPARING THE INCOMPARABLE
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of prevalence estimates across the
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person will be treated as having
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People with Disabilities in India: From Commitment to Outcomes

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