People with Disabilities in India: From Commitment to Outcomes

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Table 3.10: Probability of PWD seeking health treatment, 2002 Variable Odds ratio of the probability of ever seeking treatment Individual Characteristics Female 0.87 Age 0.99 Any education up to primary 1.32 Post Primary 1.64 Disabled from Birth 0.28 Disability Dummy (Locomotor as reference) Mental 0.75 Visual 0.61 Hearing 0.43 Speech 0.43 Household Characteristics ST 0.53 SC 0.74 OBC 0.89 Household Size 1.02 Residence Urban 1.55 North 1.40 South 1.16 East 0.78 West 1.14 NE 0.78 Living Arrangements (Living w/ Parents as reference) live_alone 0.59 live_spouse 0.77 live_kids 0.62 live_other 0.66 Notes: (a) all coefficients significant at the .001 level except NS=not significant; (b) Reference categories for dummy variables are upper caste, no education, central region (UP/Uttarnachal, Bihar, Jharkhand), rural, currently not married or never married, and male. Source: Das (2006), using logistic regression. 3.42. The NSS does not provide information on what types of health services PWD accessed, nor information on why PWD did not access services. Some information is available on these questions from the UP and TN survey, from which results are presented in Table. 74 In terms of type of service received, easily the dominant one was medication (in 86 percent of cases), with physical therapy the only other significant service (in 44 percent of cases). In terms of type of provider accessed, the results in Table 3.11 for PWD are not noticeably different from non-PWD population in terms of public/private and allopathic/traditional service providers. With respect to reasons for not accessing services, the dominant reasons are economic, and others are probably common to the non-PWD population. However, around 16 percent of PWD report negative attitudes of providers as a reason for not seeking treatment. Finally, the failure to note inaccessibility has to be interpreted with caution, as these are local facilities which may be accessible by default (e.g. entire facility at ground level; no facilities like toilets). 74 The findings are supported by evidence from the Unnati and HI study of Gujarat on health-seeking behaviour of people with disabilities. -47-
Table 3.11: Type of Service Accessed and Reasons for Not Using Services by PWD, UP & TN Type of facility used if healthcare facility accessed in the last 3 months (multiple responses possible) Public health facility – Allopathic 31.6% Private health facility – Allopathic 61.4% Private health facility – Traditional 17.5% Faith healer, tantric, or astrologer or other facility 7.1% Reasons for not using health facilities even if needed (multiple responses possible) No services in area 52.3% Transportation 20.5% Could not afford services 70.5% Building inaccessible 0.0% Waiting time too long 13.6% Providers don’t treat people like me 15.9% Other 2.3% Source: UP and TN village survey, 2005. 3.43. Clearly more work is needed on both the health-seeking behaviour of PWD and the extent to which their problems in accessing decent services are similar to those of the general population, or have specific features above and beyond that such as attitudinal or physical access problems. One specific service that is important for many PWD is access to aids, appliances and assistive devices. Evidence on this is presented in Table 3.12. Only just over 20 percent of PWD in the NSS 58 th Round had ever been advised on aids and appliances and less than 16 percent had acquired any such aids or appliances. 75 Of those who had acquired them, less than one fifth nationally had got them through a government scheme, with Table 3.12: Disabled Individuals’ Access to Aids and Appliances Percent Acquired 15.95 Not acquired 6.0 Not advised 78.0 Source: Das (2006), using NSS 58 th round almost two thirds purchasing themselves. This is shown in Figure 3.5, which also shows the cross-state variation in Government assistance, with some states such as Chattisgarh having well over 40 percent of aids and appliances provided by Government, while in much richer states such as Gujarat that share was only around 10 percent. The generally low awareness of government schemes for free aids and appliances that the numbers suggest is supported by results from the TN and UP survey, which found that close to half of PWD respondents were not aware of such schemes (and that only 4 percent of all PWD had benefited from them). 3.40. Access to free aids and appliances is currently within the ambit of a social security system that functions very inadequately, not in small part due the manner in which it is designed. Thus, assistance to buy aids and appliances fall within a range of individual beneficiary schemes that often have serious implementation problems and low coverage. Due to this and other demand and supply side issues, coverage of rehabilitative services and aids is very limited. In addition, systems for support and maintenance of assistive devices remain under-developed. 75 This excludes people with mental disabilities, who were excluded from the question. -48-
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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’
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: Figure 3.4: Proportion of disabled
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
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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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