People with Disabilities in India: From Commitment to Outcomes

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Figure 3.5: Proportion of Aids and Appliances Acquired by Source Proportion of Aids and Appliances Acquired by Source Sorted in Descending Order of Government Assistance as a Proportion of All Sources by State 100 90 80 70 Percent 60 50 40 Purchased Assistance from Govt Assistance from NGO Other 30 20 10 0 Pondicherry Tripura Chattisgarh Mizoram A & N Islands Sikkim Madhya Pradesh Dadra & Nagar Have Orissa Tamil Nadu Andhra Pradesh Rajasthan Karnataka Source: Das (2006), using NSS 58 th round. Haryana Uttar Pradesh Goa Lakshdweep Delhi West Bengal Punjab Maharashtra Jammu & Kashmi Kerala Himachal Pradesh Gujarat Daman & Diu Jharkhand Bihar Uttaranchal Manipur Assam Meghalaya Nagaland Chandigarh Arunachal Pradesh 3.41. Table 3.13 also presents results on probabilities of accessing aids and appliances according to various characteristics. While many of the results are similar to probabilities of seeking treatment, there are a few interesting differences: • female PWD are even less likely relative to male PWD to receive aids and appliances than they are to seek treatment (this may also be a factor of the low number of women technicians) • while those disabled from birth still have lower rates of access (around two thirds the level of other PWD), the situation is considerably better than for seeking treatment relative to PWD who acquired their disabilities later in life. • the disability-specific probabilities are quite different to those for seeking treatment, with visually impaired people substantially more likely to receive aids and appliances, and those with speech impairments having insignificant probability. Table 3.13: Results on Probabilities of Accessing Aids and Appliances Variable Odds ratio of the probability of acquiring aids & appliances Individual Characteristics Female 0.71 Age 1.02 Any education up to primary 1.23 Post Primary 1.56 Currently Married 1.06NS Disabled from Birth 0.64 Disability Type (Locomotor as reference) Mental Visual 1.56 Hearing 0.55 Speech 0.04 Household Characteristics ST 0.63 SC 0.81 OBC 0.87 Household Size 0.99 Residence -49-
Urban 1.46 North 1.40 South 1.10 East 0.95NS West 1.36 NE 1.38 Living Arrangements (Living w/ Parents as reference) live_alone 0.72 live_spouse 0.69 live_kids 0.63 live_other 0.74 Notes: (a) all coefficients significant at .001 level except NS=not significant; (b) upper caste, no education, central region (UP/Uttaranchal, Bihar, Jharkhand), rural, currently not married or never married, male are reference categories for dummy variables. Source: Das (2006), using NSS 58 th round logistic regression. D. Factors affecting PWD access to health care 3.42. This section outlines some of the more specific challenges faced by PWD in accessing decent health services, some on the supply side of the system and others on the demand side. 3.43. (a) Disability identification and certification: A critical element of accessing treatment and rehabilitation services for PWD is identification and certification of disability. The challenges in institutional coordination of disability identification are discussed in Chapter 4. With respect to certification, the standard model is to rely on assessment and certification by teams at district hospitals. The obvious shortcoming of the system is that rural populations will often have low knowledge of and access to such teams (in addition to the costs associated with accessing district headquarters). In addition, evidence from Orissa indicates that arrangements for disability certification do not always function well, with only just over 10 percent of hospitals having disability certification schedules in place. 76 This is supported by research from Rajasthan which found vacancies for essential medical posts at districts facilities led to major problems with certification. 77 Faced with such challenges, disability NGOs have in some areas assumed a more assertive role vis-à-vis their district hospitals, e.g. in Rajasthan, the disability group Viklang Sangharsh Samiti attends the district hospital every week on the day designated for certification and monitors doctors’ attendance and completion of certification of all PWD who present. 78 3.44. To address the problems with district level certification, the authorities have also relied on a camp-based approach to disability identification and certification. This is a more accessible form, but still faces major challenges in both scale of outreach and human resource capacity to go to scale. The shortcomings of the current identification and certification process are brought out by results from the UP and TN survey, which found that 56 percent of PWD were not aware of the disability certification process, and that only around 21 percent were in possession of a PWD card. 3.45. There is clearly a major challenge in developing mixed models of early identification of disabilities which are feasible in the face of supply side constraints on qualified assessors. In this regard, many potential actors will be involved, from health care providers to anganwadis 76 Swabhiman (2004). 77 Bhambani (2005). 78 Bhambani, op.cit. -50-
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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
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 and 76: Figure 3.4: Proportion of disabled
Page 77: Table 3.11: Type of Service Accesse
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
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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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