Summary:

India has a sizeable population of persons with disability. As the country makes economic progress,their number is likely to grow. Age and lifestyle-related disabilities and those due to traffic accidents are expected to rise sharply. Internationally, the highest reported disability rates are in OECD countries. Societal attitudes and stigma, often within their own families, limits disabled people from participating fully in social and economic life. Disabled children are less likely to be in school, adults are more likely to be unemployed, and families with a disabled member are worse off than average. Employment rates for the disabled have fallen between the 1990s and early 2000s even in the midst of economic growth. With better education and more access to jobs, people with disabilities will generate higher growth which will benefit the country as a whole.

India has a growing disability rights movement and one of the more progressive policy frameworks in the developing world. It has also just ratified the UN Convention on the Rights of Persons with Disabilities. However, a lot more needs to be done in terms of implementation and “getting the basics right”. This includes deepening preventive health programs, screening all children at a young age, empowering disabled young adults with employable skills, encouraging the private sector to employ people with disabilities, ensuring full integration by overcoming stigma, promoting newer thinking and better coordination of programs, and improving the measurement of disability to ensure that the scale of disability in India is better understood. Most importantly, persons with disabilities should themselves be made active participants in the development process.

Chapter 1: Socio-Economic Profile of Persons with Disabilities

The causes of disability are fast changing – from communicable diseases such as polio to age and lifestyle-related disabilities and accidents.

Large numbers of children with disabilities remain out of school. They are 4 to 5 times less likely to be in school than SC/ST children. If they do stay in school, they rarely progress beyond primary levels. This leads to lower employment and incomes.

There is a need for a more accurate data collection. Harmonizing definitions of disability categories in government surveys and the census would be a good beginning.

Chapter 2: Attitudes

Traditional belief attributing disability to “sins” of the individual or the family feeds a negative attitude about the individual’s capacity to be an active part of families, communities and the workforce. Those suffering from mental illness or mental retardation face the worst stigma and are subject to severe social exclusion. Unfortunately, these negative attitudes are often held by families of disabled people also and even in many cases by disabled people themselves due to low self-esteeem.

People with disabilities are considered ineligible to marry those without disabilities unless “adjusted” by high dowry. Disabled girls are usually married to older men, leading to a higher incidence of widowhood. Showcasing success stories of people with disabilities can challenge these deep rooted negative perceptions.

Chapter 3: Health

A large number of disabilities in India are preventable, including those arising from medical issues during birth, maternal conditions, malnutrition, and accidents and injuries. However, the health sector is yet to react more proactively to disability. Disability specific interventions have achieved limited penetration, especially in rural areas. These are generally limited to rehabilitation, though even there the potential of community based rehabilitation remains to be realized in many parts of the country.

There is also stark regional disparity. In general, states that lag in health services also lag in caring for the disabled. Among the disabled, those disabled from birth, women, and ST/SC/OBC are less likely to seek health care. Despite years of public intervention, access to aids and appliances remains the exception among people with disabilities.

Chapter 4: Education

While there has been a more concerted affort on the part of Governments in India to promote inclusion of children with special needs in recent years (in particular under SSA), children with special continue to have much higher out of school rates, and the system faces challenges in identifying them and responding to their needs. Only around 1% of funds under Sarva Shiksha Abhayan are spent on inclusive education. The budget for educating children with mild to moderate disabilities in regular school settings has not increased commensurately since the focus on inclusive education began in the 1970s.

A key issue in promoting education of children with special needs is institutional coordination. Coordination between the Ministries of Human Resource Development and Social Justice and Empowerment, the Rehabilitation Council of India and the general teacher training system needs to be improved. There is also a need for coming out with state-wise strategies on education for children with special needs.

Chapter 5: Employment

A large majority of disabled people are capable of productive work. But, employment rates for the disabled are lower than average, and have fallen since the early 1990s.. There are a range of public programs to promote PWD employment, but their impact has been negligible and largely confined to urban areas. Public sector employment reservations also exhibit poor outcomes due to design and implementation problems. Despite a 3% reservation in public employment since 2003, only 10% of posts have been identified as “suitable”. The quota policy is also very limiting and covers just three types of disability – locomotor, hearing and visual.

The situation in the private sector is worse. While the Persons with Disabilities Act, 1995, has a target of 5% employment in the private sector, the figure stood at 0.3% in the late 1990s; that of MNCs is even worse at 0.05%. Financial assistance too has hardly reached those in need. The National Handicapped Finance and Development Corporation disbursed assistance to less than 20,000 disabled persons between 1997 and 2002.

Chapter 6: Social Protection

The impact of the social protection system on the lives of disabled people is very low, with safety net programs for PWD offering low coverage and limited financial protection. Though centrally sponsored anti-poverty programmes have reservations for people with disabilities, the numbers benefited actually fall well below the minimum quota. The new National Rural Employment Guarantee Act has dropped the provision for reservations for the disabled entirely, though some states (e.g. AP) are making efforts to include disabled people. Several factors limit the effectiveness of safety net programs. Low program impact is a product of low awareness among PWD of programs, weak channels for increasing demand (e.g. linking SHGs of disabled people to credit), and in many states a lack of focus on the area of social protection for PWD.

Disability insurance schemes have low coverage, with financing mainly from the budget, but have considerable latent demand. While the presence of self-help groups and micro-insurance options for unorganised workers is encouraging, an ambitious Social Security Bill for the unorganised sector could deliver real benefits both for those already with disabilities and those who will become disabled in future.

Chapter 7: Policies and Institutions

Despite having one of the most progressive policy frameworks for persons with disabilities, India falls short in implementation. The Persons With Disabilities Act of 1995 is the cornerstone of India’s policy framework, but its enforcement mechanism faces many challenges in delivering the anticipate outcomes.

While they play an important role in service delivery for people with disabilities, there is a need to strengthen public-private partnerships with NGOs. In addition, persons with disability are treated more like clients than active participants. And, awareness on entitlements is very poor. . Further, the Ministry of Social Justice and Empowerment, the nodal agency for disability, is perennially short of resources.

In such a scenario, NGOs assume a larger role. However, there are concerns about weak monitoring mechanisms and accountability of public funds. There, is thus an urgent need for reforms at all levels.