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DISABILITY & 
IMPAIRMENT 
MADHUR VERMA 
PG JR III 
DEPTT. OF COMMUNITY MEDICINE 
PGIMS ROHTAK
Contents 
• Background 
• How To Define Disability 
• Causes Of Disability 
• Prevalence Of Disability 
• Data On Disability 
• Data From Census 2011 
• Socio- Economic Burden Of Disability 
• Policies And Guidelines For The Disabled 
• Schemes By The Centre And Haryana Govt.
Background 
Disability is complex, dynamic, multidimensional, and contested. 
“It is the umbrella term for impairments, activity limitations and 
participation restrictions, referring to the negative aspects of the 
interaction between an individual (with a health condition) and that 
individual’s contextual factors (environmental and personal 
factors).”
Background 
The transition from an individual, medical perspective to a 
structural, social perspective has been described as the shift from a 
“medical model to “social model” in which people are viewed as 
being disabled by society rather than by their bodies. 
The medical model and the social model are often presented 
as dichotomous, but disability should be viewed neither as purely 
medical nor as purely social: persons with disabilities can often 
experience problems arising from both. 
A balanced approach is needed, giving appropriate weightage 
to the different aspects of disability.
Effect of environment 
A person’s environment has a huge impact on the experience 
and extent of disability. Inaccessible environments create disability 
by creating barriers to participation and inclusion. 
Examples of the possible -ve impact of the environment include: 
• a Deaf individual without a sign language interpreter. 
• a wheelchair user in a building without an accessible bathroom or 
elevator. 
• a blind person using a computer without screen-reading software.
What is Disability? 
The World Health Organization (WHO 1976) draws on a three–fold 
distinction between impairment, disability and handicap: 
• Impairment is any loss or abnormality of psychological, physiological or 
anatomical structure or function. 
• Disability is any restriction or lack (resulting from an impairment) of 
ability to perform an activity in the manner or within the range 
considered normal for a human being. 
• Handicap is a disadvantage, for a given individual, resulting from 
impairment or a disability, which prevents the fulfilment of a role that is 
considered normal (depending on age, sex and social and cultural 
factors) for that individual.
ICF(International Classification of Functioning, 
Disability and Health) 
WHO reaffirmed this classification (1980), and in 2001 
issued the International Classification of Functioning, Disability 
and Health (ICF). 
The ICF distinguishes between body functions (physiological or 
psychological, e.g. vision) and body structures (anatomical parts, 
e.g. the eye and related structures) (WHO 2002). 
Since an individual’s functioning and disability occur in a context, 
the ICF also includes a list of environmental factors
ICF(International Classification of Functioning, 
Disability and Health) 
The ICF lists 9 broad domains of functioning which can be affected 
(WHO 2002): 
1. Learning and applying knowledge 
2. General tasks and demands 
3. Communication 
4. Mobility 
5. Self-care 
6. Domestic life 
7. Interpersonal interactions and relationships 
8. Major life areas 
9. Community, social and civic life
How to define disability??? 
According to the Persons with Disabilities (Equal Opportunities, Protection 
of Rights and Full Participation) Act, 1995, "Person with disability" means a 
person suffering from not less than 40% of any disability as certified by a 
medical authority (any hospital or institution, specified for the purposes of 
this Act by notification by the appropriate Government). 
As per the act "Disability" means - 
(i) Blindness; 
(ii) Low vision; 
(iii) Leprosy-cured; 
(iv) Hearing impairment 
(v) Loco motor disability; 
(vi) Mental retardation; 
(vii) Mental illness
How to define disability??? 
"Blindness" refers to a condition where a person suffers from any of 
the following conditions, 
(i) Total absence of sight. 
(ii) Visual acuity not exceeding 6/60 or 20/200 (snellen) in the 
better eye with correcting lenses; 
(iii) Limitation of the field of vision subtending an angle of 200 or 
worse; 
"Person with low vision" means a person with impairment of visual 
functioning even after treatment or standard refractive correction but 
who uses or is potentially capable of using vision for the planning or 
execution of a task with appropriate assistive device;
How to define disability??? 
"Leprosy cured person" means any person who has been cured of 
leprosy but is suffering from- 
I. Loss of sensation in hands or feet as well as loss of sensation and 
paresis in the eye and eye-lid but with no manifest deformity; 
II. Manifests deformity and paresis; but having sufficient mobility in 
their hands and feet to enable them to engage in normal economic 
activity; 
iii. Extreme physical deformity as well as advanced age which prevents 
him from undertaking any gainful occupation, and the expression 
"leprosy cured" shall be construed accordingly.
How to define disability??? 
"Hearing impairment" means loss of 60 dB or more in 
the better ear in the conversational range of frequencies; 
 "Loco motor disability" means disability of the bones, joints 
muscles leading to substantial restriction of the movement of 
the limbs or any form of cerebral palsy; 
 "Mental retardation" means a condition of arrested or 
incomplete development of mind of a person which is 
specially characterized by sub normality of intelligence; 
"Mental illness" means any mental disorder other than mental 
retardation;
Causes and Risk Factors of Disability 
• The most common causes of impairment and disability include 
chronic diseases such as diabetes, cardiovascular disease and 
cancer; injuries such as those due to road traffic crashes, 
conflicts, falls, landmines, mental impairments, birth defects, 
malnutrition, HIV/AIDS and other communicable diseases. 
• The disability manual by National Human Rights Commission 
elaborately describes various indirect causes of disability (NHRC 
2005).
Causes and Risk Factors of Disability 
Malnutrition: is a major cause of disability in India as well as a 
contributory factor in other ailments that increase susceptibility 
to disabling conditions. Common micro-nutrient deficiencies that 
affect disability include: 
• Vitamin A deficiency – blindness 
• Vitamin B complex deficiency – beriberi, pellagra, anaemia 
• Vitamin D deficiency – rickets (soft and deformed bones) 
• Iodine deficiency –learning difficulties, intellectual disabilities goitre 
• Iron deficiency – anaemia, which impedes learning and activity 
• Calcium deficiency – osteoporosis (fragile bones)
Causes and Risk Factors of Disability 
Conflict: War has been the single largest factor responsible for 
causing permanent disablement 
Occupational Hazards: for ex. low standards of safety and hazardous 
working conditions, Wheat harvesting and amputations, paddy 
sowing and muscular diseases, coconut picking and spinal cord 
injuries (NHRC 2005). 
Traffic Hazard: It is estimated that by 2020, road traffic accidents will 
be ranked as the third leading cause of disability in the Asian and 
Pacific region. (NHRC 2005)
Prevalence of disability 
The United Nations (UN) Disability Statistic’s Compendium (DISTAT) noted 
that disability rates are not comparable across the world because of 
differences in survey design, definitions, concepts and methods, as the 
proportion of disabled people per national population varies between less 
than 1% in Peru to about 21% in Austria (UN 1990).
According to world report on disability 2011…… 
Based on 2010 population (6.9 billion, 5.04 billion 15 years and 
over & 1.86 billion under 15 year) and 2004 disability prevalence 
estimates (World Health Survey and Global Burden of Disease) 
Including children, over a billion people (or about 15% of the 
world’s population) were estimated to be living with disability. 
This is higher than WHO estimates from the 1970s, which 
suggested a global prevalence of around 10%.
CENSUS OF INDIA 2011 
DATA ON DISABILITY 
Office of the Registrar General & Census Commissioner, India New Delhi
Present Dataset 
• Information on disability of individuals was collected 
during the Population Enumeration phase of Census 
2011 through ‘Household Schedule’ . 
• Similar information was collected during 2001 census 
also. Information for individuals residing in ‘Normal’, 
‘Institutional’ and ‘Houseless’ households was 
collected. 
• The table C-20- ‘Disabled by age-group and type of 
disability’ has been generated on the basis of 
processing 100% Census Schedules.
Historical Perspective 
• The question on disability was canvassed in all the Censuses 
since 1872 to 1931 
• The question on disability was not canvassed in the Censuses 
from 1941 to 1971 
• In Census 1981, information on three types of disability was 
collected 
• The question was dropped in Census 1991 
• In Census 2001, the question was again included and 
information on five types of disability was collected 
• In Census 2011 information on eight types of disability has 
been collected
Questions Canvassed in Census 2011 
Codes
Features of Disability Question, 2011 
• Has a filter question to ascertain disability status 
• Attempts to collect information on eight types of disabilities as 
against five in Census 2001. 
• Designed to cover most of the disabilities listed in the “Persons 
with Disabilities Act, 1995” and “The National Trust Act, 1999”. 
• The placement of the question on disability in the Census 
Schedule was changed. The question was brought forward at Q-9 
at Census 2011. This was the question No. 15 at the Census 2001.
Special Efforts Made to Improve Coverage 
Training 
• Intensive training at various levels including National Trainers, 
Master Trainers Facilitators 
• Training imparted by experts from disability sector using 
specially developed training modules 
• Role models from disability groups were invited in training 
classes to motivate and sensitize Census functionaries 
• National Centre for Promotion of Employment for Disabled 
People (NCPEDP) and its alliance partners were associated in 
developing training modules, imparting training and sensitizing 
Census functionaries.
Special Efforts Made to Improve Coverage (Contd.) 
Publicity 
• Wide publicity through electronic and print media undertaken. 
• Special audio/ video spots prepared in 12 languages 
• Special E-learning module prepared to show as to how to approach 
and extract information on disability from respondents 
• Leaflet on disability 
• Seminars and workshops 
• Banners and Posters 
• Events like Auto Rickshaw rally, car rally, Cycle rally
Special Efforts Made to Improve Coverage (Contd.) 
Cycle rickshaw rally at New Delhi by the disabled
Special Efforts Made to Improve Coverage (Contd.) 
Posters and Banners 
Leaflet on disability for Media Kit
Definitional Changes 2001-11 
Type of disability Change in definition 
In Seeing 1. One eyed persons were treated as disabled at Census 2001. At the 
Census 2011 such persons have not been treated as disabled in seeing. 
2. At the Census 2011 enumerators were asked to apply a simple test to 
ascertain blurred vision. At Census 2001 no such instructions were 
given. 
In Hearing 1. Persons using hearing aid have been treated as disabled at Census 2011. 
They were not treated as disabled at the Census 2001. 
2. Persons having problem in hearing through one ear although the other 
ear is functioning normally was considered having hearing disability in 
Census 2001. But in Census 2011, such persons were not considered as 
disabled. 
In Speech • Definition was made clearer in Census 2011 to record persons with 
speech disability. For instance, “persons who speak in single words and 
are not able to speak in sentences” was specifically mentioned to be 
treated as disabled.
Definitional Changes (Contd.) 
Type of 
disability 
Change in definition 
In Movement Specific mention of the following was made in the definition for 
Census 2011: 
1. Paralytic persons 
2. Those who crawl 
3. Those who are able to walk with the help of aid 
4. Have acute and permanent problems of joints/muscles 
5. Have stiffness or tightness in movement or have loose, involuntary 
movements or tremors of the body or have fragile bones 
6. Have difficulty balancing and coordinating body movement 
7. Have loss of sensation in body due to paralysis, Leprosy etc. 
8. Have deformity of body like hunch back or are dwarf.
Definitional Changes (Contd.) 
Type of disability Change in definition 
Mental 
Retardation 
New category introduced at Census 2011. Mental Retardation 
was covered under the category of Mental disability at Census 
2001. 
Mental Illness New category introduced at Census 2011. Mental Illness was 
covered under the category of Mental disability at Census 2001. 
Any Other New category introduced at Census 2011 to ensure complete 
coverage. This option enabled respondents to report those 
disabilities which are not listed in the question. In such cases, 
where informant was not sure about the type of disability this 
option of reporting disability as ‘Any Other’ was available to 
her/him. 
Multiple Disability New category introduced at Census 2011. The question has been 
designed to record as many as three types of disabilities from 
which the individual was reported to be suffering.
Data Highlights from 
census 2011
Disabled Population by Sex and Residence 
India : 2011 
Percentage of Disabled to total population 
Source: C-Series, Table C-20, Census of India 2001 and 2011 
Percentage of Disabled to total population 
India, 2011 
Residence Persons Males Females 
Total 2.21 2.41 2.01 
Rural 2.24 2.43 2.03 
Urban 2.17 2.34 1.98 
India, 2001 
Residence Persons Males Females 
Total 2.13 2.37 1.87 
Rural 2.21 2.47 1.93 
Urban 1.93 2.12 1.71
Disabled Population by Sex and Residence 
India : 2001-11 
Disabled Population by Sex and Residence 
India, 2011 
Residence Persons Males Females 
Total 26,810,557 14,986,202 11,824,355 
Rural 18,631,921 10,408,168 8,223,753 
Urban 8,178,636 4,578,034 3,600,602 
Decadal Change in Disabled Population 
by Sex and Residence, India, 2001-11 
Absolute Increase Percentage Decadal Growth 
Residence Persons Males Females Persons Males Females 
Total 4,903,788 2,380,567 2,523,221 22.4 18.9 27.1 
Rural 2,243,539 997,983 1,245,556 13.7 10.6 17.8 
Urban 2,660,249 1,382,584 1,277,665 48.2 43.3 55.0 
Source: C-Series, Table C-20, Census of India 2001 and 2011
Disabled Population by Residence 
India : 2001-2011 
2.30 
2.20 
2.10 
2.00 
1.90 
1.80 
1.70 
2.13 
2.21 
1.93 
2.21 
2.24 
Total Rural Urban 
2.17 
Percentage 
Proportion of Disabled Population by Residence 
India : 2001-11 
2001 2011 
• Percentage of disabled persons in India has increased both in rural 
and urban areas during the last decade. 
• Proportion of disabled population is higher in rural areas 
• Decadal increase in proportion is significant in urban areas 
Source: C-Series, Table C-20, Census of India 2001 and 2011
Disabled Population by Sex 
India : 2001-2011 
• Slight increase in disability among both the sexes 
over the decade 
• Proportion of disabled population is higher among 
males 
• Decadal Increase in proportion is higher among 
females 
55.9 
44.1 
Males 
Females 
Percentage Share of 
Disabled Population by Sex 
India, 2011 
Source: C-Series, Table C-20, Census of India 2001 and 2011
Proportion of Disabled Population 
India and States/UTs : 2011 
Source: C-Series, Table C-20, Census of India 2001 and 2011
Disability by Social Groups 
India : 2011 
Proportion of Disabled Population 
by Social Groups 
India, 2011 
( % ) 
Social Group Persons Males Females 
Total 2.21 2.41 2.01 
Scheduled Castes 2.45 2.68 2.20 
Scheduled Tribes 2.05 2.18 1.92 
Other than SC/ST 2.18 2.37 1.98 
Source: C-Series, Tables C-20, C-20SC and C-20ST, Census of India 2011
Disabled Population by Type of Disability (%) 
India : 2011 
Proportion of Disabled Population 
by Type of Disability 
India : 2011 
( % ) 
Type of Disability Persons Males Females 
Total 100.0 100.0 100.0 
In Seeing 18.8 17.6 20.2 
In Hearing 18.9 17.9 20.2 
In Speech 7.5 7.5 7.4 
In Movement 20.3 22.5 17.5 
Mental Retardation 5.6 5.8 5.4 
Mental Illness 2.7 2.8 2.6 
Any Other 18.4 18.2 18.6 
Multiple Disability 7.9 7.8 8.1 
Source: C-Series, Table C-20, Census of India 2011 
Proportion of Disabled Population 
In Seeing 
18.8 
In Hearing 
18.9 
In Speech 
7.5 
by Type of Disability 
In 
India : 2011 
(Persons) 
Movement 
20.3 
Any Other 
18.4 
Mental 
Illness 
2.7 
Mental 
Retardation 
5.6 
Multiple 
Disability 
7.9
Disabled Population by Type and Residence(%) 
India : 2011 
25.0 
20.0 
15.0 
10.0 
5.0 
Source: C-Series, Table C-20, Census of India 2011 
( % ) 
0.0 
In Seeing In Hearing In Speech In 
Movement 
Mental 
Retardation 
Mental 
Illness 
Any Other Multiple 
Disability 
18.8 18.2 
7.0 
21.7 
5.5 
2.7 
17.7 
8.5 
18.7 
20.5 
8.5 
17.1 
5.9 
2.8 
20.0 
6.5 
Disability by Type and Residence, India, 2011 
Rural Urban 
• Disability in hearing and speech is more in urban areas 
• Disability in movement and multiple disability is more in rural areas.
Disabled Population by Type and Social Group (%) 
India : 2011 
( % ) 
Percentage Share of Disabled Population by Type of 
Disability Among Social Groups 
India : 2011 
Type of Disability Total SCs STs OTH 
Total 100.0 100.0 100.0 100.0 
In Seeing 18.8 19.1 20.0 18.6 
In Hearing 18.9 17.4 19.3 19.2 
In Speech 7.5 5.2 5.3 8.3 
In Movement 20.3 20.5 22.5 20.0 
Mental Retardation 5.6 5.1 4.9 5.8 
Mental Illness 2.7 2.4 2.6 2.8 
Any Other 18.4 22.9 16.5 17.4 
Multiple Disability 7.9 7.3 8.9 7.9 
• Disability in seeing, hearing 
and movement and 
multiple disability is more 
among STs than that of SCs 
and Others 
• Disability in speech and 
mental retardation is more 
among others than that of 
SCs and STs 
Source: C-Series, Tables C-20, C-20SC and C-20ST, Census of India 2011
Percentage Share of Disabled Population by Type and Social Group 
India : 2011 
In Seeing 
19.1 
In Hearing 
17.4 
In Speech 
5.2 
Multiple Disability 
7.3 
Scheduled 
Castes 
In Movement 
20.5 
Any Other 
22.9 
Mental 
Illness 
2.4 
Mental 
Retardation 
5.1 
Any Other 
16.5 
Mental 
Illness 
2.6 
Any Other 
17.4 
Mental 
Illness 
2.8 
• Disability in seeing, movement and multiple disability is more among STs than that of SCs and Others 
• Disability in speech and mental retardation is more among others than that of SCs and STs 
Source: C-Series, Tables C-20, C-20SC and C-20ST, Census of India 2011 
In Seeing 
20.0 
In Hearing 
19.3 
In Speech 
In Movement 5.3 
22.5 
Mental 
Retardation 
4.9 
Multiple Disability 
8.9 
Scheduled 
Tribes 
In Seeing 
18.6 
In Hearing 
19.2 
In Speech 
In Movement 8.3 
20.0 
Mental 
Retardation 
5.8 
Multiple Disability 
7.9 
Other than 
SCs and STs
Disabled Population by Age and Sex 
India : 2011 
Proportion of Disabled Population in the 
Respective Age Groups 
India : 2011 
Age Group Persons Males Females 
All Ages 2.21 2.41 2.01 
0-4 1.14 1.18 1.11 
5-9 1.54 1.63 1.44 
10-19 1.82 1.96 1.67 
20-29 1.97 2.22 1.70 
30-39 2.09 2.41 1.77 
40-49 2.31 2.66 1.94 
50-59 2.83 3.16 2.47 
60-69 4.15 4.41 3.89 
70-79 6.22 6.26 6.19 
80-89 8.41 8.33 8.48 
90+ 8.40 7.88 8.85 
Age Not Stated 3.07 3.21 2.91 
Source: C-Series, Table C-20, Census of India 2011 
( % ) 
2.83 
2.31 
1.97 
1.82 
1.54 
8.40 
0.00 2.00 4.00 6.00 8.00 10.00 
90+ 
80-89 
70-79 
60-69 
50-59 
40-49 
30-39 
20-29 
10-19 
5-9 
0-4 
1.14 
2.09 
4.15 
6.22 
8.41 
Percentage 
Age Group 
Proportion of Disabled Population in 
the Respective Age Group 
India, 2011
Proportion of Disabled Population in the 
respective age groups by sex 
India : 2011 
3.89 
6.19 
8.85 
8.48 
90+ 
80-89 
70-79 
60-69 
50-59 
40-49 
30-39 
20-29 
10-19 
5-9 
0-4 
Females Males 
Source: C-Series, Table C-20, Census of India 2011 
( % ) 
2.47 
1.94 
1.77 
1.70 
1.67 
1.44 
1.11 
2.66 
2.41 
2.22 
1.63 
1.18 
• Disability among males is higher upto the age group 70-79 
• Disability among females is higher thereafter 
1.96 
3.16 
4.41 
6.26 
7.88 
8.33 
10.00 8.00 6.00 4.00 2.00 0.00 2.00 4.00 6.00 8.00 10.00
Poverty and Disability 
• The British Department for International Development (DFID) 
has recognized that, ‘disability is a major cause of social 
exclusion and it is both the cause and consequence of poverty’ 
(DFID 2000). 
• Recent World Bank studies assert that ‘half a billion disabled 
people are undisputedly amongst the poorest of the poor.’
Socio-Economic burden of disability 
The financial impact of disablement on the family/household is 
significant. 
 More specifically, a south Indian study evaluating the economic 
burden of families with disabled children indicated that the mean 
expenditure of the families with a disabled child was $254 per year 
compared with an expenditure of $181 per year of families with 
normal children, (t=10.2, P<.00001). (Kandamuthan and 
Kandamuthan 2004) 
Of the disabled children, 80% were not getting any social security 
payments and 90% had no special concessions for medical and 
other educational purposes. 
Of the mothers of the disabled children, 21% were unemployed as 
against 12% in the case of normal children.
Policies and Guidelines in India 
The legislative framework for the protection of the rights of disabled 
people is covered by following acts in India : 
1. Mental Health Act 1987 
2. Rehabilitation Council of India Act 1992 
3. Persons with Disabilities Act 1995 
4. The National Trust Act 1999
The Mental Health Act 1987 
Mental Health Act came into effect in April 1993 & replaced the Indian Lunacy 
Act of 1912. It consolidated and amended the law relating to the treatment and 
care of mentally ill persons and to make better provision with respect to their 
properly and affairs. 
Objectives 
• Regulate admission to psychiatric hospitals/nursing homes of mentally ill-persons 
who do not have sufficient understanding to seek treatment on a 
voluntary basis, and to protect the rights of such persons while being 
detained; 
• Protect society from the presence of mentally ill persons who have become or 
might become a danger or nuisance to others; 
• Protect citizens from being detained without sufficient cause in psychiatric 
hospitals/ nursing homes;
The Mental Health Act 1987 
• Regulate responsibility for maintenance charges of mentally ill persons who are 
admitted to psychiatric hospitals 
• Provide facilities for establishing guardianship of mentally ill persons who are 
incapable of managing their own affairs; 
• Provide for the establishment of Central Authority and State Authorities for 
Mental Health Services; 
• Regulate the powers of the Government for establishing, licensing and 
controlling psychiatric hospitals /nursing homes for mentally ill persons; 
• legal aid to mentally ill persons at State expense in certain cases. 
In 2002, the Act was implemented in 25 out of 30 states and Union Territories. 
Under the Act, each state is required to constitute a State Mental Health 
Authority (SMHA) to ensure effective and equitable enforcement of the 
provisions of the Act. (WHO 2006).
The Rehabilitation Council of India Act 
1992 
This Act sets out to regulate the training of professionals in rehabilitation 
and sets out a framework for a Central Rehabilitation Register. Specifically it 
sets out: 
1. Training policies and programmes; 
2. Standardise the training courses for professionals dealing with persons 
with disabilities; 
3. Grant recognition to the institutions running these training courses; 
4. Maintain a Central Rehabilitation Register of the rehabilitation 
professionals; 
5. Promote research in Rehabilitation and Special Education. 
6. The major functions of the council include the recognition of qualifications 
granted by Universities in India for Rehabilitation Professionals and also the 
recognition of qualification by Institutions outside India.
The Persons with Disabilities (Equal Opportunities, 
protection Of Rights And Full Participation) Act 1995 
This act provides 3% reservations for disabled people in poverty 
alleviation programmes, government posts, and in state 
educational facilities, as well as other rights and entitlement. 
Objectives : 
1. Prevention and Early Detection of Disabilities 8. Social Security 
2. Education 9. Employment 
3. Affirmative Action 10. Non-Discrimination 
4. Research And Manpower Development 
5. Recognition of Institutions for Persons with Disabilities 
6. Institution for Persons with Severe Disabilities 
7. The Chief Commissioner and Commissioners for Persons with Disabilities
The National Trust for Welfare of Persons with Autism, 
Cerebral Palsy, Mental Retardation and Multiple Disabilities 
Act 1999 
This Act provides for the constitution of a national body for the Welfare 
of Persons with Autism, Cerebral Palsy, Mental Retardation and 
Multiple Disabilities. 
Objectives: 
• Enable and empower PWD to live independently and as fully as 
possible from within and close to the community to which they 
belong; 
• to strengthen facilities & to provide support to persons with 
disability to live within their own families; 
• to extend support to registered organization to provide need based 
Services during the period of crises in the family of persons with 
disability; 
• to deal with problems of persons with disability who do not have 
family support.
National Policy for Persons with Disabilities Act 
2005 
The National Policy, released in February 2006 seeks to create an 
environment that provides them equal opportunities, protection of their 
rights and full participation in society. 
Its aim is to ensure better coordination between various wings of the 
State and Central Governments . 
The focus of the policy is on the following: 
• Prevention of Disabilities 
• Rehabilitation Measures 
• Physical Rehabilitation Strategies 
• Early Detection and Intervention 
• Counselling & Medical Rehabilitation
National Policy for Persons with Disabilities Act 
2005 
In addition to the legal framework, extensive infrastructure has 
been developed in India for disabled persons under this Act and 
includes the establishment of the following institutions: 
• Institute for the Physically Handicapped, New Delhi. 
• National Institute of Visually Handicapped, Dehradun 
• National Institute for Orthopedically Handicapped, Kolkata 
• National Institute for Mentally Handicapped, Secunderabad. 
• National Institute for Hearing Handicapped, Mumbai 
• National Institute of Rehabilitation Training & Research, Cuttack. 
• National Institute for Empowerment of Persons with Multiple 
Disabilities, Chennai
The Disability and Rehabilitation WHO 
Action Plan 2006-2011 
The document provides the overview of WHO's future plan of 
activities, which will be carried out or coordinated by the Disability 
and Rehabilitation team located in the Department of Injuries and 
Violence Prevention, in the NCD and Mental Health. 
VISION: All persons with disabilities live in dignity, with equal rights 
and opportunities 
MISSION: To enhance the quality of life for persons with disabilities 
through national, regional and global efforts to: 
• Raise awareness about the magnitude and consequences of 
disability 
• Facilitate data collection and analyse or disseminate disability-related 
data and information
The Disability and Rehabilitation WHO 
Action Plan 2006-2011 
• Support, promote and strengthen health and rehabilitation 
services for persons with disabilities and their families 
• Promote community based rehabilitation (CBR) 
• Promote development, production, distribution and servicing 
of assistive technology 
• Support the development, implementation, measuring and 
monitoring of policies to improve the rights and 
opportunities for people with disabilities. 
• Build capacity among health and rehabilitation policy makers 
and service providers 
• Foster multi-sectoral networks and partnerships
• In India, two Departments : "Department of Social Justice and 
Empowerment" and "Department of Disability Affairs" created 
under the Ministry of Social Justice and Empowerment with 
effect from May 14th, 2012. 
• The Government has introduced the Rights of Persons with 
Disabilities Bill, 2014 in the Rajya Sabha on 7th February, 2014. 
It has been proposed inter alia in the Bill to establish the 
National Commission and State Commissions for Persons with 
Disabilities.
The Rights of Persons with Disabilities Bill, 2014 
• The Bill repeals the Persons with Disabilities (Equal Opportunities Protection 
of Rights and Full Participation) Act, 1995. 
• Features of the bill: 
1. Definition of disability: Disability is defined to include 19 conditions such 
as: autism; low vision and blindness; cerebral palsy; deaf blindness; 
haemophilia; hearing impairment; leprosy; intellectual disability; mental 
illness; muscular dystrophy; multiple sclerosis; learning disability; speech and 
language disability; sickle cell disease; thalassemia; chronic neurological 
conditions; and multiple disability. Persons with benchmark disabilities are 
defined as those with at least 40 per cent of any of the above specified 
disabilities. 
2. Rights of persons with disabilities: The Bill states that persons with 
disabilities shall have the right to equality and shall not be discriminated 
against on grounds of their disability.
The Rights of Persons with Disabilities Bill, 2014 
3. Education, skill development and employment: All government 
institutions of higher education and those getting aid from the 
government are required to reserve at least 5% of seats for PWD. 
At least 5% of the vacancies are to be filled by persons or class 
of persons with at least 40 % of any of the disabilities. 
4. Legal Capacity: Disabled persons have the right, equally with others, 
to own and inherit movable and immovable property, as well as control 
their financial affairs. 
5. Guardianship: if a district court finds that a mentally ill person is not 
capable of taking legally binding decisions, it may order guardianship to 
the person.
6. National and State Commissions for persons with disabilities: 
The central and state governments are required to establish a 
National and State Commissions for Persons with Disabilities, 
respectively 
7. Central and state advisory boards: The boards shall advise 
governments on policies and programmes on disability and 
review the activities of organisations dealing with disabled 
persons.
Ali Yavar Jung National Institute For The Hearing Handicapped 
The District Disability Rehabilitation Centre (DDRCs) under 
Gramin Punarvasan Yojana (GPY) a programme of the Ministry of 
Social Justice and Empowerment, Government of India was started in 
the year 2000. 
Objectives : 
1. Provide total rehabilitation to persons with sensory (hearing 
and vision), physical and mental disabilities. 
2. Research 
3. Educational Programmes 
4. Service Facilities: Strategies for early identification and 
rehabilitative procedures. films and audio visuals on vocational 
training and job placement, etc. are being developed.
5. Community Programme: Identification and intervention, home 
bound training, correspondence training and also tele– 
rehabilitation services are being rendered and evolved with 
emerging needs. 
6. Material Development: Required for (a) education (b) public 
awareness and community education, literacy programme for adult 
deaf, Parent Counselling and Programme for strengthening 
voluntary organisations. 
7. Information and Documentation: Documenting and disseminating 
the latest information and developments in the science of hearing, 
speech and related technology is being done.
National Handicapped Finance and Development 
Corporation(NHFDC) 
Incorporated by Ministry of Social Justice and Empowerment 
Main Objectives: 
• Promote economic development of the persons with disabilities. 
• Promote self-employment for the benefit/economic rehabilitation 
• Assist individuals or groups with disabilities by way of loans and 
advances for economically and financially viable schemes. 
• Grant concessional finance in selected cases for the persons with 
disability in the country in collaboration with Government
National Handicapped Finance and Development 
Corporation(NHFDC) 
• Extend loans to the PWD for pursuing education for training at 
graduate and higher levels. 
• Assist in the upgradation of technical and entrepreneurial skills of 
PWD for proper and efficient mgt. of production units. 
• Set up training, quality control, process development, for the 
proper rehabilitation of the PWD in support of their economic 
pursuits. 
• Work as an apex institution for channelizing the funds through State 
Finance Corporation for the Handicapped or through corresponding 
Corporations authorised by State Govts./Boards set up by Union 
Govt/State Govt/Union Territory
SCHEME OF ASSISTANCE TO DISABLED PERSONS FOR 
PURCHASE/FITTING OF AIDS/APPLIANCES (ADIP SCHEME) April, 2014 
Objectives 
• to assist the needy disabled persons in procuring durable, 
sophisticated and scientifically manufactured aids & appliances to 
promote rehabilitation of PWD and enhance their economic 
potential with the help of Implementing Agencies 
• Implementing Agencies will take PRE & POST FITTING CARE of the 
aids and appliances distributed under the Scheme. 
• Implementing Agencies will give wide publicity of the distribution of 
such aid and appliances to PwDs. 
• After the camps, they shall provide a list of beneficiaries and the 
details of aids and assistive devices with the cost incurred to the 
State Government and the Department of Disability Affairs.
SCHEME OF ASSISTANCE TO DISABLED PERSONS FOR 
PURCHASE/FITTING OF AIDS/APPLIANCES (ADIP SCHEME) April, 2014 
The Scheme shall also include essential medical/surgical 
correction and intervention, prior to fitment of aids and 
appliances, as per the following norms: 
(i) From ₹.500/- to ₹.1,000/- for hearing & speech impaired. 
(ii) From ₹.1000/- to ₹2,000/- for visually disabled. 
(iii) From ₹ 3000/- to ₹ 5,000/- for orthopedically disabled
ELIGIBILITY OF THE BENEFICIARIES 
A person with disabilities fulfilling following conditions would be 
eligible for assistance under ADIP Scheme. 
i. An Indian citizen of any age. 
ii. Holds a 40% Disablement Certificate. 
iii. Has monthly income not exceeding ₹ 20,000/- pm. 
iv. For dependents, the income of parents/guardians <₹ 20,000 pm. 
v. Who have not received assistance during the last 3 years for the same 
purpose from any source. However, for children below 12 years of age, this l 
limit would be 1 year.
Schemes offered to the disabled by the central Govt. 
1. Scheme of Integrated Education for The Disabled Children 
2. Scholarships For The Disabled 
3. children's Educational Allowance 
4. Railway Travel Concession: 50% concession 
5. Reservation of Jobs: 3% vacancies, Carry forward ( A roster 
(100 point) has been prescribed for giving effect to 
reservation of jobs for physically handicapped persons. In this 
roster 67th vacancy occurring in a particular year would be 
reserved for the deaf.) 
6. Age Relaxation: UPPER AGE + 10 YEARS 
SOURCE : http://ayjnihh.nic.in/index.asp
Schemes offered to the disabled by the central Govt. 
7. Promotion: Not to be denied promotion on medical grounds. 
8. Posting of Physically Handicapped Candidates: transfer to or 
near their native places may also be given preferences. 
9. Income Tax Concessions: Section 80 DD , Max limit ₹15000. 
10. Professional Tax Exemption 
11. Award of Dealerships/Agencies by Oil Companies: 7.5% 
reservations 
12. Economic Assistance: eligible to take loans under the scheme 
with minimum rate of interest (4% uniformly)
Schemes offered to the disabled by the Haryana Govt. 
• Reservation in Government Job: 3% of jobs are reserved 
• Housing board: Handicapped persons get priority in allotment of 
Houses and there is 01.5% reservation . 
• Age Relaxation: The Upper age limit is relaxed by 10 years for 
handicapped persons for applying in Government jobs. 
• Scholarship/Stipend: The State Government awards scholarship 
to the handicapped students (50- 400 ₹ pm) 
• Disability Pension/Social Security Pension: Disabled persons of 
the age group of 65 years and above having disability of 70% and 
above with family income of ₹ 200/– p.m. or less get disability 
pension of ₹ 100/– p.m. 
• Un–employment allowance: Disabled persons who has registered 
in employment exchange get unemployment allowance (150-250 
₹ pm) SOURCE : http://ayjnihh.nic.in/index.asp
Schemes offered to the disabled by the Haryana Govt. 
• Conveyance Allowances: Physically handicapped employees get 
conveyance allowance @ 8% of their basic pay subject to a 
maximum of Rs.150/– p.m 
• Bus concession: The State Government gives free bus pass to all 
types of blind and other disabled persons having 100 disability. 
• Assistance for self employment: Haryana Financial Corporation 
gives loan to all types of handicapped for starting self 
employment. 
• Exemption in road tax: All types of handicapped persons are 
exempted from paying road tax. 
• Awards/Sports/Seminars: State Government gives awards to 
the best handicapped employees and the best self employed 
disabled for their encouragement.
Schemes offered to the disabled by the Haryana Govt. 
• Assistance for purchase of aids and appliances: The crippled 
and orthopaedically handicapped persons get artificial limbs 
and wheel chair by the State Government whose case is 
recommended by a medical specialist or Chief Medical Officer. 
• Other Concessions/facilities: 
Welfare activities: Deaf & dumb person get vocational training 
during which they get free rationing & free lodging/boarding & 
medical facilities.
Next time u c smbdy on a wheel chair, don’t feel 
pitty!!!!! 
THEY MIGHT BE THE BEST OF ALL U 
REMEMBER !!!!!

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Disability and impairment

  • 1. DISABILITY & IMPAIRMENT MADHUR VERMA PG JR III DEPTT. OF COMMUNITY MEDICINE PGIMS ROHTAK
  • 2. Contents • Background • How To Define Disability • Causes Of Disability • Prevalence Of Disability • Data On Disability • Data From Census 2011 • Socio- Economic Burden Of Disability • Policies And Guidelines For The Disabled • Schemes By The Centre And Haryana Govt.
  • 3. Background Disability is complex, dynamic, multidimensional, and contested. “It is the umbrella term for impairments, activity limitations and participation restrictions, referring to the negative aspects of the interaction between an individual (with a health condition) and that individual’s contextual factors (environmental and personal factors).”
  • 4. Background The transition from an individual, medical perspective to a structural, social perspective has been described as the shift from a “medical model to “social model” in which people are viewed as being disabled by society rather than by their bodies. The medical model and the social model are often presented as dichotomous, but disability should be viewed neither as purely medical nor as purely social: persons with disabilities can often experience problems arising from both. A balanced approach is needed, giving appropriate weightage to the different aspects of disability.
  • 5. Effect of environment A person’s environment has a huge impact on the experience and extent of disability. Inaccessible environments create disability by creating barriers to participation and inclusion. Examples of the possible -ve impact of the environment include: • a Deaf individual without a sign language interpreter. • a wheelchair user in a building without an accessible bathroom or elevator. • a blind person using a computer without screen-reading software.
  • 6. What is Disability? The World Health Organization (WHO 1976) draws on a three–fold distinction between impairment, disability and handicap: • Impairment is any loss or abnormality of psychological, physiological or anatomical structure or function. • Disability is any restriction or lack (resulting from an impairment) of ability to perform an activity in the manner or within the range considered normal for a human being. • Handicap is a disadvantage, for a given individual, resulting from impairment or a disability, which prevents the fulfilment of a role that is considered normal (depending on age, sex and social and cultural factors) for that individual.
  • 7. ICF(International Classification of Functioning, Disability and Health) WHO reaffirmed this classification (1980), and in 2001 issued the International Classification of Functioning, Disability and Health (ICF). The ICF distinguishes between body functions (physiological or psychological, e.g. vision) and body structures (anatomical parts, e.g. the eye and related structures) (WHO 2002). Since an individual’s functioning and disability occur in a context, the ICF also includes a list of environmental factors
  • 8. ICF(International Classification of Functioning, Disability and Health) The ICF lists 9 broad domains of functioning which can be affected (WHO 2002): 1. Learning and applying knowledge 2. General tasks and demands 3. Communication 4. Mobility 5. Self-care 6. Domestic life 7. Interpersonal interactions and relationships 8. Major life areas 9. Community, social and civic life
  • 9. How to define disability??? According to the Persons with Disabilities (Equal Opportunities, Protection of Rights and Full Participation) Act, 1995, "Person with disability" means a person suffering from not less than 40% of any disability as certified by a medical authority (any hospital or institution, specified for the purposes of this Act by notification by the appropriate Government). As per the act "Disability" means - (i) Blindness; (ii) Low vision; (iii) Leprosy-cured; (iv) Hearing impairment (v) Loco motor disability; (vi) Mental retardation; (vii) Mental illness
  • 10. How to define disability??? "Blindness" refers to a condition where a person suffers from any of the following conditions, (i) Total absence of sight. (ii) Visual acuity not exceeding 6/60 or 20/200 (snellen) in the better eye with correcting lenses; (iii) Limitation of the field of vision subtending an angle of 200 or worse; "Person with low vision" means a person with impairment of visual functioning even after treatment or standard refractive correction but who uses or is potentially capable of using vision for the planning or execution of a task with appropriate assistive device;
  • 11. How to define disability??? "Leprosy cured person" means any person who has been cured of leprosy but is suffering from- I. Loss of sensation in hands or feet as well as loss of sensation and paresis in the eye and eye-lid but with no manifest deformity; II. Manifests deformity and paresis; but having sufficient mobility in their hands and feet to enable them to engage in normal economic activity; iii. Extreme physical deformity as well as advanced age which prevents him from undertaking any gainful occupation, and the expression "leprosy cured" shall be construed accordingly.
  • 12. How to define disability??? "Hearing impairment" means loss of 60 dB or more in the better ear in the conversational range of frequencies;  "Loco motor disability" means disability of the bones, joints muscles leading to substantial restriction of the movement of the limbs or any form of cerebral palsy;  "Mental retardation" means a condition of arrested or incomplete development of mind of a person which is specially characterized by sub normality of intelligence; "Mental illness" means any mental disorder other than mental retardation;
  • 13. Causes and Risk Factors of Disability • The most common causes of impairment and disability include chronic diseases such as diabetes, cardiovascular disease and cancer; injuries such as those due to road traffic crashes, conflicts, falls, landmines, mental impairments, birth defects, malnutrition, HIV/AIDS and other communicable diseases. • The disability manual by National Human Rights Commission elaborately describes various indirect causes of disability (NHRC 2005).
  • 14. Causes and Risk Factors of Disability Malnutrition: is a major cause of disability in India as well as a contributory factor in other ailments that increase susceptibility to disabling conditions. Common micro-nutrient deficiencies that affect disability include: • Vitamin A deficiency – blindness • Vitamin B complex deficiency – beriberi, pellagra, anaemia • Vitamin D deficiency – rickets (soft and deformed bones) • Iodine deficiency –learning difficulties, intellectual disabilities goitre • Iron deficiency – anaemia, which impedes learning and activity • Calcium deficiency – osteoporosis (fragile bones)
  • 15. Causes and Risk Factors of Disability Conflict: War has been the single largest factor responsible for causing permanent disablement Occupational Hazards: for ex. low standards of safety and hazardous working conditions, Wheat harvesting and amputations, paddy sowing and muscular diseases, coconut picking and spinal cord injuries (NHRC 2005). Traffic Hazard: It is estimated that by 2020, road traffic accidents will be ranked as the third leading cause of disability in the Asian and Pacific region. (NHRC 2005)
  • 16. Prevalence of disability The United Nations (UN) Disability Statistic’s Compendium (DISTAT) noted that disability rates are not comparable across the world because of differences in survey design, definitions, concepts and methods, as the proportion of disabled people per national population varies between less than 1% in Peru to about 21% in Austria (UN 1990).
  • 17. According to world report on disability 2011…… Based on 2010 population (6.9 billion, 5.04 billion 15 years and over & 1.86 billion under 15 year) and 2004 disability prevalence estimates (World Health Survey and Global Burden of Disease) Including children, over a billion people (or about 15% of the world’s population) were estimated to be living with disability. This is higher than WHO estimates from the 1970s, which suggested a global prevalence of around 10%.
  • 18. CENSUS OF INDIA 2011 DATA ON DISABILITY Office of the Registrar General & Census Commissioner, India New Delhi
  • 19. Present Dataset • Information on disability of individuals was collected during the Population Enumeration phase of Census 2011 through ‘Household Schedule’ . • Similar information was collected during 2001 census also. Information for individuals residing in ‘Normal’, ‘Institutional’ and ‘Houseless’ households was collected. • The table C-20- ‘Disabled by age-group and type of disability’ has been generated on the basis of processing 100% Census Schedules.
  • 20. Historical Perspective • The question on disability was canvassed in all the Censuses since 1872 to 1931 • The question on disability was not canvassed in the Censuses from 1941 to 1971 • In Census 1981, information on three types of disability was collected • The question was dropped in Census 1991 • In Census 2001, the question was again included and information on five types of disability was collected • In Census 2011 information on eight types of disability has been collected
  • 21. Questions Canvassed in Census 2011 Codes
  • 22. Features of Disability Question, 2011 • Has a filter question to ascertain disability status • Attempts to collect information on eight types of disabilities as against five in Census 2001. • Designed to cover most of the disabilities listed in the “Persons with Disabilities Act, 1995” and “The National Trust Act, 1999”. • The placement of the question on disability in the Census Schedule was changed. The question was brought forward at Q-9 at Census 2011. This was the question No. 15 at the Census 2001.
  • 23. Special Efforts Made to Improve Coverage Training • Intensive training at various levels including National Trainers, Master Trainers Facilitators • Training imparted by experts from disability sector using specially developed training modules • Role models from disability groups were invited in training classes to motivate and sensitize Census functionaries • National Centre for Promotion of Employment for Disabled People (NCPEDP) and its alliance partners were associated in developing training modules, imparting training and sensitizing Census functionaries.
  • 24. Special Efforts Made to Improve Coverage (Contd.) Publicity • Wide publicity through electronic and print media undertaken. • Special audio/ video spots prepared in 12 languages • Special E-learning module prepared to show as to how to approach and extract information on disability from respondents • Leaflet on disability • Seminars and workshops • Banners and Posters • Events like Auto Rickshaw rally, car rally, Cycle rally
  • 25. Special Efforts Made to Improve Coverage (Contd.) Cycle rickshaw rally at New Delhi by the disabled
  • 26. Special Efforts Made to Improve Coverage (Contd.) Posters and Banners Leaflet on disability for Media Kit
  • 27. Definitional Changes 2001-11 Type of disability Change in definition In Seeing 1. One eyed persons were treated as disabled at Census 2001. At the Census 2011 such persons have not been treated as disabled in seeing. 2. At the Census 2011 enumerators were asked to apply a simple test to ascertain blurred vision. At Census 2001 no such instructions were given. In Hearing 1. Persons using hearing aid have been treated as disabled at Census 2011. They were not treated as disabled at the Census 2001. 2. Persons having problem in hearing through one ear although the other ear is functioning normally was considered having hearing disability in Census 2001. But in Census 2011, such persons were not considered as disabled. In Speech • Definition was made clearer in Census 2011 to record persons with speech disability. For instance, “persons who speak in single words and are not able to speak in sentences” was specifically mentioned to be treated as disabled.
  • 28. Definitional Changes (Contd.) Type of disability Change in definition In Movement Specific mention of the following was made in the definition for Census 2011: 1. Paralytic persons 2. Those who crawl 3. Those who are able to walk with the help of aid 4. Have acute and permanent problems of joints/muscles 5. Have stiffness or tightness in movement or have loose, involuntary movements or tremors of the body or have fragile bones 6. Have difficulty balancing and coordinating body movement 7. Have loss of sensation in body due to paralysis, Leprosy etc. 8. Have deformity of body like hunch back or are dwarf.
  • 29. Definitional Changes (Contd.) Type of disability Change in definition Mental Retardation New category introduced at Census 2011. Mental Retardation was covered under the category of Mental disability at Census 2001. Mental Illness New category introduced at Census 2011. Mental Illness was covered under the category of Mental disability at Census 2001. Any Other New category introduced at Census 2011 to ensure complete coverage. This option enabled respondents to report those disabilities which are not listed in the question. In such cases, where informant was not sure about the type of disability this option of reporting disability as ‘Any Other’ was available to her/him. Multiple Disability New category introduced at Census 2011. The question has been designed to record as many as three types of disabilities from which the individual was reported to be suffering.
  • 30. Data Highlights from census 2011
  • 31. Disabled Population by Sex and Residence India : 2011 Percentage of Disabled to total population Source: C-Series, Table C-20, Census of India 2001 and 2011 Percentage of Disabled to total population India, 2011 Residence Persons Males Females Total 2.21 2.41 2.01 Rural 2.24 2.43 2.03 Urban 2.17 2.34 1.98 India, 2001 Residence Persons Males Females Total 2.13 2.37 1.87 Rural 2.21 2.47 1.93 Urban 1.93 2.12 1.71
  • 32. Disabled Population by Sex and Residence India : 2001-11 Disabled Population by Sex and Residence India, 2011 Residence Persons Males Females Total 26,810,557 14,986,202 11,824,355 Rural 18,631,921 10,408,168 8,223,753 Urban 8,178,636 4,578,034 3,600,602 Decadal Change in Disabled Population by Sex and Residence, India, 2001-11 Absolute Increase Percentage Decadal Growth Residence Persons Males Females Persons Males Females Total 4,903,788 2,380,567 2,523,221 22.4 18.9 27.1 Rural 2,243,539 997,983 1,245,556 13.7 10.6 17.8 Urban 2,660,249 1,382,584 1,277,665 48.2 43.3 55.0 Source: C-Series, Table C-20, Census of India 2001 and 2011
  • 33. Disabled Population by Residence India : 2001-2011 2.30 2.20 2.10 2.00 1.90 1.80 1.70 2.13 2.21 1.93 2.21 2.24 Total Rural Urban 2.17 Percentage Proportion of Disabled Population by Residence India : 2001-11 2001 2011 • Percentage of disabled persons in India has increased both in rural and urban areas during the last decade. • Proportion of disabled population is higher in rural areas • Decadal increase in proportion is significant in urban areas Source: C-Series, Table C-20, Census of India 2001 and 2011
  • 34. Disabled Population by Sex India : 2001-2011 • Slight increase in disability among both the sexes over the decade • Proportion of disabled population is higher among males • Decadal Increase in proportion is higher among females 55.9 44.1 Males Females Percentage Share of Disabled Population by Sex India, 2011 Source: C-Series, Table C-20, Census of India 2001 and 2011
  • 35. Proportion of Disabled Population India and States/UTs : 2011 Source: C-Series, Table C-20, Census of India 2001 and 2011
  • 36. Disability by Social Groups India : 2011 Proportion of Disabled Population by Social Groups India, 2011 ( % ) Social Group Persons Males Females Total 2.21 2.41 2.01 Scheduled Castes 2.45 2.68 2.20 Scheduled Tribes 2.05 2.18 1.92 Other than SC/ST 2.18 2.37 1.98 Source: C-Series, Tables C-20, C-20SC and C-20ST, Census of India 2011
  • 37. Disabled Population by Type of Disability (%) India : 2011 Proportion of Disabled Population by Type of Disability India : 2011 ( % ) Type of Disability Persons Males Females Total 100.0 100.0 100.0 In Seeing 18.8 17.6 20.2 In Hearing 18.9 17.9 20.2 In Speech 7.5 7.5 7.4 In Movement 20.3 22.5 17.5 Mental Retardation 5.6 5.8 5.4 Mental Illness 2.7 2.8 2.6 Any Other 18.4 18.2 18.6 Multiple Disability 7.9 7.8 8.1 Source: C-Series, Table C-20, Census of India 2011 Proportion of Disabled Population In Seeing 18.8 In Hearing 18.9 In Speech 7.5 by Type of Disability In India : 2011 (Persons) Movement 20.3 Any Other 18.4 Mental Illness 2.7 Mental Retardation 5.6 Multiple Disability 7.9
  • 38. Disabled Population by Type and Residence(%) India : 2011 25.0 20.0 15.0 10.0 5.0 Source: C-Series, Table C-20, Census of India 2011 ( % ) 0.0 In Seeing In Hearing In Speech In Movement Mental Retardation Mental Illness Any Other Multiple Disability 18.8 18.2 7.0 21.7 5.5 2.7 17.7 8.5 18.7 20.5 8.5 17.1 5.9 2.8 20.0 6.5 Disability by Type and Residence, India, 2011 Rural Urban • Disability in hearing and speech is more in urban areas • Disability in movement and multiple disability is more in rural areas.
  • 39. Disabled Population by Type and Social Group (%) India : 2011 ( % ) Percentage Share of Disabled Population by Type of Disability Among Social Groups India : 2011 Type of Disability Total SCs STs OTH Total 100.0 100.0 100.0 100.0 In Seeing 18.8 19.1 20.0 18.6 In Hearing 18.9 17.4 19.3 19.2 In Speech 7.5 5.2 5.3 8.3 In Movement 20.3 20.5 22.5 20.0 Mental Retardation 5.6 5.1 4.9 5.8 Mental Illness 2.7 2.4 2.6 2.8 Any Other 18.4 22.9 16.5 17.4 Multiple Disability 7.9 7.3 8.9 7.9 • Disability in seeing, hearing and movement and multiple disability is more among STs than that of SCs and Others • Disability in speech and mental retardation is more among others than that of SCs and STs Source: C-Series, Tables C-20, C-20SC and C-20ST, Census of India 2011
  • 40. Percentage Share of Disabled Population by Type and Social Group India : 2011 In Seeing 19.1 In Hearing 17.4 In Speech 5.2 Multiple Disability 7.3 Scheduled Castes In Movement 20.5 Any Other 22.9 Mental Illness 2.4 Mental Retardation 5.1 Any Other 16.5 Mental Illness 2.6 Any Other 17.4 Mental Illness 2.8 • Disability in seeing, movement and multiple disability is more among STs than that of SCs and Others • Disability in speech and mental retardation is more among others than that of SCs and STs Source: C-Series, Tables C-20, C-20SC and C-20ST, Census of India 2011 In Seeing 20.0 In Hearing 19.3 In Speech In Movement 5.3 22.5 Mental Retardation 4.9 Multiple Disability 8.9 Scheduled Tribes In Seeing 18.6 In Hearing 19.2 In Speech In Movement 8.3 20.0 Mental Retardation 5.8 Multiple Disability 7.9 Other than SCs and STs
  • 41. Disabled Population by Age and Sex India : 2011 Proportion of Disabled Population in the Respective Age Groups India : 2011 Age Group Persons Males Females All Ages 2.21 2.41 2.01 0-4 1.14 1.18 1.11 5-9 1.54 1.63 1.44 10-19 1.82 1.96 1.67 20-29 1.97 2.22 1.70 30-39 2.09 2.41 1.77 40-49 2.31 2.66 1.94 50-59 2.83 3.16 2.47 60-69 4.15 4.41 3.89 70-79 6.22 6.26 6.19 80-89 8.41 8.33 8.48 90+ 8.40 7.88 8.85 Age Not Stated 3.07 3.21 2.91 Source: C-Series, Table C-20, Census of India 2011 ( % ) 2.83 2.31 1.97 1.82 1.54 8.40 0.00 2.00 4.00 6.00 8.00 10.00 90+ 80-89 70-79 60-69 50-59 40-49 30-39 20-29 10-19 5-9 0-4 1.14 2.09 4.15 6.22 8.41 Percentage Age Group Proportion of Disabled Population in the Respective Age Group India, 2011
  • 42. Proportion of Disabled Population in the respective age groups by sex India : 2011 3.89 6.19 8.85 8.48 90+ 80-89 70-79 60-69 50-59 40-49 30-39 20-29 10-19 5-9 0-4 Females Males Source: C-Series, Table C-20, Census of India 2011 ( % ) 2.47 1.94 1.77 1.70 1.67 1.44 1.11 2.66 2.41 2.22 1.63 1.18 • Disability among males is higher upto the age group 70-79 • Disability among females is higher thereafter 1.96 3.16 4.41 6.26 7.88 8.33 10.00 8.00 6.00 4.00 2.00 0.00 2.00 4.00 6.00 8.00 10.00
  • 43. Poverty and Disability • The British Department for International Development (DFID) has recognized that, ‘disability is a major cause of social exclusion and it is both the cause and consequence of poverty’ (DFID 2000). • Recent World Bank studies assert that ‘half a billion disabled people are undisputedly amongst the poorest of the poor.’
  • 44. Socio-Economic burden of disability The financial impact of disablement on the family/household is significant.  More specifically, a south Indian study evaluating the economic burden of families with disabled children indicated that the mean expenditure of the families with a disabled child was $254 per year compared with an expenditure of $181 per year of families with normal children, (t=10.2, P<.00001). (Kandamuthan and Kandamuthan 2004) Of the disabled children, 80% were not getting any social security payments and 90% had no special concessions for medical and other educational purposes. Of the mothers of the disabled children, 21% were unemployed as against 12% in the case of normal children.
  • 45. Policies and Guidelines in India The legislative framework for the protection of the rights of disabled people is covered by following acts in India : 1. Mental Health Act 1987 2. Rehabilitation Council of India Act 1992 3. Persons with Disabilities Act 1995 4. The National Trust Act 1999
  • 46. The Mental Health Act 1987 Mental Health Act came into effect in April 1993 & replaced the Indian Lunacy Act of 1912. It consolidated and amended the law relating to the treatment and care of mentally ill persons and to make better provision with respect to their properly and affairs. Objectives • Regulate admission to psychiatric hospitals/nursing homes of mentally ill-persons who do not have sufficient understanding to seek treatment on a voluntary basis, and to protect the rights of such persons while being detained; • Protect society from the presence of mentally ill persons who have become or might become a danger or nuisance to others; • Protect citizens from being detained without sufficient cause in psychiatric hospitals/ nursing homes;
  • 47. The Mental Health Act 1987 • Regulate responsibility for maintenance charges of mentally ill persons who are admitted to psychiatric hospitals • Provide facilities for establishing guardianship of mentally ill persons who are incapable of managing their own affairs; • Provide for the establishment of Central Authority and State Authorities for Mental Health Services; • Regulate the powers of the Government for establishing, licensing and controlling psychiatric hospitals /nursing homes for mentally ill persons; • legal aid to mentally ill persons at State expense in certain cases. In 2002, the Act was implemented in 25 out of 30 states and Union Territories. Under the Act, each state is required to constitute a State Mental Health Authority (SMHA) to ensure effective and equitable enforcement of the provisions of the Act. (WHO 2006).
  • 48. The Rehabilitation Council of India Act 1992 This Act sets out to regulate the training of professionals in rehabilitation and sets out a framework for a Central Rehabilitation Register. Specifically it sets out: 1. Training policies and programmes; 2. Standardise the training courses for professionals dealing with persons with disabilities; 3. Grant recognition to the institutions running these training courses; 4. Maintain a Central Rehabilitation Register of the rehabilitation professionals; 5. Promote research in Rehabilitation and Special Education. 6. The major functions of the council include the recognition of qualifications granted by Universities in India for Rehabilitation Professionals and also the recognition of qualification by Institutions outside India.
  • 49. The Persons with Disabilities (Equal Opportunities, protection Of Rights And Full Participation) Act 1995 This act provides 3% reservations for disabled people in poverty alleviation programmes, government posts, and in state educational facilities, as well as other rights and entitlement. Objectives : 1. Prevention and Early Detection of Disabilities 8. Social Security 2. Education 9. Employment 3. Affirmative Action 10. Non-Discrimination 4. Research And Manpower Development 5. Recognition of Institutions for Persons with Disabilities 6. Institution for Persons with Severe Disabilities 7. The Chief Commissioner and Commissioners for Persons with Disabilities
  • 50. The National Trust for Welfare of Persons with Autism, Cerebral Palsy, Mental Retardation and Multiple Disabilities Act 1999 This Act provides for the constitution of a national body for the Welfare of Persons with Autism, Cerebral Palsy, Mental Retardation and Multiple Disabilities. Objectives: • Enable and empower PWD to live independently and as fully as possible from within and close to the community to which they belong; • to strengthen facilities & to provide support to persons with disability to live within their own families; • to extend support to registered organization to provide need based Services during the period of crises in the family of persons with disability; • to deal with problems of persons with disability who do not have family support.
  • 51. National Policy for Persons with Disabilities Act 2005 The National Policy, released in February 2006 seeks to create an environment that provides them equal opportunities, protection of their rights and full participation in society. Its aim is to ensure better coordination between various wings of the State and Central Governments . The focus of the policy is on the following: • Prevention of Disabilities • Rehabilitation Measures • Physical Rehabilitation Strategies • Early Detection and Intervention • Counselling & Medical Rehabilitation
  • 52. National Policy for Persons with Disabilities Act 2005 In addition to the legal framework, extensive infrastructure has been developed in India for disabled persons under this Act and includes the establishment of the following institutions: • Institute for the Physically Handicapped, New Delhi. • National Institute of Visually Handicapped, Dehradun • National Institute for Orthopedically Handicapped, Kolkata • National Institute for Mentally Handicapped, Secunderabad. • National Institute for Hearing Handicapped, Mumbai • National Institute of Rehabilitation Training & Research, Cuttack. • National Institute for Empowerment of Persons with Multiple Disabilities, Chennai
  • 53. The Disability and Rehabilitation WHO Action Plan 2006-2011 The document provides the overview of WHO's future plan of activities, which will be carried out or coordinated by the Disability and Rehabilitation team located in the Department of Injuries and Violence Prevention, in the NCD and Mental Health. VISION: All persons with disabilities live in dignity, with equal rights and opportunities MISSION: To enhance the quality of life for persons with disabilities through national, regional and global efforts to: • Raise awareness about the magnitude and consequences of disability • Facilitate data collection and analyse or disseminate disability-related data and information
  • 54. The Disability and Rehabilitation WHO Action Plan 2006-2011 • Support, promote and strengthen health and rehabilitation services for persons with disabilities and their families • Promote community based rehabilitation (CBR) • Promote development, production, distribution and servicing of assistive technology • Support the development, implementation, measuring and monitoring of policies to improve the rights and opportunities for people with disabilities. • Build capacity among health and rehabilitation policy makers and service providers • Foster multi-sectoral networks and partnerships
  • 55. • In India, two Departments : "Department of Social Justice and Empowerment" and "Department of Disability Affairs" created under the Ministry of Social Justice and Empowerment with effect from May 14th, 2012. • The Government has introduced the Rights of Persons with Disabilities Bill, 2014 in the Rajya Sabha on 7th February, 2014. It has been proposed inter alia in the Bill to establish the National Commission and State Commissions for Persons with Disabilities.
  • 56. The Rights of Persons with Disabilities Bill, 2014 • The Bill repeals the Persons with Disabilities (Equal Opportunities Protection of Rights and Full Participation) Act, 1995. • Features of the bill: 1. Definition of disability: Disability is defined to include 19 conditions such as: autism; low vision and blindness; cerebral palsy; deaf blindness; haemophilia; hearing impairment; leprosy; intellectual disability; mental illness; muscular dystrophy; multiple sclerosis; learning disability; speech and language disability; sickle cell disease; thalassemia; chronic neurological conditions; and multiple disability. Persons with benchmark disabilities are defined as those with at least 40 per cent of any of the above specified disabilities. 2. Rights of persons with disabilities: The Bill states that persons with disabilities shall have the right to equality and shall not be discriminated against on grounds of their disability.
  • 57. The Rights of Persons with Disabilities Bill, 2014 3. Education, skill development and employment: All government institutions of higher education and those getting aid from the government are required to reserve at least 5% of seats for PWD. At least 5% of the vacancies are to be filled by persons or class of persons with at least 40 % of any of the disabilities. 4. Legal Capacity: Disabled persons have the right, equally with others, to own and inherit movable and immovable property, as well as control their financial affairs. 5. Guardianship: if a district court finds that a mentally ill person is not capable of taking legally binding decisions, it may order guardianship to the person.
  • 58. 6. National and State Commissions for persons with disabilities: The central and state governments are required to establish a National and State Commissions for Persons with Disabilities, respectively 7. Central and state advisory boards: The boards shall advise governments on policies and programmes on disability and review the activities of organisations dealing with disabled persons.
  • 59. Ali Yavar Jung National Institute For The Hearing Handicapped The District Disability Rehabilitation Centre (DDRCs) under Gramin Punarvasan Yojana (GPY) a programme of the Ministry of Social Justice and Empowerment, Government of India was started in the year 2000. Objectives : 1. Provide total rehabilitation to persons with sensory (hearing and vision), physical and mental disabilities. 2. Research 3. Educational Programmes 4. Service Facilities: Strategies for early identification and rehabilitative procedures. films and audio visuals on vocational training and job placement, etc. are being developed.
  • 60. 5. Community Programme: Identification and intervention, home bound training, correspondence training and also tele– rehabilitation services are being rendered and evolved with emerging needs. 6. Material Development: Required for (a) education (b) public awareness and community education, literacy programme for adult deaf, Parent Counselling and Programme for strengthening voluntary organisations. 7. Information and Documentation: Documenting and disseminating the latest information and developments in the science of hearing, speech and related technology is being done.
  • 61. National Handicapped Finance and Development Corporation(NHFDC) Incorporated by Ministry of Social Justice and Empowerment Main Objectives: • Promote economic development of the persons with disabilities. • Promote self-employment for the benefit/economic rehabilitation • Assist individuals or groups with disabilities by way of loans and advances for economically and financially viable schemes. • Grant concessional finance in selected cases for the persons with disability in the country in collaboration with Government
  • 62. National Handicapped Finance and Development Corporation(NHFDC) • Extend loans to the PWD for pursuing education for training at graduate and higher levels. • Assist in the upgradation of technical and entrepreneurial skills of PWD for proper and efficient mgt. of production units. • Set up training, quality control, process development, for the proper rehabilitation of the PWD in support of their economic pursuits. • Work as an apex institution for channelizing the funds through State Finance Corporation for the Handicapped or through corresponding Corporations authorised by State Govts./Boards set up by Union Govt/State Govt/Union Territory
  • 63. SCHEME OF ASSISTANCE TO DISABLED PERSONS FOR PURCHASE/FITTING OF AIDS/APPLIANCES (ADIP SCHEME) April, 2014 Objectives • to assist the needy disabled persons in procuring durable, sophisticated and scientifically manufactured aids & appliances to promote rehabilitation of PWD and enhance their economic potential with the help of Implementing Agencies • Implementing Agencies will take PRE & POST FITTING CARE of the aids and appliances distributed under the Scheme. • Implementing Agencies will give wide publicity of the distribution of such aid and appliances to PwDs. • After the camps, they shall provide a list of beneficiaries and the details of aids and assistive devices with the cost incurred to the State Government and the Department of Disability Affairs.
  • 64. SCHEME OF ASSISTANCE TO DISABLED PERSONS FOR PURCHASE/FITTING OF AIDS/APPLIANCES (ADIP SCHEME) April, 2014 The Scheme shall also include essential medical/surgical correction and intervention, prior to fitment of aids and appliances, as per the following norms: (i) From ₹.500/- to ₹.1,000/- for hearing & speech impaired. (ii) From ₹.1000/- to ₹2,000/- for visually disabled. (iii) From ₹ 3000/- to ₹ 5,000/- for orthopedically disabled
  • 65. ELIGIBILITY OF THE BENEFICIARIES A person with disabilities fulfilling following conditions would be eligible for assistance under ADIP Scheme. i. An Indian citizen of any age. ii. Holds a 40% Disablement Certificate. iii. Has monthly income not exceeding ₹ 20,000/- pm. iv. For dependents, the income of parents/guardians <₹ 20,000 pm. v. Who have not received assistance during the last 3 years for the same purpose from any source. However, for children below 12 years of age, this l limit would be 1 year.
  • 66. Schemes offered to the disabled by the central Govt. 1. Scheme of Integrated Education for The Disabled Children 2. Scholarships For The Disabled 3. children's Educational Allowance 4. Railway Travel Concession: 50% concession 5. Reservation of Jobs: 3% vacancies, Carry forward ( A roster (100 point) has been prescribed for giving effect to reservation of jobs for physically handicapped persons. In this roster 67th vacancy occurring in a particular year would be reserved for the deaf.) 6. Age Relaxation: UPPER AGE + 10 YEARS SOURCE : http://ayjnihh.nic.in/index.asp
  • 67. Schemes offered to the disabled by the central Govt. 7. Promotion: Not to be denied promotion on medical grounds. 8. Posting of Physically Handicapped Candidates: transfer to or near their native places may also be given preferences. 9. Income Tax Concessions: Section 80 DD , Max limit ₹15000. 10. Professional Tax Exemption 11. Award of Dealerships/Agencies by Oil Companies: 7.5% reservations 12. Economic Assistance: eligible to take loans under the scheme with minimum rate of interest (4% uniformly)
  • 68. Schemes offered to the disabled by the Haryana Govt. • Reservation in Government Job: 3% of jobs are reserved • Housing board: Handicapped persons get priority in allotment of Houses and there is 01.5% reservation . • Age Relaxation: The Upper age limit is relaxed by 10 years for handicapped persons for applying in Government jobs. • Scholarship/Stipend: The State Government awards scholarship to the handicapped students (50- 400 ₹ pm) • Disability Pension/Social Security Pension: Disabled persons of the age group of 65 years and above having disability of 70% and above with family income of ₹ 200/– p.m. or less get disability pension of ₹ 100/– p.m. • Un–employment allowance: Disabled persons who has registered in employment exchange get unemployment allowance (150-250 ₹ pm) SOURCE : http://ayjnihh.nic.in/index.asp
  • 69. Schemes offered to the disabled by the Haryana Govt. • Conveyance Allowances: Physically handicapped employees get conveyance allowance @ 8% of their basic pay subject to a maximum of Rs.150/– p.m • Bus concession: The State Government gives free bus pass to all types of blind and other disabled persons having 100 disability. • Assistance for self employment: Haryana Financial Corporation gives loan to all types of handicapped for starting self employment. • Exemption in road tax: All types of handicapped persons are exempted from paying road tax. • Awards/Sports/Seminars: State Government gives awards to the best handicapped employees and the best self employed disabled for their encouragement.
  • 70. Schemes offered to the disabled by the Haryana Govt. • Assistance for purchase of aids and appliances: The crippled and orthopaedically handicapped persons get artificial limbs and wheel chair by the State Government whose case is recommended by a medical specialist or Chief Medical Officer. • Other Concessions/facilities: Welfare activities: Deaf & dumb person get vocational training during which they get free rationing & free lodging/boarding & medical facilities.
  • 71. Next time u c smbdy on a wheel chair, don’t feel pitty!!!!! THEY MIGHT BE THE BEST OF ALL U REMEMBER !!!!!