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India has some 40 to 80 million persons with disability. But low literacy, few jobs and widespread social stigma are making disabled people among the most excluded in India. Children with disabilites are less likely to be in school, disabled adults are more likely to be unemployed, and families with a disabled member are often worse off than average. With better education and more access to jobs, people with disabilities can become an integral part of society, as well as help generate higher economic growth that will benefit the country as a whole.

In the years to come, the number of disabled people in India is expected to rise sharply as age related disabilities grow and traffic accidents increase. This is borne out by the fact that internationally, the highest reported disability rates are in OECD countries.

India has a growing disability rights movement and one of the more progressive policy frameworks in the developing world. But, a lot more needs to be done in implementation and “getting the basics rightâ€ï¿½. Newer thinking and better coordination of programs is called for. Preventive health programs need to be deepened and all children screened at a young age. People with disabilities need to be better integrated into society by overcoming stigma; disabled adults need to be empowered with employable skills; and the private sector needs to be encouraged to employ them. The scale of disability in India needs to be better understand by improving the measurement of disability. Most importantly,persons with disabilities should themselves be made active participants in the development process.

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Chapter 1: Socio-Economic Profile of Persons with Disabilities

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 in government surveys and the census would be a good beginning.

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Chapter 2: Attitudes

Negative attitudes held by the families of the disabled, and often the disabled themselves, deter disabled persons from taking an active part in the family, community or workforce. Those suffering from mental illness or mental retardation face the worst stigma and are subject to severe social exclusion.

People with disabilities are considered ineligible to marry those without disabilities unless “adjustedâ€ï¿½ 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.

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Chapter 3: Health

A large number of disabilities in India are preventable, including those arising from medical issues during birth, maternal conditions, malnutrition, as well as accidents and injuries. However, the health sector is yet to react more proactively to disability, especially in the rural areas.

There is stark regional disparity. In general, states that lag in health services also lag in caring for the disabled. Those disabled from birth, women, and ST/SC/OBC are less likely to seek health care. Despite years of public intervention, only a few disabled people have access to aids and appliances.

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Chapter 4: Education

While the Sarva Shiksha Abhiyan (SSA)has made a concerted affort to promote the inclusion of children with special needs, the system faces challenges in identifying these children and responding to their needs. Only around 1% of funds under SSA are spent on inclusive education. And, 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.

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. State-wise strategies on education for children with special needs need to be devised.

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Chapter 5: Employment

Even though many disabled adults are capable of productive work, disabled adults have far lower employment rates than the general population. In fact, employment of people with disability actually fell from 43% in 1991 to 38% in 2002, despite the country's economic growth. In the public sector, despite a 3% reservation since 2003, only 10% of posts have been identified as “suitableâ€ï¿½. The quota policy is also covers just three types of disability – locomotor, hearing and visual.

The situation is far worse in the private sector. The sector has few incentives for hiring disabled people. In the late 1990s, employment of people with disability among large private firms was only 0.3% of their workforce. Among multinational companies, this was a mere 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.

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Chapter 6: Social Protection

Though centrally sponsored anti-poverty programmes have reservations for people with disabilities, the numbers who have benefited are well below the minimum laid down. The new National Rural Employment Guarantee Act has dropped reservations for the disabled entirely, though some states (e.g. AP) are making efforts to include disabled people. Few people with disabilites are aware of such programs and many states lack focus on social protection for PWD.

While the presence of self-help groups is encouraging, an ambitious Social Security Bill for the unorganised sector could deliver real benefits.

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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 faces many challenges.

For one, the Ministry of Social Justice and Empowerment - the nodal agency for disability- is perennially short of resources.

There is therefore a need to strengthen public-private partnerships with NGOs. However, there are concerns about weak monitoring mechanisms and accountability of public funds. And, persons with disability need to be treated more like active participants than clients. There is thus an urgent need for reforms at all levels.

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Chapter 8: Access

Physical accessibility in buildings, transportation and the like, as well as assess to services is key for persons with disability. Guidelines already exist for buildings that are friendly for both the disabled and the elderly. But these guidelines need to be adopted into building bye-laws to make them legally binding.

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