Current policies and gaps in programs for Persons with Disability in India: An Exploratory Study

Background

In recent years, India has made progress in implementing policies and programs for persons with disabilities (PWDs), but there is still a long way to go to ensure full inclusion and access for PWDs in all aspects of society. The Rights of Persons with Disabilities Act, 2016 is a key piece of legislation that has helped to promote the rights and inclusion of PWDs in India [1]. The Act provides for equal opportunities, non- discrimination, accessibility, and full participation in all aspects of life for PWDs. It also mandates the creation of a National and State Disability Rights Authority to oversee the implementation of the Act.

In addition to the Rights of Persons with Disabilities Act, the Indian government has launched several programs and initiatives to support PWDs. Some of these programs include the Accessible India Campaign, which aims to make public buildings, transportation, and information and communication technology (ICT) accessible for PWDs; the National Scholarship Scheme for Persons with Disabilities, which provides financial assistance to PWDs to pursue education; and the Swavlamban Health Insurance Scheme, which provides health insurance coverage to PWDs.

The WHO’s worldwide action plan for disability aims to ensure that every impaired person has access to the best possible health, functioning, well-being, and human rights. According to the United Nations Convention on the Rights of Persons with Disabilities (UNCPRD), “Persons with disabilities (PWD) have the right to the enjoyment of the highest attainable standard of health without discrimination on the basis of disability [2].”India is a signatory to both and works to enhance both public health and the lives of the disabled. The Ministry of Social Justice and Empowerment (MoSJE) and, to a lesser extent, the Ministry of Health and Family Welfare (MoHFW) are the two main ministries in India that deal with disability.

The first is in charge of carrying out and delivering different national health programmes in India. The MoSJE looks out for the welfare of the underprivileged, minorities, and the disabled. The MoSJE has policies, plans, and initiatives pertaining to the health and rehabilitation of the disabled, such as the national policy for the disabled, the aid to disabled person programme, etc. Numerous statutory organisations and national institutes fall within the purview of the MoSJE, such as the National Trust for People with Autism, Cerebral Palsy, and Multiple Disabilities [3]. The PWD Act of 1995 was modified to comply with the UNCRPD, and a new version was approved by both chambers of parliament in 2016. The act emphasizes equality of rights (social model), effective involvement, respect for difference, and non-discrimination.

Ministry and their programs aimed at improving access for PwDs in India

• MoSJE: Ministry of Social Justice and Empowerment The Ministry of Social Justice and Empowerment’s (MoSJE) Department of Empowerment and Welfare of Persons with Disabilities (DEPwD) received INR 1,225 crore in FY 2023–24, representing 0.027 per cent of the overall budget. The overall expenditure in FY 2023–24 increased by about 7.5% compared to the prior year, however, the DEPwD expenditure only climbed by 1% [4].

• Deendayal Disabled Rehabilitation Scheme (DDRS) The scheme provides financial assistance for rehabilitation services to PWDs including physical and mental rehabilitation, special education, and skill development [5].

• National Handicapped Finance and Development Corporation (NHFDC) The corporation provides financial assistance in the form of loans, scholarships, and grants to PWDs for self- employment, education, and training [6].

• Assistance to Disabled Persons for Purchase/Fitting of Aids and Appliances (ADIP) The scheme provides financial assistance for the purchase and fitting of various aids and appliances to PWDs [7].

• Scheme for Implementation of Persons with Disabilities Act (SIPDA) The scheme aims to promote the effective implementation of the Rights of Persons with Disabilities Act, 2016 by providing technical and financial support to states and union territories [8].

• Scholarship Schemes for PWDs The government offers various scholarships for PWDs, including the National Scholarship Scheme for Persons with Disabilities, the Pre-Matric Scholarship for PWDs, and the Post-Matric Scholarship for PWDs [9].

• MoHFW: Ministry of Health and Family Welfare The Ministry of Health and Family Welfare (MoHFW) of India has implemented various programs and schemes for persons with disabilities to provide them with healthcare services, assistive devices, and other support services [10].

• Some of the prominent programs and schemes are
• National Program for Prevention and Control of Cancer, Diabetes, Cardiovascular Diseases and Stroke (NPCDCS): This program aims to provide early diagnosis and treatment of non-communicable diseases, including those affecting persons with disabilities [11].

• Rashtriya Bal Swasthya Karyakram (RBSK) The RBSK scheme provides health screening and early intervention services to children with disabilities [12].

• District Disability Rehabilitation Centers (DDRCs) The MoHFW has established DDRCs in various districts to provide rehabilitation services and assistive devices to persons with disabilities [13].

Despite the presence of various welfare programs for persons with disabilities (PWDs) in India, there exists a significant gap in their access to healthcare as compared to those without disabilities. The main issue stems from the lack of collaboration between the two relevant ministries, with the Ministry of Health and Family Welfare (MoHFW) showing little involvement in rehabilitation services despite the fact that a majority of PWDs frequently visit health facilities for their health needs. As the health sector is usually the first point of contact for PWDs, the MoHFW should prioritize the inclusion of disability services in its health policy. It is important to sensitize and educate medical facilities and professionals across the country about the specific health needs of PWDs. Numerous people with disabilities had to wait months to receive the vaccination due to physical and informational difficulties, fear, shame, and prejudice, despite the heightened risk of contracting Covid-19, particularly at a time when the disease is once again spreading throughout India [14]. There is a need to address issues such as inaccessible hospital buildings and equipment, negative attitudes, negligence, and the lack of training to communicate with PWDs who have hearing and speech problems. These issues need to be tackled under the healthcare delivery system.

To ensure that people with disabilities are not left behind, national health programs should prioritize healthcare and inclusiveness in their program guidelines. The two ministries should collaborate to establish inclusive rehabilitative services at the state and district levels. It is important to make health insurance mandatory for all people with disabilities, given the rising costs of healthcare. Including disability-related topics in medical teaching programs will improve services for disabled individuals. The Ministry of Social Justice should expand support for Non-government Organisations (NGOs) to reach as many people with disabilities as possible, in collaboration with the Ministry of Health. Collecting high-quality disability-related data will aid in the planning of inclusive disability-care services [4].

MoE: Ministry of Education

The Ministry of Education (MoE) of India has implemented various programs and schemes for persons with disabilities to provide them with access to education, skill development, and other support services. Some of the prominent programs and schemes are: • Sarva Shiksha Abhiyan (SSA) The SSA aims to provide free and compulsory education to all children, including those with disabilities, up to the age of 14 years.

• Rashtriya Madhyamik Shiksha Abhiyan (RMSA) The RMSA scheme provides secondary education to all children, including those with disabilities [15].

• Inclusive Education for Disabled at Secondary Stage (IEDSS) The IEDSS scheme provides financial assistance to children with disabilities for their education in secondary and higher secondary schools [16].

• National Scholarship Scheme for Persons with Disabilities This scheme provides financial assistance to persons with disabilities for pursuing higher education [17].

• Vocational Rehabilitation Centres for Handicapped (VRCH) The VRCH scheme provides vocational training and skill development to persons with disabilities [18].

• National Institute of Open Schooling (NIOS) The NIOS provides open and distance education to children with disabilities who cannot attend regular schools [19].

• Deen Dayal Upadhyaya Centres for Knowledge Acquisition and Upgradation of Skilled Human Abilities and Livelihood (DDU KAUSHAL Kendras) These centres provide skill development and training to persons with disabilities to enhance their employability [20].

MoRD: Ministry of Rural Development

• National Rural Livelihoods Mission (NRLM) The NRLM scheme aims to provide sustainable livelihoods to rural households, including those with disabilities, through self-employment and wage employment opportunities [21].

• Deen Dayal Upadhyaya Grameen Kaushalya Yojana (DDU-GKY)

The DDU-GKY scheme provides skill development training to rural youth, including persons with disabilities, to enhance their employability [22].

• Mahatma Gandhi National Rural Employment Guarantee Act (MGNREGA) The MGNREGA scheme provides guaranteed wage employment to rural households, including those with disabilities, for a minimum of 100 days in a year [23].

• Pradhan Mantri Awaas Yojana - Gramin (PMAY-G) The PMAY-G scheme aims to provide pucca houses to rural households, including those with disabilities, who are living in kutcha houses [24].

• Swarnjayanti Gram Swarozgar Yojana (SGSY) The SGSY scheme provides self-employment opportunities to rural poor, including persons with disabilities, through the establishment of micro- enterprises [25].

MoR: Ministry of Railways

• Sarathi Seva: This scheme provides free-of-cost assistance to PWDs, including visually impaired and orthopedically challenged passengers, at railway stations. Sarathi Seva personnel help PWDs in boarding and de-boarding trains and provide assistance with luggage [26].

• Mobile Applications: The Ministry of Railways has developed mobile applications such as NTES (National Train Enquiry System) and UTS (Unreserved Ticketing System) to help PWDs access information about train schedules and book tickets online [27].

• Reservation Quota: The Ministry of Railways has reserved a quota of seats for PWDs in all classes of trains. These seats are reserved exclusively for PWDs and their companions [28].

• Concession: The Ministry of Railways provides concessions on ticket prices to PWDs, as well as to their companions [27].

• Braille Signage: The Ministry of Railways has introduced braille signage at railway stations to help visually impaired PWDs navigate the station.

Limitations And Gaps

Firstly, the policies and programs for PWDs are often fragmented and lack a comprehensive approach. There are several ministries and departments responsible for the welfare of PWDs, but coordination between them is often lacking. This can lead to duplication of efforts, inefficient use of resources, and gaps in coverage.

Secondly, while there are several policies and programs aimed at promoting the welfare and empowerment of PWDs, their implementation is often weak. Many of these policies and programs suffer from inadequate funding, lack of awareness and outreach, and limited accountability mechanisms. This can result in a limited impact on the lives of PWDs and perpetuate social and economic exclusion. Thirdly, the policies and programs for PWDs often do not take into account the diversity and intersectionality of disabilities. The needs and challenges of PWDs vary based on factors such as gender, age, location, and type of disability. However, the policies and programs often take a one-size- fits-all approach, which can result in inadequate support and services for certain groups of PWDs.

Fourthly, there is a lack of emphasis on building the capacity of PWDs and their organizations to participate in decision-making processes and advocate for their rights. PWDs are often excluded from decision-making processes, and their perspectives and needs are not adequately reflected in policies and programs. This can lead to a lack of ownership and engagement from PWDs and perpetuate paternalistic attitudes.

Finally, there is a lack of reliable data on PWDs in India, which hampers evidence-based policymaking and program design. The existing data is often incomplete, outdated, and inconsistent, making it difficult to understand the magnitude and nature of the challenges faced by PWDs and to design effective policies and programs to address them.

In conclusion, while the government of India has made some progress in promoting the welfare and empowerment of PWDs, there are still several gaps in policies and programs that need to be addressed to ensure that PWDs have equal access and opportunities in all aspects of life [29].

Way Forward

Equal engagement in mainstream society is the first step in the empowerment of people with disabilities. Accessibility is a highly critical issue for people with disabilities, and a barrier-free environment is a necessity. The term “accessible environment” refers to a setting that provides equitable access to knowledge, information, communication technology, as well as the built environment.

Gupta (2019) accessibility and the level of disability are inversely proportional to each other, meaning that “as accessibility increases, the level of disability decreases” [30]. Every person in the world can benefit from celebrating human diversity.