Estimates of the number of disabled vary a great deal, depending on the definitions, the source, the methodology and the extent of use of scientific instruments in identifying and measuring the degree of disability. It is estimated that the population with disability in India is approximately over 90 million, of these 12 million are blind, 28.5 million are with low vision, 12 million are with speech and hearing defects, 6 million orthopaedically handicapped, 24 million mentally retarded, 7.5 million mentally ill, 1.1 million leprosy cured.
A comprehensive country-wide sample survey of persons with disabilities was undertaken by National Sample Survey Organisation (NSSO) in its 36th round in 1981 at the request of the Ministry of Welfare which indicated that 1.8 per cent of the total population of the country has physical and sensory disabilities. No survey on mentally retarded persons was done at that time. However, surveys done by various research organisations indicate that about 2 - 2.5 per cent of the total population of the country has mental retardation.
Another survey was conducted by NSSO in 1991 to estimate the magnitude of the persons with disabilities in India. The survey indicated the following important findings :-
Estimated number of disabled persons in the country, on the basis of the survey is as follows :
Estimated Number of Disabled Persons in India - 1991
(in millions)
Type of Disability | Rural | Urban | Total | ||||
Male (1) | Female (2) | Persons (3) | Male |(4) | Female (5) | Persons (6) | (3)+(6) | |
Visual | 1.539 (46.15) | 1.796 (53.85) | 3.335 (83.27) | 0.308 (45.97) | 0.362 (54.03) | 0.670 (16.73) | 4.005 |
Hearing | 1.409 (54.76) | 1.164 (45.24) | 2.573 (79.36) | 0.339 (50.67) | 0.330 (49.33) | 0.669 (20.64) | 3.242 |
Speech | 0.942 (62.84) | 0.557 (37.16) | 1.499 (76.25) | 0.298 (63.81) | 0.169 (36.19) | 0.467 (23.75) | 1.966 |
Hearing and/or Speech | 2.009 (57.42) | 1.490 (42.58) | 3.499 (78.07) | 0.557 (56.66) | 0.426 (43.34) | 0.983 (21.93) | 4.482 |
Locomotor | 4.396 (64.58) | 2.411 (35.42) | 6.807 (76.15) | 1.370 (64.26) | 0.762 (35.74) | 2.132 (23.85) | 8.939 |
Physical (at least one of the above) | 7.442 (58.82) | 5.210 (41.18) | 12.652 (78.32) | 2.078 (59.34) | 1.424 (40.66) | 3.502 (21.68) | 16.154 |
Notes :
Source : Report No. 393. NSSO. A Report on Disabled Persons. 47th Round July - December 1991 & Report on Manpower Development. Rehabilitation Council of India, New Delhi, January 1996.
The age-wise distribution per thousand disabled has been found to be as follows:
Type of Disability
Age group (Years) | Visual | Hearing | Speech | Locomotor | Disability | |||||
Rur. | Urb. | Rur. | Urb. | Rur. | Urb. | Rur. | Urb. | Rur. | Urb. | |
0-4 | 4 | 5 | N.A. | N.A. | 47 | 47 | 27 | 30 | ||
5-14 | 24 | 21 | 85 | 80 | 262 | 261 | 224 | 223 | 150 | 165 |
15-59 | 255 | 304 | 387 | 377 | 539 | 513 | 487 | 503 | 425 | 458 |
60 and above | 717 | 670 | 526 | 541 | 197 | 225 | 240 | 227 | 398 | 346 |
Notes :
Rur = Rural
Urb = Urban
N.A. = Not Available
Source : Report No. 393 NSSO A Report on Disabled Persons 47th Round July - December - 1991.
Amongst the visually handicapped, nearly 70 per cent are in the age-group 60+ and less than 3 per cent are in the age group of 0-14. For speech disability, nearly 26 per cent are in 5-14 age group. Nearly 50 per cent of the locomotor disabled and the speech disabled are in the age group 15-59.
The table below shows that after 45 years of age most of the people acquire all kinds of disabilities–visual, hearing, speech, locomotor.
Per 1000 distribution of physically disabled persons of age 60 years and above by age at onset of disability for each type of disability
All India | ||||||||||||
Age at onset (years) | ||||||||||||
Type of disability | 0-4 | 5-9 | 10-14 | 15-19 | 20-24 | 25-29 | 30-34 | 35-44 | 45-59 | 60 and above | Total | |
(1) | (2) | (3) | (4) | (5) | (6) | (7) | (8) | (9) | (10) | (11) | (12) | |
Rural | ||||||||||||
Visual | 8 | 8 | 9 | 1 | 3 | 3 | 4 | 18 | 255 | 689 | 1000 | |
Hearing | 9 | 6 | 12 | 9 | 11 | 10 | 12 | 41 | 280 | 609 | 1000 | |
Speech | 42 | 23 | 24 | 10 | 12 | 25 | 262 | 594 | 1000 | |||
Locomotor | 29 | 19 | 17 | 17 | 10 | 8 | 22 | 59 | 278 | 511 | 1000 | |
Urban | ||||||||||||
Visual | 12 | 15 | 7 | 3 | 6 | 5 | 5 | 18 | 236 | 1000 | ||
Hearing | 7 | 13 | 10 | 11 | 9 | 14 | 13 | 55 | 215 | 651 | 1000 | |
Speech | 35 | 39 | 9 | 23 | 7 | 27 | 287 | 572 | 1000 | |||
Locomotor | 21 | 16 | 15 | 9 | 12 | 8 | 13 | 41 | 280 | 586 | 1000 |
Source : Table (2.6.2) of Report No. 393. A Report on Disabled Persons, NSSO, 47th Round, July-December 1991.
Comparison with 1981 Sample Survey
The prevalence in 1991 has marginally gone up as compared to 1981. In 1991, the prevalence in rural areas is 1.99 per cent as against 1.84 per cent in 1981. The prevalence in urban areas in 1991 is 1.58 per cent as against 1.42 per cent in 1981. The tables below show that the prevalence as well as incidence of visual, hearing and speech disabilities have shown marginal to substantial decline and the prevalence of locomotor disability has shown substantial increase, although the incidence remains nearly the same.
Causes of disability as per NSSO survey
The survey has also estimated the causes of various disabilities. The findings can be summarised in the following tables:
Per thousand distribution of persons with a particular disability
Causes of Disability | Rural | Urban |
Sore eyes during first month of life | 5 | 3 |
Sore eyes after the month | 6 | 8 |
Severe diarrhoea before 6 years of age | 11 | 13 |
Cataract | 236 | 280 |
Glaucoma | 34 | 42 |
Corneal opacity | 13 | 16 |
Other eye diseases | 130 | 107 |
Smallpox | 29 | 35 |
Burns | 2 | 5 |
Injuries other than burns | 32 | 35 |
Medical/surgical intervention | 18 | 38 |
Old age | 362 | 273 |
Other reasons | 49 | 74 |
Not known | 72 | 71 |
Total | 999 | 1000 |
The major share of cataract, old age and injuries are among the causes of visual disability.
Causes | Rural | Urban |
German measles/rubella | 9 | 14 |
Noise induced hearing loss | 17 | 18 |
Ear discharge | 175 | 143 |
Other illnesses | 186 | 197 |
Burns | 2 | 2 |
Injury other than burns | 35 | 52 |
Medical/surgical intervention | 10 | 21 |
Old age | 310 | 316 |
Other reasons | 77 | 88 |
Not known | 179 | 149 |
Total | 1000 | 1000 |
For about 31 per cent, the cause is old age. For a large number, the reasons are unknown. Ear discharge, too, is an important reason for this disability.
Causes | Rural | Urban |
Hearing Impairment | 36 | 32 |
Voice disorder | 90 | 63 |
Cleft palate | 26 | 14 |
Paralysis | 191 | 240 |
Mental illness/retardation | 91 | 90 |
Other illness | 221 | 207 |
Burns | 4 | 6 |
Injury other than burns | 32 | 47 |
Medical/surgical intervention | 15 | 29 |
Old age | 25 | 27 |
Other reasons | 72 | 81 |
Not known | 197 | 164 |
Total 1000 | 1000 | 1000 |
Cause | Rural | Urban |
Cerebral Palsy | 48 | 43 |
Polio | 328 | 346 |
Leprosy | 30 | 19 |
Stroke | 29 | 41 |
Arthritis | 20 | 19 |
Cardio-respiratory diseases | 4 | 5 |
Other illnesses | 112 | 115 |
Burns | 22 | 15 |
Injury other than burns | 211 | 225 |
Medical/surgical intervention | 22 | 34 |
Old age | 62 | 49 |
Not known | 60 | 44 |
Total | 1002 | 999 |
Source : Report No. 393, Report on Disabled Persons, NSSO, 47th Round, July - December 1991.
Definitions used in the survey
The NSSO survey defined disability as ‘any restriction or lack of abilities to perform an activity in the manner or within the range considered normal for human being’.
The definitions used by the NSSO were :
Visually disabled:
A person who had no light perception, and also who had light perception but could not count the fingers of a hand correctly (using glasses if ordinarily used) from a distance of three metres in good daylight with both eyes open.
Hearing disability :
A person was treated as having hearing disability if he/she could not hear at all or could hear only loud sounds or could hear only shouted words or could hear only when the speaker was sitting in the front, or would usually ask to repeat the words spoken or would like to see the face of the speaker.
Speech disability :
Speech disability speech of a person was judged to be disordered if the persons’s speech was not understood by the listener, drew attention to the manner in which he/she spoke than to the meaning, and was aesthetically unpleasant.
Locomotor disability :
Locomotor disability was defined as the loss or lack of normal ability of an individual to move both himself/herself and /or objects from one place to another. It may occur due to
Additional Estimates of The Disabled
In most populations all over the world approximately two to three per cent of the population is expected to be mentally handicapped, mental handicap being defined as a condition characterised by significantly sub-average general intellectual functioning existing concurrently with deficits in adaptive behaviour and manifested during the developmental period.
On this basis it can be estimated that there are nearly 24 million individuals in India with mental retardation, out of which approximately six million are moderately, severely or profoundly handicapped. Out of the 24 million, 0.8 million are adults over 20 years of age whereas 15 million are children below 10 years of age.
A National Survey on Blindness conducted during 1986–89 under the aegis of the Ministry of Health & Family Welfare by Dr. Madan Mohan estimated that 11.92 million persons are blind as against 3.47 million estimated by the NSSO survey in 1981. The NSSO Survey conducted in 1991 reports that there has been marginal decline in the incidence of blindness. It has also been observed in the report (NSSO : 1991) "experts are of the opinion that with greater pace of development and urbanisation the disability prevalence rate is also likely to rise". On the other hand, owing to better health care and advancement of medical sciences during the decade (1981–91), the incidence of some types of disabilities may show a decreasing trend, although, as the survey reveals, the overall impact of these factors is a marginal rise in the prevalence rate of physical disability of all types, taken together, during the decade 1981–91.
According to the National Programme for Control of Blindness (WHO Report : 1989) about 28.56 million persons are with low vision. A study conducted by Indian Council for Medical Research (ICMR) estimated that 6.8 per cent in urban areas and 10.8 per cent in rural areas had significant hearing losses.
Conclusions :
From the above discussions, it is clear that the estimates on disability very a great deal. For policy formulation and provision of services it is imperative that reliable estimates of the incidence and prevalence of various disabilities be made in accordance with accepted definitions of various categories of disabilities.
With the strengthening of preventive measures and coordinated efforts at their universal application the rate of disability should get reduced. But, tragically, the reverse is true. New modes of living, a dramatic increase in accidents at home and outside, on agricultural farms and in industrial units, misuse and abuse of drugs and other chemicals, failure of health services to considerably reduce mortality of mothers and new–born children and a host of other factors associated with advanced, modern and industrialised societies are adding to the partial or total disabilities caused by fatal and non-fatal accidents. Furthermore, there is every likelihood that the disabled are going to live upto retirement age and beyond. Incidence of violence – domestic, ethnic, communal etc. is on the rise and keeps adding to the numbers of disabled people.
Disability can be prevented and controlled to some extent but can not be totally eradicated. The expectations of disabled people in India, like in other progressive countries of the world, are rising and instead of pity and charity they demand and get their civil rights. They are not second class citizens and can not be treated as such.
The logical answer to this new trend for rights and dignity of disabled people can be responded to by planning and implementing a range of services aimed at making them independent in all respects. These services cover all aspects of an individual’s life from before birth to death – from health to education to nourishment/nutrition to leisure to employment to housing to transport to others. Together, these services must help disabled people to fully participate in all activities of the society.
A cost benefit analysis should, however, convince us that by undertaking the task of providing an adequate level of services and goods the country would be able to generate productive forces, hitherto untapped. It is an opportune time to avoid the wastage caused by excluding disabled people from the productive activities of the society and at the same time by making them dependent on existing resources. But, the greatest benefit of the active participation of disabled people in mainstream activities of the society, however, is the improvement in the quality of their lives which can not be calculated in monetary terms.
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