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    Disability and Rehabilitation Services in India: Issues and Challenges

    Disability is an important public health problem especially in developing countries like India. The problem will increase in future because of increase in trend of non-communicable diseases and change in age structure with an increase in life expectancy. ...

    J Family Med Prim Care. 2012 Jan-Jun; 1(1): 69–73.

    doi: 10.4103/2249-4863.94458

    PMCID: PMC3893941 PMID: 24479007

    Disability and Rehabilitation Services in India: Issues and Challenges

    S. Ganesh Kumar, Gautam Roy, and Sitanshu Sekhar Kar

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    Abstract

    Disability is an important public health problem especially in developing countries like India. The problem will increase in future because of increase in trend of non-communicable diseases and change in age structure with an increase in life expectancy. The issues are different in developed and developing countries, and rehabilitation measures should be targeted according the needs of the disabled with community participation. In India, a majority of the disabled resides in rural areas where accessibility, availability, and utilization of rehabilitation services and its cost-effectiveness are the major issues to be considered. Research on disability burden, appropriate intervention strategies and their implementation to the present context in India is a big challenge. Recent data was collected from Medline and various other sources and analyzed. The paper discusses various issues and challenges related to disability and rehabilitation services in India and emphasize to strengthen health care and service delivery to disabled in the community.

    Keywords: Challenges, disability, India, issues, rehabilitation services

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    Introduction

    Any restriction or lack of ability to perform an activity in a manner or within the range considered normal for the human beings, resulting from impairment is termed as disability. Impairment concerns the physical aspects of health; disability is the loss of functional capacity resulting from an impairment organ; handicap is a measure of the social and cultural consequences of an impairment or disability.[1] The types of disability include loco-motor, hearing, speech, visual and mental disability. Recent development is the International Classification of Functioning, Disability and Health[2] developed by WHO in 2000 which has been used in the Multi-Country Survey Study during 2000 and 2001 and the World Health Survey Program in 2002 and 2003 to measure health status of the general population in 71 countries.[3] The domains here are classified into body, individual, and societal perspectives by the conceptual components that includes body functions and structure, activity and participation along with contextual factors that includes a list of environmental and personal factors. The ICF considers that every human being can experience some degree of disability and it is a continuous process from attainable level of health. With this background, the paper discusses various issues and challenges related to disability and rehabilitation services in India.

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    Review of Literature

    Recent data was collected from Medline and various other sources. Information gathered was summarized for Indian context and analyzed for discrepancies. Information was depicted under categories of problem burden of disability and its socio-demographic characteristics, determinants, service delivery under community-based rehabilitation, challenges ahead and recommendations to address the problem in the country.

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    Problem Burden

    Globally, around 785-795 million persons aged 15 years and older are living with disability based on 2010 population estimates. Of these, the World Health Survey estimates that 110 million people (2.2%) have very significant difficulties in functioning while the Global Burden of Disease Survey estimates 190 million have (3.8%) have severe disability. Including children, over a billion people (about 15% of the world's population) were estimated to be living with disability.[4]

    Systematic research into prevalence and determinants of disability has been scanty from India although it is an important public health problem. Disability is the best example of the iceberg phenomenon of disease. This is because of difficulty in identifying the mild and moderate degrees of physical and mental disability which are unrecognized by the health care delivery system and the survey team members.[5] The WHO estimates that 10% of the world's population has some form of disability.[6] In contrast, the National Sample Survey Organization (NSSO) report[7] and Census data of 2001[8] stated that its prevalence was as low as 2% in India. A recent community-based study in India found the prevalence of all types of disability as 6.3% out of which mental disability was found to be the most common type of disability (36.7%).[9]

    The disability prevalence varies in different age groups and urban-rural areas. The burden of disability is more among the geriatric (>60 years) age group with 6401 and 5511 per lakh population in rural and urban areas respectively.[7] A study in Chandigarh reported that 87.5% of elderly people had minimal to severe disabilities.[10] Another study in Dehradun showed that visual disability was the most common (74.1%) among the geriatric age group.[11] A community-based study conducted in Rajasthan among children below 14 years found that 7% of them had at least one or other form of disability.[12] Another study in Gorakhpur found that in children below the age of 6 years the disability rate was 7638 per lakh population.[13] In India, NSSO reported that a total of 1,40,85,000, and 44,06,000 people are disabled in rural and urban areas, respectively. Overall, 1846 and 1499 per lakh population had any type of disability during the survey in rural and urban areas respectively.[7] With respect to gender distribution, some studies showed proportionately more disability among males,[7] while some other studies more among females.[9] Lack of education among disabled is an important barrier for effective delivery of services and 54.7% of disabled belonged to illiterate category according to NSSO 2002 survey findings.[7] The differences observed in various studies are mainly due to difference in methodology adopted, conceptual framework, the scope and coverage of surveys undertaken, operational definitions used for various types of disabilities along with difference socio–cultural, and risk factors prevailing in that area. Social attitudes and stigma, international evidence, gap driven by mental retardation, and mental health measurement are also important factors related to prevalence of disability.

    स्रोत : www.ncbi.nlm.nih.gov

    ::District Disability Rehabilitation Centre::

     » Programs & Interventions » NIEPID Reports » Act & Polices » Important Schemes » Achievements » Directory of Institutions » DDRC » Governance

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    21 Jan 2023

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    District Disability Rehabilitation Centre (DDRC) is an initiative by the Ministry of Social Justice and Empowerment, Govt. of India, to facilitate comprehensive services to Persons with Disabilities in the rural areas.  These units have a group of rehabilitation professions for providing services like identification of Persons with Disabilities, Awareness Generation, Early Detection and Intervention, Provision / Fitment, Follow-up and repairing of Assistive Devices, Therapeutic Services like Physiotherapy, Speech Therapy etc., and facilitation of Disability Certificates, Buss Passes and other concessions/ facilities for Persons with Disabilities.

    DDRC’s is a joint venture of Central and State Governments wherein Central Government will establish, initiate, implement the centre for three years involving funding for man power contingencies as well as required equipments and coordination.  State Government will provide provision for rent free , well connected building, basic infrastructure, furniture, monitoring and coordination of activities through District Management Team (DMT) Chaired by the District Collector and also identification of implementing agency.

    NIMH had the responsibility of establishing 16 DDRC’s among  7 states.   After successfully establishing and running for initiating three years, suitable implementing agencies have been identified with the help of State Government and all the 16 DDRCs have been handed over to the District Administration to be run by the identified implementing agencies.  Currently NIMH does not have any DDRC under its control. The details of the 16 DDRC’s established and handed over by the NIMH are as follows:

    S.No.Name of the DDRCThe date when the DDRC become functionalName of Implementing AgencyDate on which DDRC was handed over to the Implementing Agency12345

    1

    Gulbarga (Karnataka)

    July, 2000

    Indian Red Cross Society,

    Gulbarga, Dist. Branch 17.10.03 2

    Wardha (Maharashtra)

    July, 2000

    Kasturba Health Society, Sevagram, Wardha

    02.10.04 3 Madurai (T.N) August, 2000

    Manasa – Dist. Mentally Disabled Welfare Agency, Madurai

    13.04.04 4 Kozhikode (Kerala) August, 2000

    Hospital Development Society, Medical College, Kazhikode

    17.12.04 5 Thoothukudi (T.N) November, 2000

    V.O.C. Educational Society, Thoothukudi

    08.05.03 6

    Thiruvananthapuram (Kerala)

    January, 2001

    PMR Dept. Medical College, Thiruvananthapuram

    19.08.06 7 Indore (M.P) March, 2001

    Welfare Association for the Disabled, Indore

    17.02.03 8 Thrissur (Kerala) June, 2001

    Govt. Medical College, Thrissur

    01.010.4 9 Ujjain (M.P) December, 2001

    Seva Bharati, Ujjain

    01.04.05 10 Mandya (Karnataka) August, 2003

    Indian Red Cross Society, Mandya

    27.02.07 11 Dewas (M.P) September, 2003

    Indian Red Cross Society, Dist. Branch, Dewas

    27.10.06 12 Karimnagar (A.P) December, 2003 DRDA, Karimnagar 10.05.07 13 Satna (M.P) January, 2004

    Indian Red Cross Society, Satna

    25.01.07 14

    Jashpur (Chhatisgarh)

    June, 2004

    Kalyan Asharam, Jashpur

    16.05.07 15 Damoh (M.P) August, 2004

    Indian Red Cross Society, Damoh

    05.09.07 16

    Bastar (Chhatisgarh)

    September, 2004

    Indian Red Cross Society, Bastar

    25.09.07

    As all these DDRC’s have been handed over to respective implementing agencies, further information related to these DDRC’s can  be sought from the implementing agencies as mentioned above.

    DDRS Inspection Reports for the year 2010-11, 2012-13 & 2013-14 (Size:11.8 KB)

    स्रोत : www.niepid.nic.in

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    The Department of Empowerment of Persons with Disabilities in the Ministry of Social Justice & Empowerment facilitates empowerment of the persons with disabilities, who as per Census 2011 are 2.68 crore and are 2.21 percent of the total population of the Country. These include persons with Visual, Hearing, Speech & Locomotive disability, Mental Retardation, Mental Illness, Multiple Disability and any other disabilities.

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