The Hindu Business Line : Importance of awareness

No data on the nature and extent of awareness of prevention of disability is available and the welfare programmes do not include awareness activities.

Welfare of differently-abled persons is under the Concurrent List. Accordingly, both the Centre (the Ministry of Social Justice and Empowerment) and the State governments (Ministries of Women and Child Development) formulate and implement welfare programmes such as provision of special education services, employment and training, and rehabilitation and social security schemes.

Policy frameworks

The welfare programmes are guided by such national-level policy frameworks as the Persons with Disabilities (Equal Opportunities, Protection of Rights and Full Participation) Act, 1995 and the National Policy for Persons with Disabilities. The programmes cover all types of disability, whether acquired or congenital.

The policy frameworks have a list of activities for prevention and early detection of disability. For instance, the National Policy for Persons with Disabilities includes awareness of nutrition, health-care and sanitation amongst adolescent girls, expectant mothers and women in the reproductive period; and awareness at school level and at the level of teachers' training.

Nevertheless, no data on the nature and extent of awareness of prevention of disability are available in the country. The welfare programmes do not include awareness activities. These need to be rectified on priority basis in disability research and policy through new initiatives.

Policy integration

Many of the disabilities are preventable by intake of a calcium- and protein-rich diet, reduction in nutritional anaemia, and genetic counselling for expectant mothers. The family welfare programme (comprising measures for maternal and child health) emphasises this. Also relevant are the Integrated Child Development Programme's health and nutritional schemes for pre-school children, pregnant women, nursing mothers, and adolescent girls. This justifies the integration of schemes for prevention of disability with these programmes.

Policy integration has two implications. First, awareness of prevention of disability gets integrated with existing measures and network of information, education, and communication activities. This helps in speedy and cost-effective delivery of awareness services. Second, data on awareness of prevention may be collectable through periodic national family health surveys and reproductive and child health surveys. This new data may be supplemented by additional questions on awareness in future Census and National Sample Survey questionnaires.

Awareness is essential for private medical practitioners and workers and volunteers in non-governmental health organisations in both rural and urban areas.

Thus, inter-ministerial co-ordination and public-private partnership are essential for the design and implementation of such programmes.

Social awareness may be targeted at individuals, households and communities. In particular, women in the reproductive age groups with higher fertility rates, poor and less educated in rural and urban areas, and in areas where antenatal care and institutional deliveries are less may be targeted. The data and results of the Third National Family Health Survey 2005-06 would be of help in this.

Research plan

Assessment and awareness of private cost and benefits of prevention of disability are essential for self-motivation of households. Social cost-and-benefit analysis of public investment on human development on disability is essential to justify public programmes. For instance, the Third National Family Health Survey 2005-06 shows remarkable trends in antenatal care, institutional deliveries, and nutritional status in children.

What do these trends imply for prevention in terms of reduction in prevalence and incidence of disability? A scientific answer to this question will provide an empirical basis for long-term policy interventions as well as for social awareness.

Medical professionals may help policy-makers by sharing their latest knowledge and experience. This calls for identifying specific preventable medical causes of disability as against the general causes known for observed disability in the National Sample Survey data. The Approach Paper to the Eleventh Plan emphasises "inclusive growth", or "including the excluded" and marginalised persons in the process of economic growth and development.

If left uncorrected, persistence of non-inclusive growth may accentuate the disparities and divides, and cause disabilities to increase in spatial, societal, economic and gender contexts. Thus, prevention of disability and its awareness deserve to be priority areas for policy action and research during the Eleventh Plan period.

(The author is Professor of Economics and Head, Centre for Economic Studies and Policy, Institute for Social and Economic Change, Bangalore.)

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