4. Concepts & Definitions
Population:
The population of an area is the total number of all individuals alive in a particular
point in time. Thomas Frejka, (1973)
Population explosion:
The Theory of Demographic Transition, asserts that the population explosion
implying a sudden spurt in the rate of population growth is a transitory
phenomena that occurs in the second stage of demographic transition due to
rapid fall in mortality rate without a corresponding fall in the birth rate.
Birth Rate is the total number of births per 1000 of a population each year.
Mortality rate is the total number of deaths per 1000 individuals per year.
Total fertility rate (TFR) is the average number of children that would be born to a
woman over her lifetime.
5. Malthusian views
✓Population tends to increase at a geometric rate
✓Food can only increase arithmetically
✓Population expands to eat up any surplus
✓Choose moral checks or positive checks
7. World Population Growth
First Billion: 1804
Second Billion: 1927 (123 yrs)
Third Billion: 1960 (33 yrs)
Fourth Billion: 1974 (14 yrs)
Fifth Billion: 1987 (13 yrs)
Sixth Billion: 1999 (11 yrs)
Seventh Billion: 2011 (12 yrs)
Sources:World population milestones (USCB)
8. World Population Growth Rate
(Decadal growth- 2001 to 2011)
Sources: Population Reference Bureau, 2011
S.No. Country Population (In millions) Decadal change
(in %)
1 China 1,341.0 5.43
2 India 1,210.2 17.64
3 U.S.A 308.7 7.26
4 Indonesia 237.6 15.05
5 Brazil 190.7 9.39
6 Pakistan 184.8 24.78
7 Bangladesh 164.4 16.76
8 Nigeria 158.3 26.84
9 Russian Fed. 140.4 -4.29
10 Japan 128.1 1.1
Other Countries 2844.7 15.43
World 6908.7 12.93
10. Country wise share in world population
Sources: Population Reference Bureau, 2011
11. Percentage decadal population growth rate in India:
1951-1961 to 2001-2011
21.64
24.8 24.66 23.87
21.54
17.64
0.
6.25
12.5
18.75
25.
31.25
1951-91 1961-71 1971-81 1981-91 1991-01 2001-2011
12. Rural & urban population in India
Source: Census, GOI
13. Causes of rapid population Growth
1. High birth rate
2. Relatively lower death rate and
3. Migration
Net Migration is the difference between emigration &
immigration
▪Emigration is when a person moves out of the country.
▪Immigration is when a person moves into a country.
14. Interaction
In India the population has rapidly increased
mainly due to decline in the death rate,
while the birth rate remained high.
Population growth =
(Birth rate+ Immigration) - (Mortality + Emigration)
15. Reasons for High Birth Rate
1. Predominance of agriculture
In agrarian society children never been considered as
economic burden.
2. Slow urbanization process &
predominance of villages
3. Poverty
People are not poor because they have large
families. Quite the contrary, they have large
families because they are poor.
-(Mahmood Mandani)
A. Economic factors B. Social factors
A. Economic factors
16. 1. Near universality of marriage
Presently in India by the age of 50, only 5 out of 1000
Indian women remain unmarried.
2. Lower age at the time of
marriage
3. Religious & social superstitions
Belief that it is a must to have a son, because
according to religion certain rites can be
performed only by him & none else.
4. Joint family system
The joint family system induces the young couple to
have children, though they may not be in a
position to support them.
B. Social factors
17. 5. Lack of education
6. Unawareness about family
planning services
7. Social and religious beliefs -
especially in relation to
contraception and abortion
8. Infant Mortality Rate
Contd..
18. Reasons for decline in the mortality rate
a. Elimination of famines
b. Control of epidemics &
decline in the incidence of
Malaria & Tuberculosis
c. Supply of pure drinking water
d. Sanitation & hygiene
19. Contd..
e. Nutrition levels
f. Living standard
g. Education, health care
& expanded medical
facilities
h. Social factors such as
conflicts and levels of
violent crimes
20. Birth rate & Death rate in India
Year
Birth rate
(births/1,000 population)
Death rate
(deaths/1,000 population)
1941-51 39.9 27.4
1951-61 41.7 22.8
1961-71 41.1 19
1971-81 37.2 15
1981-91 29.5 9.8
1991-01 25.8 8.5
2001-11 22.5 7.7
Source: Calculated from the Census of India data and Ministry of Health and Family Welfare,
Government of India
21. Birth rate & Death rate in India
0.
12.5
25.
37.5
50.
1941-51 1951-61 1961-71 1971-81 1981-91 1991-01 2001-11
rate
of
growth
years
Birth rate (births/1,000 population) Death rate (deaths/1,000 population)
22. Why there are so many children in poor countries ??
Because children are “investment goods” rather
than “consumption goods”
The “expected return of the investment” is given by child
labour and financial support for parents in old age
24. Population growth, GDP and food grain
production in India
Source: analysis based on census 1950-51 to 2001-2011
25.
26. Labour force and economy
“India’s large population is an important asset,
and the key to the economic future of our
nation". - Jawaharlal Nehru
A. J. Coale and E. M. Hoover (1958)
Indicated that the rate of economic growth in a developing country is
primarily determined by two factors:
1. The growth in labour force; and
2. The amount of capital available per labourer.
Coale and Hoover model
27. • Today, 36% of India’s one billion populations are below the
age of 15 years.
• This means that by 2020, 325 million people in India will
reach the working age. India will have the largest working
population in the world.
• This expected rise in India’s working population comes at a
time when the developed world is faced with large, ageing
populations.
Population and labour forces
•US will be short of 17 million people of working age, China 10 million, Japan 9 million
and Russia 6 million.
•Against this, India will have a surplus of 47 million working age people.
•India equipped with the advantage of a large, vibrant work-force, will grow at more
than 5% a year until 2050.
28. year unemployment rate (%)
2002 8.8
2003 9.5
2004 9.2
2005 8.9
2006 7.8
2007 7.2
2008 6.8
2009 10.7
2010 10.8
2011 9.8
With limited progress in human development, India’s large
population can become a liability rather than an advantage.
Unemployment rate: This entry contains the percent of the labor force that is
without jobs.
Population and unemployment trends in India
Source:www.wikipedia.com
29. poverty
Despite of booming economy and a $ 9billion jobs program, India ranks poorly in
poverty indicators.
Sources: Indian Government, World Bank (poorest nations)
Countries with the largest percentage of people living on $ 1.25 or less /day (2011)
30. • Today, high population densities have
led to overloaded infrastructure in
urban areas.
• 27% of India’s urban population today
lives without sanitation; 24% lives
without access to tap water.
• The population of India’s major cities is
expected to increase by an average of
25% by 2020.
Over-strained infrastructure
India’s population will be 72% urbanized by 2030. It is estimated that India will
require construction of 3.6 million housing units in urban areas every year, to
address additional population requirements.
31. Contd..
The annual growth in
India’s population
alone is estimated to
require the opening of
66,000 new primary
schools and 3,000 new
health centers every
year.
32. Effects on agriculture land
The total area of the country is fixed & where
agriculture is predominant.
Population increases at a faster rate, larger
and larger area of land is needed for
dwelling units, roads, factories, etc.
An estimated half of India’s 329 million hectares of soil is degraded.
India will lose all its productive land to desertification within 200
years, if the present annual loss of land continues.
Small size of land holdings results in wastage of land & capital and
productivity is adversely affected.
33. Effect on water and grass lands
The water table in India is
falling by an average of
6 feet every year. It is
predicted that India
will cross into water
scarcity by 2025.
The population impact on India’s resources has been severe.
According to the World Bank, resource degradation costs the Indian
economy 4.5% of GDP annually.
Common property such as grasslands has declined by 25%, through
encroachments and over-cultivation.
34. Effects on forests
Forests contribute in a big way to
economic growth of the country.
Fast increase in population in India
resulted in deforestation for ever
increasing demand of agricultural
land, fuel, wood dwellings, etc.
35. Effects on mineral resources
Mineral resources are limited.
Faster growth of population &
its size in India resulted in
greater exploitation of these
resources.
This will obviously affects
adversely the future
economic growth in
developing countries.
36. Food Security
• To provide for the food
requirements of the
additional population, India
will have to consistently
increase food production by
3% every year.
➢The number of people who require a food subsidy would double
in 50 years; and
➢Greater pressure would be placed on the government to provide
food subsidies.
37. How to reduce rapid population growth?
1. Expansion of industrial sector:
Industrial workers are aware of difficulties in
getting the employment & are interested in
restricting the size of their family.
2. Creation of employment opportunities in
urban areas:
The housing problem and the cost of upbringing of
children in urban areas are the two factors which
usually deter people from having big families
38. 4. Increase education, employment and wages for
women
Education often changes the
attitude of a person towards
family, marriage and the number
of children he/she should have.
3. Equitable distribution of income and removal of poverty
Poor people have virtually no interest in limiting the size of the family.
39. 6. Provide better old-age
social security
To reduce the dependency on the
children
7. Raising the minimum age
of marriage
India should try to draw some
lesson from the experiences of
China, Malaysia and Sri Lanka
where fertility decline has
occurred largely through an
increase in age at marriage.
5. Increase the minimum-age child
labor
40. 8. Improve child health to reduce infant
mortality
9. Implementation of family-
planning programs
10. Monetary subsidies to small
families
41. Population Policy in India
• It is difficult to decide as what is optimum size of population for India under the
existing conditions.
• There has been complete reliance on family planning in order to reduce population
explosion.
• The national family planning program was launched in 1951, and was the world's first
governmental population stabilization program.
• Low female literacy levels and the lack of widespread availability of birth-control
methods is hampering the use of contraception in India.
• Family planning accepted & practiced effectively in some of the states in India.
• Education and awareness needed about Family Planning.
42. The Demographic dividend of India, if not harnessed, can turn
into a demographic disaster. Critically Analyze.
43. Population and Development: China &
India
Two of the world’s fastest growing economies.
China and India, also happen to be the world’s two most
populous nations.
In India, it is common to hear the view that,
Everything is growing faster in China than India, except
population.
India, which had well under 2/3rd of China’s population
half a century ago, is projected to surpass China’s
population by 200 million people by 2050.
45. What is Urbanization?
• Urbanization is referred to as the migration of
people in large numbers from rural to urban
areas.
• Urbanization occurs mainly because of the
concentration of resources and facilities in
towns and cities.
47. A large number of people are attracted to
urban areas because of:
• The availability of jobs
• Proper infrastructure – roads, water, electricity
etc.
• Availability of social services – health,
education, recreation, postal services and
police stations.
• A wide variety of entertainment and night life
facilities
49. • Scarcity of jobs except in agriculture, and most
people consider agricultural occupations to be low-
paying, labourious, risky and menial.
• Lack of infrastructure such as poor roads, irregular
water and electricity supplies.
• Poor facilities in education, health and security
• Lack of entertainment and recreational facilities.
58. T H E S O L U T I O N S T O U R B A N I S A T I O N N E E D T O B E
T R A N S F O R M A T I V E A N D N O T I N C R E M E N T A L . D O Y O U
A G R E E ? E V A L U A T E T H E S O L U T I O N S A V A I L A B L E T O U S
F O R T A C K L I N G T H E P R O B L E M S P O S E D B Y
U R B A N I S A T I O N .
59. Limit the size of cities by setting boundaries and
controlling population size.
60. Put a stop to using agricultural lands for non-
agricultural purposes such as housing.
61. Develop the rural areas by providing recreation,
education, health care and other social services.
67. What is Poverty?
Poverty is hunger.
Poverty is lack of shelter.
Poverty is being sick and not being able to
see a doctor.
Poverty is not having access to school and
not knowing how to read.
Poverty is not having a job, is fear for the
future, living one day at a time.
Poverty is losing a child to illness brought
about by unclean water.
Poverty is powerlessness, lack of
representation and freedom.
MORE…
68.
69. TWO WAYS OF POVERTY
RELATIVE POVERTY
Under Relative poverty the economic
conditions of different regions or countries
is compared. The capita income and the
national income are the two indicators of
relative poverty. According to the UNO
those countries are treated poor whose per
capita income is less than US $725 per
annum.
ABSOLUTE POVERTY
Absolute poverty refers to the
measure of poverty , keeping in view
the per capita intake of calories and
minimum level of consumption .
Per capita income :
National income
Population
74. Corruption is in many ways, a side
effect of Democracy. Analyse.
75. ➢Most of us have an idea of what corruption is.
➢But we don’t necessarily share the same idea.
➢That is why we need to ask the question about what corruption is.
For example,
➢do you believe giving money to speed up the processing of an
application is corruption?
➢Do you think awarding contracts to those who gave large campaign
contributions is corruption?
➢Do you think bribing a doctor to ensure your mother gets the medicine
she needs is corruption?
➢Do you think using government construction equipment to build an
addition on one’s house is corruption?
76. Corruption is not just the clearly “bad” cases of government officials skimming off money
for their own benefit. It includes cases where the systems don’t work well, and ordinary
people are left in a bind, needing to give a bribe for the medicine or the licenses they need.
All of the above are examples of public corruption. They all involve the misuse of public
office for private gain. In other words, they involve a government official benefiting at the
expense of the taxpayer or at the expense of the average person who comes into contact
with the government. By contrast, private corruption is between individuals in the private
sector, such as the Mafia extorting money from
a local business.
Public Corruption: The
misuse of public office
for private gain.
77. Corruption is not only a western concept. In any society, there is a difference between
what happens above board and what is under the table, of what is accepted
and what causes outrage. Although different societies have their own notions of
corruption, here are four questions to help determine what is right:
• Transparency: Do I mind if others know or the
press reports on what I do?
• Accountability: Do I report my actions to others?
Do they hold me to standards?
• Reciprocity: Would I feel hurt if others did the
Same thing?
• Generalization: Would it harm society if everybody
Did the same thing?
78. If only corruption were this obvious...
Gift giving in many village
traditions, for example, is not
considered corruption as the
transaction is transparent and
not secret; the scale is modest,
not life-changing; the benefits
are usually shared with the
community, for example the
council of elders; and the
public rights are not violated.
79. There are many types of corruption.
For most people, bribery probably comes first to mind when they hear
the word corruption, but other common types of corruption include
nepotism, fraud, and Embezzlement.
Definition : -
Bribery: - An offer of money or favors to influence a public official.
Nepotism: - Favoritism shown by public officials to relatives or close friends.
Fraud: - Cheating the government through deceit.
Embezzlement: - Stealing money or other government property.
80. In talking about different types of corruption, an important distinction is between
administrative corruption and political corruption.
Administrative Corruption: Corruption that alters the implementation of policies,
such as getting a license even if you don’t qualify for it
Political Corruption: Corruption that influences the formulation of laws,
regulations, and policies, such as revoking all licenses, and gaining the sole right to operate
the beer or gas monopoly.
Another important distinction is between grand corruption and petty corruption
Grand Corruption: - Corruption involving substantial amounts of money and
usually high-level officials.
Petty Corruption: - Corruption involving smaller sums and typically more junior
officials
81. Corruption levels can vary within a
country for different types.
For example, there may be very little
grand corruption in a country with a
relatively clean elite, but a large amount
of petty corruption in the lower offices of
government.
82. Source: - Dealing with Bribery and Corruption, a Management Primer of
Shell International, 1999. Used with permission
83.
84.
85.
86.
87.
88. T E R R O R I S M I S N O T H I N G B U T
E C O N O M I C S A N D G E O G R A P H Y .
E X P L A I N .
89.
90. 90
Definition of Terrorism
Terrorism actually comes from the Latin
Word “Fear”
“The Unlawful Use of Force Against Persons
or Property to Intimidate or Coerce a
Government, the Civilian Population, or
Segment Thereof, in the Furtherance of
Political or Social Objectives.”(Source FBI)
91. “…warfare seeks to conquer territories
and capture cities;
terrorism seeks to hurt a few people and
to scare a lot of people in order to make a
point” NYTimes, 1/6/2000
“Putting the horror in the minds of the audience, and not
necessarily on the screen”
95. Modern History of Terrorism
■ Terrorism is Asymmetric Warfare.
❑ Asymmetric warfare is the use of apparently
random/unpredictable violence by an weak military
against a stronger military to gain advantage.
(Allen, 1997).
❑ The key of Asymmetric warfare is using
unexpected, unconventional tactics in combat
(Craig, 1998).
Arthur H. Garrison
96. TYPES OF TERRORISM
• CIVIL DISORDER
• POLITICAL TERRORISM
• NON-POLITICAL TERRORISM
• QUASI TERRORISM
• LIMITED POLITICAL TERRORISM
• OFFICIAL OR STATE TERRORISM
97. CIVIL DISORDER
• A form of collective violence interfering with the
peace, security, and normal functioning of the
community.
98. POLITICAL TERRORISM
• Violent criminal behavior designed primarily to
generate fear in the community, or substantial
segment of it, for political purposes.
99. NON-POLITICAL TERRORISM
• Terrorism that is not aimed at political purposes
but which exhibits “conscious design to create
and maintain a high degree of fear for coercive
purposes, but the end is individual or collective
gain rather than the achievement of a political
objective.”
100. QUASI TERRORISM
The activities incidental to the commission of crimes of
violence that are similar in form and method to genuine
terrorism but which nevertheless lack its essential
ingredient. It is not the main purpose of the quasi-
terrorists to induce Terror in the immediate victim as in the
case of genuine terrorism, but the quasi-terrorist uses the
Modalities and techniques of the genuine terrorist and
Produces similar consequences and reaction. For example,
the fleeing felon who takes hostages is a quasi-terrorist, w
hose methods are similar to those of the genuine
terrorist but whose purposes are quite different.
101. LIMITED POLITICAL TERRORISM
• Genuine political terrorism is characterized by a
revolutionary approach; limited political
terrorism refers to “acts of terrorism which are
committed for ideological or political motives
but which are not part of a concerted campaign
to capture control of the state.
102. OFFICIAL OR STATE TERRORISM
• "referring to nations whose rule is based upon
fear and oppression that reach similar to
terrorism or such proportions.” It may also be
referred to as Structural Terrorism defined
broadly as terrorist acts carried out by
governments in pursuit of political objectives,
often as part of their foreign policy.
103.
104.
105. 105
Terrorist Units and Cells:
A Functional Approach
Funding
• Sources:
crime, harvesting
• Processing and
management,
•Nation States
Training
• Recruitment
• Instructors
• Sites
• Equipment
Intelligence
• Supplied
• Gathered
• Internet/other
open source
• Information
and politics
Logistics
• Equipment &
supplies
• Other essentials
• Sources
Operations
• One-man
• Team
• Multilateral/
collaborative
106. 106
Government Response to
Terrorism:
A Functional Approach
Funding
• Sources:
•Federal, State and
•Local Taxes
Training
• Recruitment
• Instructors
• Sites
• Equipment
Intelligence
• Supplied
• Gathered
• Internet/other
open source
• Information
and politics
Logistics
• Equipment &
supplies
• Other essentials
• Sources
Operations
• One-man
• Team
• Multilateral/
collaborative
108. Prevention of Terrorism
■ Primary prevention:
❑ Education!!!
❑ Understand the differences in cultures, religions,
beliefs and human behaviors
❑ Think of the peace, freedom and equality of all
human beings, not just “my group of people”
❑ Eliminate the root of terrorism
109. Prevention of Terrorism
■ Secondary prevention:
❑ Establish surveillance and monitoring system on
terrorism attack
❑ Improve protective system for citizens
110. Prevention of Terrorism
■ Tertiary prevention
❑ Early detection of the sources
❑ Prevent the extension of impairments
❑ Rescue the survivors
❑ Console the rest of the population
111. The only thing we
have to fear is
fear itself. FDR, 1933
Fears are educated into us & can,
if we wish, be educated out.
112.
113.
114.
115.
116.
117.
118.
119.
120.
121.
122.
123.
124.
125.
126.
127.
128.
129.
130.
131.
132.
133.
134.
135.
136.
137.
138. W H A T D O E S G E N D E R
E Q U A L I T Y M E A N T O
Y O U ?
139.
140.
141. Need of child welfare
➢1 million out of 21 million babies
born every year in India are
abandoned soon after their birth
due to different socio-economic
reasons.
➢Around 20 million children in our
country are estimated to be
working as child labors, some of
them in various hazardous
industries like the match industry,
firework industry and pottery
industry.
144. Key facts on Child Labour (ILO)
⦿246 million children are child labourers.
⦿73 million working children are less than 10 years old
⦿Every year, 22,000 children die in work related accidents.
⦿127 million - age 14 and under are in the Asia-Pacific region.
⦿8.4 million children are trapped in slavery, trafficking, debt
bondage.
145. The State-wise break up is as follows:
State No. of children mainstreamed
Andhra Pradesh
Bihar
Jharkhand
Karnataka
Madhya Pradesh
Chhattisgarh
Maharashtra
Orissa
Rajasthan
Tamilnadu
Uttar Pradesh
West Bengal
Punjab
Total
1,73,297
10,704
10,231
10,467
2,314
4,171
8,235
63,237
11,371
39,523
23,251
16,086
1,368
3,74,255
146. Causes of Child Labour
⦿Poverty
⦿Over Population
⦿Parental Illiteracy and want more income
⦿Lack of schools for study
⦿High education and living cost
⦿Weak laws to protect
⦿Adult unemployment and Urbanization
⦿Lack of education and exposure
⦿Wrong intention of factories
147. Child Labour in India
⦿India accounts for the second highest number where child
labour in the world is concerned.
⦿Child Labour is a source of income for poor families.
⦿80% child labourers in India are employed in the agriculture
sector.
⦿Landholding in agricultural areas and caste system in the rural
areas.
⦿The study found that a child's income accounted for between
34 and 37% of the total household income.
151. Child Rights
⦿Rights to Survival
That includes the right to life, the highest attainable standard of
health, nutrition and adequate standard of living. It also includes
the right to name and nationally.
⦿Rights to Protection
That includes freedom all forms of exploitation, abuses, in human
or degrading treatment and negligence including the right to
special protection in situation of emergency and armed conflicts.
152. Child Rights
⦿Rights to Development
That consists of the rights to education, support for early
childhood development and care, social security and right to
leisure, recreation and cultural activities.
⦿Rights to Participation
That includes respect for the views of the child, freedom of
expression, access to appropriate information and freedom of
thought, consensus and religions.
162. Background
Disability is complex, dynamic, multidimensional, and contested.
“It is the umbrella term for impairments, activity limitations and
participation restrictions, referring to the negative aspects of the
interaction between an individual (with a health condition) and that
individual’s contextual factors (environmental and personal
factors).”
163. Background
The transition from an individual, medical perspective to a
structural, social perspective has been described as the shift from a
“medical model to “social model” in which people are viewed as being
disabled by society rather than by their bodies.
The medical model and the social model are often presented as
dichotomous, but disability should be viewed neither as purely medical
nor as purely social: persons with disabilities can often experience
problems arising from both.
A balanced approach is needed, giving appropriate weightage to
the different aspects of disability.
164. Effect of environment
A person’s environment has a huge impact on the experience and
extent of disability. Inaccessible environments create disability by
creating barriers to participation and inclusion.
Examples of the possible -ve impact of the environment include:
• a Deaf individual without a sign language interpreter.
• a wheelchair user in a building without an accessible bathroom or
elevator.
• a blind person using a computer without screen-reading software.
165. What is Disability?
The World Health Organization (WHO 1976) draws on a three–fold distinction
between impairment, disability and handicap:
• Impairment is any loss or abnormality of psychological, physiological or
anatomical structure or function.
• Disability is any restriction or lack (resulting from an impairment) of ability
to perform an activity in the manner or within the range considered normal
for a human being.
• Handicap is a disadvantage, for a given individual, resulting from impairment
or a disability, which prevents the fulfilment of a role that is considered
normal (depending on age, sex and social and cultural factors) for that
individual.
166. ICF(International Classification of Functioning,
Disability and Health)
WHO reaffirmed this classification (1980), and in 2001 issued
the International Classification of Functioning, Disability and Health
(ICF).
The ICF distinguishes between body functions (physiological or
psychological, e.g. vision) and body structures (anatomical parts, e.g.
the eye and related structures) (WHO 2002).
Since an individual’s functioning and disability occur in a context, the
ICF also includes a list of environmental factors
167. The ICF lists 9 broad domains of functioning which can be affected
(WHO 2002):
1. Learning and applying knowledge
2. General tasks and demands
3. Communication
4. Mobility
5. Self-care
6. Domestic life
7. Interpersonal interactions and relationships
8. Major life areas
9. Community, social and civic life
ICF(International Classification of Functioning,
Disability and Health)
168. How to define disability???
According to the Persons with Disabilities (Equal Opportunities, Protection of
Rights and Full Participation) Act, 1995, "Person with disability" means a
person suffering from not less than 40% of any disability as certified by a
medical authority (any hospital or institution, specified for the purposes of this
Act by notification by the appropriate Government).
As per the act "Disability" means -
(i) Blindness;
(ii) Low vision;
(iii) Leprosy-cured;
(iv) Hearing impairment
(v) Loco motor disability;
(vi) Mental retardation;
(vii) Mental illness
170. Disabled Population by Sex and Residence
India : 2011
Source: C-Series, Table C-20, Census of India 2001 and 2011
Percentage of Disabled to total population
India, 2011
Residence Persons Males Females
Total 2.21 2.41 2.01
Rural 2.24 2.43 2.03
Urban 2.17 2.34 1.98
Percentage of Disabled to total population
India, 2001
Residence Persons Males Females
Total 2.13 2.37 1.87
Rural 2.21 2.47 1.93
Urban 1.93 2.12 1.71
171. Disabled Population by Sex and Residence
India : 2001-11
Source: C-Series, Table C-20, Census of India 2001 and 2011
Disabled Population by Sex and Residence India, 2011
Residence Persons Males Females
Total 26,810,557 14,986,202 11,824,355
Rural 18,631,921 10,408,168 8,223,753
Urban 8,178,636 4,578,034 3,600,602
Decadal Change in Disabled Population
by Sex and Residence, India, 2001-11
Absolute Increase Percentage Decadal Growth
Residence Persons Males Females Persons Males Females
Total 4,903,788 2,380,567 2,523,221 22.4 18.9 27.1
Rural 2,243,539 997,983 1,245,556 13.7 10.6 17.8
Urban 2,660,249 1,382,584 1,277,665 48.2 43.3 55.0
172. Disabled Population by Residence
India : 2001-2011
1.75
1.88
2.00
2.13
2.25
Total Rural Urban
2.13
2.21
1.93
2.21
2.24
2.17
Percentage
Proportion of Disabled Population by Residence
India : 2001-11
2001 2011
• Percentage of disabled persons in India has increased both in rural and
urban areas during the last decade.
• Proportion of disabled population is higher in rural areas
• Decadal increase in proportion is significant in urban areas
Source: C-Series, Table C-20, Census of India 2001 and 2011
173. Poverty and Disability
• The British Department for International Development (DFID) has
recognized that, ‘disability is a major cause of social exclusion and
it is both the cause and consequence of poverty’ (DFID 2000).
• Recent World Bank studies assert that ‘half a billion disabled
people are undisputedly amongst the poorest of the poor.’
174. Socio-Economic burden of disability
➢The financial impact of disablement on the family/household is
significant.
➢ More specifically, a south Indian study evaluating the economic
burden of families with disabled children indicated that the mean
expenditure of the families with a disabled child was $254 per year
compared with an expenditure of $181 per year of families with
normal children, (t=10.2, P<.00001). (Kandamuthan and Kandamuthan
2004)
➢Of the disabled children, 80% were not getting any social security
payments and 90% had no special concessions for medical and other
educational purposes.
➢Of the mothers of the disabled children, 21% were unemployed as
against 12% in the case of normal children.
175. Policies and Guidelines in India
The legislative framework for the protection of the rights of disabled
people is covered by following acts in India :
1. Mental Health Act 1987
2. Rehabilitation Council of India Act 1992
3. Persons with Disabilities Act 1995
4. The National Trust Act 1999
176. The Mental Health Act 1987
Mental Health Act came into effect in April 1993 & replaced the Indian Lunacy Act
of 1912. It consolidated and amended the law relating to the treatment and care
of mentally ill persons and to make better provision with respect to their properly
and affairs.
Objectives
• Regulate admission to psychiatric hospitals/nursing homes of mentally ill-
persons who do not have sufficient understanding to seek treatment on a
voluntary basis, and to protect the rights of such persons while being detained;
• Protect society from the presence of mentally ill persons who have become or
might become a danger or nuisance to others;
• Protect citizens from being detained without sufficient cause in psychiatric
hospitals/ nursing homes;
177. • Regulate responsibility for maintenance charges of mentally ill persons who are
admitted to psychiatric hospitals
• Provide facilities for establishing guardianship of mentally ill persons who are
incapable of managing their own affairs;
• Provide for the establishment of Central Authority and State Authorities for
Mental Health Services;
• Regulate the powers of the Government for establishing, licensing and
controlling psychiatric hospitals /nursing homes for mentally ill persons;
• legal aid to mentally ill persons at State expense in certain cases.
In 2002, the Act was implemented in 25 out of 30 states and Union Territories.
Under the Act, each state is required to constitute a State Mental Health Authority
(SMHA) to ensure effective and equitable enforcement of the provisions of the Act.
(WHO 2006).
The Mental Health Act 1987
178. The Rehabilitation Council of India Act 1992
This Act sets out to regulate the training of professionals in rehabilitation and
sets out a framework for a Central Rehabilitation Register. Specifically it sets
out:
1. Training policies and programmes;
2. Standardise the training courses for professionals dealing with persons with
disabilities;
3. Grant recognition to the institutions running these training courses;
4. Maintain a Central Rehabilitation Register of the rehabilitation professionals;
5. Promote research in Rehabilitation and Special Education.
6. The major functions of the council include the recognition of qualifications
granted by Universities in India for Rehabilitation Professionals and also the
recognition of qualification by Institutions outside India.
179. The Persons with Disabilities (Equal Opportunities,
protection Of Rights And Full Participation) Act 1995
This act provides 3% reservations for disabled people in poverty
alleviation programmes, government posts, and in state educational
facilities, as well as other rights and entitlement.
Objectives :
1. Prevention and Early Detection of Disabilities 8. Social Security
2. Education 9. Employment
3. Affirmative Action 10. Non-Discrimination
4. Research And Manpower Development
5. Recognition of Institutions for Persons with Disabilities
6. Institution for Persons with Severe Disabilities
7. The Chief Commissioner and Commissioners for Persons with Disabilities
180. The National Trust for Welfare of Persons with Autism,
Cerebral Palsy, Mental Retardation and Multiple Disabilities
Act 1999
This Act provides for the constitution of a national body for the Welfare of
Persons with Autism, Cerebral Palsy, Mental Retardation and Multiple
Disabilities.
Objectives:
• Enable and empower PWD to live independently and as fully as possible
from within and close to the community to which they belong;
• to strengthen facilities & to provide support to persons with disability to
live within their own families;
• to extend support to registered organization to provide need based
Services during the period of crises in the family of persons with
disability;
• to deal with problems of persons with disability who do not have family
support.
181. National Policy for Persons with Disabilities Act 2005
The National Policy, released in February 2006 seeks to create an
environment that provides them equal opportunities, protection of their
rights and full participation in society.
Its aim is to ensure better coordination between various wings of the State
and Central Governments .
The focus of the policy is on the following:
• Prevention of Disabilities
• Rehabilitation Measures
• Physical Rehabilitation Strategies
• Early Detection and Intervention
• Counselling & Medical Rehabilitation
182. In addition to the legal framework, extensive infrastructure has
been developed in India for disabled persons under this Act and
includes the establishment of the following institutions:
• Institute for the Physically Handicapped, New Delhi.
• National Institute of Visually Handicapped, Dehradun
• National Institute for Orthopedically Handicapped, Kolkata
• National Institute for Mentally Handicapped, Secunderabad.
• National Institute for Hearing Handicapped, Mumbai
• National Institute of Rehabilitation Training & Research, Cuttack.
• National Institute for Empowerment of Persons with Multiple
Disabilities, Chennai
National Policy for Persons with Disabilities Act 2005
183. The Disability and Rehabilitation WHO Action
Plan 2006-2011
The document provides the overview of WHO's future plan of activities,
which will be carried out or coordinated by the Disability and
Rehabilitation team located in the Department of Injuries and Violence
Prevention, in the NCD and Mental Health.
VISION: All persons with disabilities live in dignity, with equal rights and
opportunities
MISSION: To enhance the quality of life for persons with disabilities
through national, regional and global efforts to:
• Raise awareness about the magnitude and consequences of disability
• Facilitate data collection and analyse or disseminate disability-related
data and information
184. • Support, promote and strengthen health and rehabilitation
services for persons with disabilities and their families
• Promote community based rehabilitation (CBR)
• Promote development, production, distribution and servicing
of assistive technology
• Support the development, implementation, measuring and
monitoring of policies to improve the rights and
opportunities for people with disabilities.
• Build capacity among health and rehabilitation policy makers
and service providers
• Foster multi-sectoral networks and partnerships
The Disability and Rehabilitation WHO Action
Plan 2006-2011
185. • In India, two Departments : "Department of Social Justice and
Empowerment" and "Department of Disability Affairs" created
under the Ministry of Social Justice and Empowerment with
effect from May 14th, 2012.
• The Government has introduced the Rights of Persons with
Disabilities Bill, 2014 in the Rajya Sabha on 7th February, 2014.
It has been proposed inter alia in the Bill to establish the
National Commission and State Commissions for Persons with
Disabilities.
186. The Rights of Persons with Disabilities Bill, 2014
• The Bill repeals the Persons with Disabilities (Equal Opportunities Protection of
Rights and Full Participation) Act, 1995.
• Features of the bill:
1. Definition of disability: Disability is defined to include 19 conditions such as:
autism; low vision and blindness; cerebral palsy; deaf blindness;
haemophilia; hearing impairment; leprosy; intellectual disability; mental illness;
muscular dystrophy; multiple sclerosis; learning disability; speech and
language disability; sickle cell disease; thalassemia; chronic neurological conditions;
and multiple disability. Persons with benchmark disabilities are
defined as those with at least 40 per cent of any of the above specified disabilities.
2. Rights of persons with disabilities: The Bill states that persons with disabilities
shall have the right to equality and shall not be discriminated against on grounds
of their disability.
187. 3. Education, skill development and employment: All government
institutions of higher education and those getting aid from the government
are required to reserve at least 5% of seats for PWD.
At least 5% of the vacancies are to be filled by persons or class of
persons with at least 40 % of any of the disabilities.
4. Legal Capacity: Disabled persons have the right, equally with others, to
own and inherit movable and immovable property, as well as control their
financial affairs.
5. Guardianship: if a district court finds that a mentally ill person is not
capable of taking legally binding decisions, it may order guardianship to the
person.
The Rights of Persons with Disabilities Bill, 2014
188. 6. National and State Commissions for persons with disabilities:
The central and state governments are required to establish a
National and State Commissions for Persons with Disabilities,
respectively
7. Central and state advisory boards: The boards shall advise
governments on policies and programmes on disability and
review the activities of organisations dealing with disabled
persons.
189. Ali Yavar Jung National Institute For The Hearing Handicapped
The District Disability Rehabilitation Centre (DDRCs) under
Gramin Punarvasan Yojana (GPY) a programme of the Ministry of Social
Justice and Empowerment, Government of India was started in the year
2000.
Objectives :
1. Provide total rehabilitation to persons with sensory (hearing and
vision), physical and mental disabilities.
2. Research
3. Educational Programmes
4. Service Facilities: Strategies for early identification and rehabilitative
procedures. films and audio visuals on vocational training and job
placement, etc. are being developed.
190. 5. Community Programme: Identification and intervention, home bound
training, correspondence training and also tele–rehabilitation services
are being rendered and evolved with emerging needs.
6. Material Development: Required for (a) education (b) public
awareness and community education, literacy programme for adult
deaf, Parent Counselling and Programme for strengthening voluntary
organisations.
7. Information and Documentation: Documenting and disseminating the
latest information and developments in the science of hearing, speech
and related technology is being done.
191. National Handicapped Finance and Development
Corporation(NHFDC)
Incorporated by Ministry of Social Justice and Empowerment
Main Objectives:
• Promote economic development of the persons with disabilities.
• Promote self-employment for the benefit/economic rehabilitation
• Assist individuals or groups with disabilities by way of loans and
advances for economically and financially viable schemes.
• Grant concessional finance in selected cases for the persons with
disability in the country in collaboration with Government
192. • Extend loans to the PWD for pursuing education for training at graduate
and higher levels.
• Assist in the upgradation of technical and entrepreneurial skills of PWD
for proper and efficient mgt. of production units.
• Set up training, quality control, process development, for the proper
rehabilitation of the PWD in support of their economic pursuits.
• Work as an apex institution for channelizing the funds through State
Finance Corporation for the Handicapped or through corresponding
Corporations authorised by State Govts./Boards set up by Union
Govt/State Govt/Union Territory
National Handicapped Finance and Development
Corporation(NHFDC)
193. SCHEME OF ASSISTANCE TO DISABLED PERSONS FOR
PURCHASE/FITTING OF AIDS/APPLIANCES (ADIP SCHEME) April, 2014
Objectives
• to assist the needy disabled persons in procuring durable, sophisticated
and scientifically manufactured aids & appliances to promote
rehabilitation of PWD and enhance their economic potential with the
help of Implementing Agencies
• Implementing Agencies will take PRE & POST FITTING CARE of the aids
and appliances distributed under the Scheme.
• Implementing Agencies will give wide publicity of the distribution of
such aid and appliances to PwDs.
• After the camps, they shall provide a list of beneficiaries and the details
of aids and assistive devices with the cost incurred to the State
Government and the Department of Disability Affairs.
194. The Scheme shall also include essential medical/surgical correction
and intervention, prior to fitment of aids and appliances, as per the
following norms:
(i) From ₹.500/- to ₹.1,000/- for hearing & speech impaired.
(ii) From ₹.1000/- to ₹2,000/- for visually disabled.
(iii) From ₹ 3000/- to ₹ 5,000/- for orthopedically disabled
SCHEME OF ASSISTANCE TO DISABLED PERSONS FOR
PURCHASE/FITTING OF AIDS/APPLIANCES (ADIP SCHEME) April, 2014
195. ELIGIBILITY OF THE BENEFICIARIES
A person with disabilities fulfilling following conditions would be
eligible for assistance under ADIP Scheme.
i. An Indian citizen of any age.
ii. Holds a 40% Disablement Certificate.
iii. Has monthly income not exceeding ₹ 20,000/- pm.
iv. For dependents, the income of parents/guardians <₹ 20,000 pm.
v. Who have not received assistance during the last 3 years for the same
purpose from any source. However, for children below 12 years of age, this l
limit would be 1 year.
196. Schemes offered to the disabled by the central Govt.
1. Scheme of Integrated Education for The Disabled Children
2. Scholarships For The Disabled
3. children's Educational Allowance
4. Railway Travel Concession: 50% concession
5. Reservation of Jobs: 3% vacancies, Carry forward ( A roster (100
point) has been prescribed for giving effect to reservation of
jobs for physically handicapped persons. In this roster 67th
vacancy occurring in a particular year would be reserved for the
deaf.)
6. Age Relaxation: UPPER AGE + 10 YEARS
SOURCE : http://ayjnihh.nic.in/index.asp
197. 7. Promotion: Not to be denied promotion on medical grounds.
8. Posting of Physically Handicapped Candidates: transfer to or
near their native places may also be given preferences.
9. Income Tax Concessions: Section 80 DD , Max limit ₹15000.
10. Professional Tax Exemption
11. Award of Dealerships/Agencies by Oil Companies: 7.5%
reservations
12. Economic Assistance: eligible to take loans under the scheme
with minimum rate of interest (4% uniformly)
Schemes offered to the disabled by the central Govt.
198. Schemes offered to the disabled by the Haryana Govt.
• Reservation in Government Job: 3% of jobs are reserved
• Housing board: Handicapped persons get priority in allotment of Houses and
there is 01.5% reservation .
• Age Relaxation: The Upper age limit is relaxed by 10 years for handicapped
persons for applying in Government jobs.
• Scholarship/Stipend: The State Government awards scholarship to the
handicapped students (50- 400 ₹ pm)
• Disability Pension/Social Security Pension: Disabled persons of the age group
of 65 years and above having disability of 70% and above with family income
of ₹ 200/– p.m. or less get disability pension of ₹ 100/– p.m.
• Un–employment allowance: Disabled persons who has registered in
employment exchange get unemployment allowance (150-250 ₹ pm)
SOURCE : http://ayjnihh.nic.in/index.asp
199. • Conveyance Allowances: Physically handicapped employees get
conveyance allowance @ 8% of their basic pay subject to a maximum
of Rs.150/– p.m
• Bus concession: The State Government gives free bus pass to all types
of blind and other disabled persons having 100 disability.
• Assistance for self employment: Haryana Financial Corporation gives
loan to all types of handicapped for starting self employment.
• Exemption in road tax: All types of handicapped persons are
exempted from paying road tax.
• Awards/Sports/Seminars: State Government gives awards to the best
handicapped employees and the best self employed disabled for their
encouragement.
Schemes offered to the disabled by the Haryana Govt.
200. • Assistance for purchase of aids and appliances: The crippled and
orthopaedically handicapped persons get artificial limbs and
wheel chair by the State Government whose case is
recommended by a medical specialist or Chief Medical Officer.
• Other Concessions/facilities:
Welfare activities: Deaf & dumb person get vocational training
during which they get free rationing & free lodging/boarding &
medical facilities.
Schemes offered to the disabled by the Haryana Govt.
201. Next time u c smbdy on a wheel chair, don’t feel
pitty!!!!!
THEY MIGHT BE THE BEST OF ALL U
REMEMBER !!!!!
203. 204
• Primary education is a fundamental right in India, and at
the international level an important Millennium Development
Goal to which India and the Bank are totally committed.
• GOI and States increasingly recognize education as a critical
input for human capital development, employment/ jobs,
and economic growth, and are putting major financial and
technical resources into this effort.
• Nevertheless, demand for education far exceeds supply, in
terms of both access and quality, at all levels.
• Anxious to get YOUR views as to how the Bank can improve
its impact on access, learning outcomes and reducing skills
shortages.
204. 205
Basic Education
• Two decades of focused programs in basic
education have reduced out-of-school youth to
about 10 M (down from 25 M in 2003), most from
marginalized social groups. Net enrollment rate is
85%, with social disparities.
• Key challenge is to finish the “access agenda” and
dramatically increase focus on quality, with more
attention to classroom processes, basic reading
skills in early grades, teacher quality and
accountability, community/parent oversight,
evaluation/assessment.
205. 206
Secondary Education
• Access and Quality remain big challenges.
• Gross enrollment rate of 40%, with significant gaps
between genders, social groups, urban/rural, such
that most secondary students are urban boys from
wealthier population groups.
• Private aided and unaided schools = 60% of all
secondary schools, and growing.
• Overloaded curriculum, poor teaching practices and
low primary level quality affect secondary quality.
206. 207
Vocational Education and Training (VET)
• VET system is small, and not responding of needs
of labor market; <40% of graduates find
employment quickly.
• Insufficient involvement of industry and
employers in VET system management,
internships.
• Lack of incentives of public training institutions to
improve performance.
207. 208
Technical and Higher Education
• Numerically huge: 330 universities and 18,000
colleges
• Substantial private provision in professional
education.
• But just 11% of youth 18-23 are enrolled.
• Problems of capacity, quality, relevance, and
public funding. Hard to retain qualified faculty.
Limited research.
• Several world-class institutions.
208. 209
GOI Education Strategy
• Unprecedented priority to universal elementary education.
• Sarva Shiksha Abhiyan: aims to universalize elementary
education by 2010, and improve learning outcomes.
• Education cess of 3% on income tax, corporation tax, excise
and customs duties generates necessary resources
• Cost-Share: was 50/50 (2007), moving to 65/35
Center/State
• Estimate: 11th Plan: ’07-’12: 60,000-70,000 crores (US$17
billion)
• Increased focus on quality and upper primary in phase II.
209. 210
GOI Strategy (continued)
• National Mission for Skills is being set up,
looking at both VET and secondary education
• New centrally sponsored scheme to update all
industrial training institutes (ITIs)
• Significant investments in higher education
(including reforms and expansion) are expected
210. 211
• IDA Lending: 0%, 35 years to repay with first 10 years
“grace” (no repayment)
• Since FY00: over US$ 1 Billion (Rupees 40 billion)
committed to sector.
• Over last 10 years: eight State-level District Primary
Education Projects
• US$ 500 M for SSA I; Additional US$500 M in
November 2007 for SSA II
– Increased focus on quality in SSA II
– Partner with European Commission and UK DFID
– Still a small player: Bank $ is less than 10% of GOI $
211. 212
• US$ 280 M for VET: support 400 Industrial Training
Institutes, for improved quality and relevance (June
2007)
• US$ 250 M for Technical Education and Engineering:
reforms in 128 competitively selected engineering
institutions in 13 states to address skills shortages
• US$ 70 M for polytechnics in six remote states
(possible $300 M additional)
• State education reforms in Orissa and AP
212. 213
Collaboration with Civil Society
• Over 7,000 NGOs participating as partners in SSA
– Alternative education programs: “bridge courses”
– Monitoring of quality
– Capacity-building of VECs
– Reference Groups advising States, Districts and Blocs
– Contracting (e.g. MP with Pratham)
• Not surprisingly, varies greatly by State
213. 214
• Elementary Education
– Impact evaluation regarding:
• Incentive payments and schooling inputs on
student learning
• Dissemination of education information on school
governance and student outcomes
• School characteristics and student outcomes
• Instructional time on task survey
214. 215
• Early Childhood Development – focus on integrated
(health/nutrition/education) approaches
– Will feed into US$ 450 M Integrated Child Development
Services Project
• Secondary Education – major analytical study related
to expanding access, particularly for girls and
marginalized groups, and to role of private sector
• Higher Education – contribute to debate regarding
how India can address skills shortages among HE
graduates, linked to economic growth opportunities.
215. 216
• Engagement in Indian education is largely
through centrally-sponsored schemes, while
most implementation happens at the State
level. Need to find ways to foster dialogue and
technical assistance with States, and increase
exchanges with civil society on substantive
policy issues.
216. 217
Additional Issues for Discussion
• Access versus quality tradeoffs
• Role of public and private sectors in education
financing and provision
• Prioritization of education levels (basic, secondary,
VET, higher)
• Role of civil society in policy debates and project
implementation
217.
218. Key Growth Inhibitors
Delivery of qualitative healthcare services is considered a basic need irrespective of age, gender, and culture.
Indian healthcare system faces substantial challenges in providing qualitative healthcare.
The key growth inhibitors are:
1. Fastest growing population
2. Changing disease profile and Re-emerging diseases
3. Multilayered Healthcare System / Landscape
4. Lack of or Absence of Infrastructure
5. Paucity of Manpower (Doctors, Nurses, Paramedics)
6. Extremely Low Public Expenditure on Health and its Inefficiencies
7. Inaccessibility of Healthcare Services
Source: KPMG
220. Changing Disease Profile: India
Shift towards biotech speciality therapies, increased R&D expenditure and acute disease segment will sustain strong growth
Source: IDFC Institutional Securities, Indian Pharma, 2010 Source: NSSO Morbidity & Healthcare Survey, McKinsey’s Analysis, 2004
Per 1000 cases
221. http://usf.vc/wp-content/uploads/2013/12/NCD-burden-
India_PwC-copy.jpg
• India which makes up 16.5 percent of world’s population and faces a significant burden of diseases.
• It accounts for “a third of diarrheal diseases, tuberculosis, respiratory, parasitic infestations, prenatal conditions;
• A quarter of maternal ailments;
• A fifth of nutritional deficiencies;
• Second largest number of HIV/AIDS cases in the world;
FEDERATION OF INDIAN CHAMBERS OF COMMERCE AND INDUSTRY (FICCI), INDIA NEEDS TO SPENDS AROUND US $203 BILLION, IF MISSION OF ACHIEVING
“HEALTH FOR ALL” IS TO BE ATTAINED.
225. Human Resources Shortages: India
Indian healthcare expenditure has grown slower than the economy
Source: WHO, E&Y Analys
http://cdn-www.ceicdata.com
227. Inaccessibility of Healthcare Services: India
• Physical Reach / Accessibility of a healthcare facility
which is having an outpatient department (OPD) for
common ailments, and an inpatient department (IPD) for
hospitalization. These facilities may either be public or
private in nature within 5km from the place of residence
or work.
• Availability/Capacity means availability of the requisite
healthcare resources to provide patient treatment, i.e.
doctors, nurses, in-patient beds, diagnostics, consumables,
etc. it is governed by minimum specifications defined by
the Government of India for public healthcare facilities,
and WHO.
• Quality/Functionality means quality of the healthcare
resources available at the point of patient treatment.
• Affordability means the ability of a patient to afford
complete treatment for the illness or disease.
Source: IMS Institute for Healthcare Informatics, Understanding Healthcare Access
in India, June 2013
228. India and Its Neighbors
(SAARC Countries)
Source: http://thecalibre.in/wp-
content/uploads/2013/01/Number-fetish.jpg
229. Healthcare Challenges: India
1:20,00
0,
versus
the
urban
ratio of
1:2000.
• The
quality
and
availabil
ity of
medicin
are at
just 7%.
80% of
the
rural
populati
on is on
a daily
wage,
income
levels
are as
low as
and
their
treatme
nt
option.
• They
rely
mainly
on
alternat
ive
forms
of
• This is
because
80% of
rural
inhabita
nts lack
adequat
e
sanitati
on, and
70%
don’t
have
230. Government Appointed Review & Its Findings
All reviews have pointed towards:
• Occurrence of major legislative gaps and poor
implementation
• Ineffective implementation of Laws and Policies
• Lack of rules and poor enforcement
• Fragmented and uncontrolled nature of private
healthcare delivery system
• Lack of uniform standards
• Non coverage of laboratories or diagnostic centres
• Also information about the number, role, nature,
structure, functioning, and quality of healthcare in
private hospitals remain inadequate or poor.
• Absence of national regulations regarding provider
standards and healthcare treatment protocols, over
diagnosis, over treatment, and maltreatment is
rampant practice.
232. Major Challenges
• Indian healthcare establishments have pitiable operational strategies, absence of documented waste
management and disposal policy, very poor budgetary support in the government run hospitals, private
hospitals ignore the rules for monetary consideration, untrained ward attendants, and other
supporting staff.
• There are no waste management committees at present in Indian hospitals which should essentially be
consist of the head of the establishment, all the departmental heads, hospital superintendents, nursing
superintendents, hospital engineers with a waste management officer along with an environmental
control advisor and an infection control advisor.
• Insufficient support and guidance from regulatory agencies further complicates the problem of waste
management. Regulations in the form of waste reduction and recycling targets, carbon credit earnings,
development of minimum energy efficiency standards for equipments are necessary for prevention of
pollution and reduction of environmental load on sustained basis.
• Adequate and requisite number of sanitary landfills is lacking in India.
• Resistance to change is often a barrier to implementation of new programmes.
233. Major Challenges
• It is the ethical, social responsibility, and duty of state, legislators, hospitals, healthcare professionals, and
the general public to make sure that environmentally acceptable waste disposal techniques is introduced
and implemented effectively.
• At present we have good enactments of laws, but political will is lacking to enforce these laws.
• There is no forum for ordinary citizen to approach for compensation.
• The present system provides only one remedy, that is, to go to ordinary civil courts, which are
overburdened with heavy pendency, and it may take decades to get relief to compensate the loss caused
by the medical wastes under the head of public nuisance.
• There is no effective tribunal like consumer forum to provide a speedy remedy for the persons infected
with disease by medical waste. The Environmental Tribunals have to be constituted.
• Training Development of safe and effective system of bio-medical waste management along with handling
protocols, detailed institutional plans, strict policies, appropriate training and feedback programs for all
the healthcare workers is very important.
234. Conclusion: General
• India lags behind in in key healthcare indicators
• There is Growing Burden of Disease and Disease Mix
• Inadequate and Poor Healthcare Planning (Top Down)
• Inequitable distribution of resources between different States as well as Urban Rural settings
• Shortfall of Physical Infrastructure
• Shortfall of Trained Manpower (Doctors, Nurses, Para-medics)
• Miniscule Healthcare Budget by Governments
• High Cost of Advanced Treatments
• Low Insurance Penetration
• Unregulated Private Sector (Only 244 hospitals in India are accredited by NABH)
235. References
CORPORATE RESEARCH REPORTS:
• HEALTHCARE IN INDIA: A REPORT BY BOSTON ANALYTICS, JANUARY 2009
• GLOBAL INFRASTRUCTURE: TREND MONITOR INDIAN HEALTHCARE EDITION: OUTLOOK 2009 –2013 BY KPMG
• STRATEGIES FOR PROVIDING EQUITABLE HEALTHCARE, BY ECS LIMITED, MARCH 2008
• PHARMACEUTICAL OFFSHORING LANDSCAPE, ZINNOV MANAGEMENT CONSULTING, SEPTEMBER 2008
• INDIAN PHARMACEUTICAL INDUSTRY ON COURSE OF GLOBALIZATION, DEUTSCHE BANK RESEARCH, APRIL
2008
• HEALTHCARE IN INDIA: EMERGING MARKET REPORT 2007 BY: PRICEWATERHOUSE AND COOPERS (PWC)
• HEALTHCARE OUTLOOK, TEN INDUSTRY TRENDS 2007, A QUARTERLY REPORT BY TECHNOPAK, FEBRUARY 07 /
VOLUME 1
• HEALTHCARE OUTLOOK, NEW PARADIGMS IN HEALTHCARE DELIVERY 2007, A QUARTERLY REPORT BY
TECHNOPAK, FEBRUARY 07 / VOLUME 2
• HEALTHCARE OUTLOOK, TRENDS IN HEALTHCARE DESIGN 2007, A QUARTERLY REPORT BY TECHNOPAK,
FEBRUARY 07 / VOLUME 3
• HEALTHCARE, MARKET OVERVIEW, INDIA BRAND EQUITY FOUNDATION (IBEF) OCTOBER 2007
• OVERVIEW OF THE HEALTHCARE INDUSTRY IN INDIA, THE INDO ITALIAN CHAMBER OF COMMERCE AND
INDUSTRY, APRIL 2007
• HEALTHCARE REPORT: BY ERNST & YOUNG, INDIAN BRAND EQUITY FOUNDATION (IBEF), 2006
• BOOMING CLINICAL TRIAL MARKET IN INDIA: RNCOS REPORT, NOVEMBER 2007
• DRAFT NATIONAL PHARMACEUTICALS POLICY, 2006, PART - A (CONTAINS ISSUES OTHER THAN STATUTORY
PRICE CONTROL), DEPARTMENT OF CHEMICALS AND PETROCHEMICALS, GOVERNMENT OF INDIA, DECEMBER
28, 2005
• HEALTH ATTAINMENTS AND DEMOGRAPHIC CONCERNS: NATIONAL HUMAN DEVELOPMENT REPORT, 2001:
CHAPTER 5
• THE STATE OF HUMAN DEVELOPMENT: NATIONAL HUMAN DEVELOPMENT REPORT, 2001: CHAPTER 1
• HEALTHCARE IN INDIA, CARING FOR MORE THAN A BILLION: BY SRIVATHSAN APARAJITHAN Y, MATHUR
SHANTHI, MOUNIB EDGAR L., NAKHOODA FARHANA, PAI ADITYA AND BASKARAN LIBI, IBM INSTITUTE OF
BUSINESS VALUE, IBM GLOBAL BUSINESS SERVICES
• CASE STUDY ON MANIPLE CURE & CARE: INDEGENEOUS CONCEPT THAT COMBINES HEALTHCARE AND RETAIL
IN A SINGLE FORMAT: BY PRICE WATER HOUSE AND COOPERS(PWC) AND DYNAMIC VERTICAL SOLUTIONS
• INDIAN PHARMACEUTICAL INDUSTRY: ISSUES AND OPPORTUNITIES: RESEARCH AND MARKETS REPORT (
http://www.researchandmarkets.com/reports/35229)
SUMMARIES:
• INADEQUATE REGULATIONS UNDERMINE INDIA'S HEALTHCARE: BY: MUDUR GANPATI: BMJ 2004; 328;124-
DOI:10.1136/BMJ.328.7432.124-A
• HEALTH CARE IN INDIA: LEARNING FROM EXPERIENCE: BY THE WORLD BANK GROUP
• HEALTHCARE INDICATORS: BY MS. MUKHERJI SRIMOTI, COMMERCIAL SPECIALIST, THE U.S. COMMERCIAL
SERVICE IN INDIA, THE AMERICAN CENTER, NEW DELHI
• INDIA’S NATIONAL HEALTH SYSTEM PROFILE: WHO
• OPPORTUNITIES IN HEALTHCARE: “DESTINATION INDIA”: FICCI AND ERNST & YOUNG.
• RURAL HEALTH CARE SYSTEM: THE STRUCTURE AND CURRENT SCENARIO
• INTRODUCTION TO NURSING AND HEALTH CARE DELIVERY SYSTEM IN INDIA
• A POLICY FRAMEWORK FOR REFORMS IN HEALTH CARE, PERSPECTIVES ON HEALTH CARE IN INDIA: BY PRIME
MINISTER’S COUNCIL ON TRADE AND INDUSTRY
• FAILURE OF PUBLIC HEALTHCARE SYSTEM: CJ: BY SINGH CHANDRA SHEKAR, FEBURARY, 2008
• FINANCING THE HEALTH CARE SECTOR IN INDIA: BLOG BY DR SINGH HARMEET, MBA (BIRMINGHAM)
• IN CHINA, INDIA, HEALTH CARE BURDEN SHIFTS TO POOR, GROUND-LEVEL IMPLEMENTATION 'IS SIMPLY NOT
THERE': BY POWELL ALVIN, HARVARD NEWS OFFICE
• STRENGTHEN THE INDIAN HEALTHCARE INDUSTRY (RECOMMENDATIONS): MODE 1 GATS REPORT INDIA
PAGE 83, 84
• ROLE OF PRIVATE SECTOR IN HEALTH CARE IN INDIA CHALLENGES, OPPORTUNITIES & STARTEGIES: BY LATH G
K, CEO, APOLLO HOSPITAL BILASPUR, MP
• UNHEALTHY PRESCRIPTIONS: THE NEED FOR HEALTH SECTOR REFORM IN INDIA: BY SUNIL NANDRAJ,
INFORMING REFORMING, THE NEWSLETTER OF THE INTERNATIONAL CLEARING HOUSE OF HEALTH SYSTEM
REFORM INITIATIVES ICHSRI, APRIL-JUNE 1997, PP. 7-11.
• MEDICAL TOURISM IN INDIA: ISSUES AND CHALLENGES: BY CHACKO PHEBA, THE ICFAI UNIVERSITY PRESS.
• HEALTH INSURANCE IN INDIA: OPPORTUNITIES, CHALLENGES AND CONCERNS: BY MAVALANKAR DILEEP AND
BHAT RAMESH, IIM AHMEDABAD
• INDIA BRAND EQUITY FOUNDATION (IBEF), MARCH 2013, AUGUST 2013 REPORT (WWW.IBEF.ORG)
• HEALTHCARE INDIA SECTOR NOTES, MAY 2014, (WWW.IIMJOBS.COM)
• INDIAN HEALTHCARE SYSTEM – OVERVIEW AND QUALITY IMPROVEMENTS, DIRECT RESPONSE, 2013:04,
SWEDISH AGENCY FOR GROWTH POLICY ANALYSIS , WWW.GROWTHANALYSIS.SE
• INDIAN PHARMA, INC.: CAPITALIZING ON INDIA’S GROWTH POTENTIAL, www.pwc.com/India
• INDIAN PHARMA INC. CARING FUP OR NEXT LELVEL OF GROWTH, www.pwc.com/India
236. References
Websites:
• www.technopak.com
• www.kpmg.com/infrastructure
• www.ibef.org
• www.dbresearch.com
• www.dynamicverticals.com
• www.bostonanalytics.com
• www.ibm.com/healthcare/hc2015
• www.pwc.com/globalhealthcare
• www.wikepedia.com/healthcare
• www.ficci.com
• www.timeswellness.com
• www.fortishealthworld.com
• www.whoindia.org
• www.who.int
• www.mohfw.nic.in
• www.crisil.com
• www.pharmabiz.com
• www.pharma.org
Journals
• JOURNAL OF THE ACADEMY OF HOSPITAL ADMINISTRATION
• INDIAN JOURNAL FOR THE PRACTICING DOCTOR
• JOURNAL OF HEALTHCARE AND MEDICAL TECHNOLOGY AND MANAGEMENT
• INDIAN JOURNAL OF MEDICAL ETHICS
• THE PHARMA REVIEW AND PHARMA TIMES
• JOURNAL OF HOSPITAL PHARMACY
Other Publications:
• MINISTRY OF HEALTH, GOVERNMENT OF INDIA
• INDIAN MEDICAL COUNCIL & INDIAN DENTAL COUNCIL
• EXPRESS HEALTHCARE MANAGEMENT
• INDIAN HEALTHCARE FEDERATION
• MEDICA: PHARMACEUTICAL INDUSTRY PUBLICATIONS
• MEDICA: HEALTHCARE SERVICES PUBLICATIONS
Chapters:
• COMPETITION CONCERNS: THE PHARMACEUTICAL INDUSTRY BY CUTS INTERNATIONAL
• CHAPTER 10: DRUG PRICE DIFFERENTIALS ACROSS DIFFERENT RETAIL MARKET SETTINGS: AN
ANALYSIS OF RETAIL PRICES OF 12 COMMONLY USED DRUGS: BY GODWIN S K AND VARATHARAJAN
D., HEALTH ADMINISTRATOR VOL: XIX NUMBER 1: 41-47
• HEALTHCARE POLICY AND ADMINISTRATION IN INDIA: BY SAPRU R K, STERLING PUBLICATION, II
EDITION, CHAPTER 15, PAGES 228-249.
My Books:
• Indian Health Sector and Healthcare System: A critical Insight, LAP Lambert Academic Publishing,
Germany, 2012, ISBN-10: 3659268895, ISBN-13: 978-3659268892, Prashant Mehta
• Indian Retail Analytics: An In-depth Study of Indian Retail Market, its Dimensions, Opportunities,
Problems, and Prospects, LAP Lambert Academic Publishing, Germany, 2012, ISBN-10: 3659147303,
ISBN-13: 978-3659147302 Prashant Mehta
My Publications:
• Legal Provisions and Management Perspectives of Biomedical and Hospital Waste in India. Journal
Club for Management Studies (JCMS),1(II), 11-36 (2014).Dr. Prashant Mehta. ISSN No : 2394 - 3033, V
– 1, I – 2, 2014
• Biomedical Waste Disposal: Indian Perspective: Scholasticus, Journal of National Law University,
Jodhpur Vol. 5 No. 1, September 2007, Prashant Mehta, ISBN: 0975-1157, Indexed
Editor's Notes
2
Often we talk about terrorism, without really defining it. Terrorism is not warfare, the goals are different. Terrorists want to seed a political message into our minds, murder, and violence are secondary. Hitchcock is a perfect spokesperson for terrorism as he is the master of terrorism. Terrorist make us afraid, which makes them heard.
We want to prevent our children, and us from being afraid. Educators, teachers, and mentors need the best possible information quickly to prevent the buildup of fear, and to dissipate fear after it has arisen. In many ways fear, for the survivors, is more disruptive than death.
The major destructive force of terrorism is fear. However, we can reduce fear by building up our knowledge of terrorism.
There has been much discussion of Asymmetric Warfare. This is where a superior power is confronted with an unconventional, much smaller enemy. However, the enemy has a fervent belief in a cause, but attacks using new, often never used before approaches often to the surprise of the dominant force.
Arthur H. Garrison, How the World Changed: a History of the Development of Terrorism, presented at Delaware criminal Justice Council Annual Retreat, Oct 28-29, 2001
http://www.state.de.us/cjc/history.ppt
Just because of its uncertainty, it is hard to collect unbiased data on terrorism and it is hard to propose specific prevention measures. Here we present the general approaches of prevention from the epidemiological and public health point of view.
