Living Conditions Among People with Disability in Nepal
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SINTEF A27656‐ Unrestricted Living conditions among people with disability in Nepal Arne H. Eide, Shailes Neupane, Karl‐Gerhard Hem Photo: Shutterstock SINTEF Technology and Society Department of Health Research 2016‐04‐28 Disclaimer This study, "The National Survey on Living Condition among Individuals with Disabilities in Nepal", was designed and implemented based on the consultations of the Steering committee representing members from the Ministry of Women, Children and Social Welfare, National Planning Commission, Central Bureau of Statistics, Ministry of Education, Ministry of Health and Population, Department of Education, Valley Research Groups and National Federation of the Disabled, Nepal. The opinions expressed in the report are those of the researchers and do not necessarily reflect the views of the Government of Nepal, Ministry of Women,n Childre and Social Welfare. Report SINTEF Teknologi og samfunn SINTEF Technology and Society Address: Postboks 4760 Sluppen NO‐7465 Trondheim NORWAY Living conditions among people with Telephone:+47 73593000 Telefax:+47 93270500 [email protected] disability in Nepal www.sintef.no Enterprise /VAT No: VERSION DATE Version 2016‐04‐28 AUTHOR(S) Arne H. Eide, Shailes Neupane, Karl‐Gerhard Hem CLIENT(S) CLIENT’S REF. Norwegian Federation of Organisations of Disable Hanne Witsø People (FFO) PROJECT NO. NUMBER OF PAGES/APPENDICES: 102007659 157 + Appendices ABSTRACT This report is from the National study on living conditions among people with disabilities carried out in Nepal in 2014-2015. The study was carried out as a household survey with two-stage stratified sampling, including a screening/listing procedure using the Washington Group on Disability Statistics 6 questions, one Household questionnaire administered to households with (Case HHs) and without disabled members (Control HHs), one Individual Case questionnaire administered to individuals who were found to qualify as being disabled in the screening (Case individuals), and an Individual Control questionnaire administered to matched non-disabled individuals in the Control HHs (Control individuals). The study covers a range of indicators on level of living, such as socio- economic indicators, economic activity, income, ownership and infrastructure, health (including reproductive health), access to health information, access to services, education, access to information, social participation, and exposure to discrimination and abuse (see all questionnaires in Appendix). PREPARED BY SIGNATURE Arne H. Eide, Research Manager CHECKED BY SIGNATURE Gloria Azalde APPROVED BY SIGNATURE Randi E. Reinertsen, Research Director REPORT NO. ISBN CLASSIFICATION CLASSIFICATION THIS PAGE SINTEF A27656 978‐82‐14‐06036‐2 Unrestricted Unrestricted Contents 1 Acknowledgements ............................................................................................................. 5 2 Executive summary .............................................................................................................. 8 3 Preface .............................................................................................................................. 17 4 Introduction ....................................................................................................................... 22 5 Disability policy and practice in the context of Nepal ......................................................... 23 5.1 Some legal provisions on disability ................................................................................. 24 5.2 United Nations Convention on the Rights of Persons with Disability (CRPD, 2006): ... 25 5.3 National provisions .......................................................................................................... 29 5.4 Disabled Protection and Welfare Act 2039(1982): ......................................................... 30 5.5 National Planning and Plan of Action on Disability in Nepal, 2063(NPPAD, 2007) ........ 32 6 The current situation for persons with disability in Nepal .................................................. 35 6.1 Prevalence of disability in Nepal ..................................................................................... 35 6.2 Educational status ........................................................................................................... 36 6.3 General health services ................................................................................................... 39 6.4 Livelihood ........................................................................................................................ 41 6.5 Access to facilities/services ............................................................................................. 44 6.6 Gap between policy and practice .................................................................................... 46 6.7 Way forward .................................................................................................................... 49 6.8 Conclusions ...................................................................................................................... 50 7 Conceptual understanding ................................................................................................. 54 7.1 Disability .......................................................................................................................... 54 7.2 International Classification of Functioning, Disability and Health (ICF) .......................... 55 7.3 Application of ICF in the current study ........................................................................... 55 7.4 Living conditions .............................................................................................................. 56 7.5 Disability and living conditions ........................................................................................ 57 7.6 Combining two traditions and ICF ................................................................................... 59 8 Design and Methodology ................................................................................................... 60 8.1 Introduction ..................................................................................................................... 60 8.2 Sampling design ............................................................................................................... 61 8.3 Sample size determination .............................................................................................. 62 Living Conditions Study in Nepal |2 8.4 Selection of enumeration areas ...................................................................................... 65 8.5 Household listing and screening ..................................................................................... 65 8.6 Selection of households .................................................................................................. 67 8.7 Data collection tools ........................................................................................................ 68 8.8 Disability screening in the context of the survey ............................................................ 68 8.9 Research team (field organization and data collection) ................................................. 69 8.10 Data processing and analysis .......................................................................................... 70 9 Results ............................................................................................................................... 75 9.1 Household section ........................................................................................................... 76 9.1.1 Household characteristics .................................................................................... 77 9.1.2 Household size ..................................................................................................... 78 9.1.3 Age of members ................................................................................................... 80 9.1.4 Dependency ratio ................................................................................................. 80 9.1.5 Gender .................................................................................................................. 82 9.1.6 Socioeconomic status .......................................................................................... 82 9.1.7 Dietary diversity ................................................................................................... 85 9.1.8 Access to information .......................................................................................... 88 9.1.9 Buildings ............................................................................................................... 91 9.1.10 Drinking water, energy sources and sanitations .................................................. 94 9.1.11 Education ............................................................................................................. 96 9.1.12 Literacy ............................................................................................................... 104 9.1.13 Employment ....................................................................................................... 106 9.2 Individual section .......................................................................................................... 109 9.2.1 Demographics ...................................................................................................