Living conditions among people with disability in Nepal

198 Pages·2016·4.47 MB·English

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, Children 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 
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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 

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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 .................................................................................................... 109 
9.2.2  Distribution of disability core domains .............................................................. 110 
9.2.3  Cause of disability .............................................................................................. 115 
9.2.4  Abuse and discrimination .................................................................................. 118 
9.2.5  Welfare and Health Services: Needed, Aware of or Received ........................... 120 
9.2.6  Assistive devices ................................................................................................. 122 
9.2.7  Employment ....................................................................................................... 128 
9.2.8  Accessibility ........................................................................................................ 131 
9.2.9  Assistance in daily life activity ............................................................................ 133 
9.2.10 Involvement in family, social life and social activities ....................................... 134 
9.2.11 Health ................................................................................................................. 138 
9.2.12 Knowledge, access to information and exposure to some common  
diseases ............................................................................................................. 144 

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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 

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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 .................................................................................................... 109 
9.2.2  Distribution of disability core domains .............................................................. 110 
9.2.3  Cause of disability .............................................................................................. 115 
9.2.4  Abuse and discrimination .................................................................................. 118 
9.2.5  Welfare and Health Services: Needed, Aware of or Received ........................... 120 
9.2.6  Assistive devices ................................................................................................. 122 
9.2.7  Employment ....................................................................................................... 128 
9.2.8  Accessibility ........................................................................................................ 131 
9.2.9  Assistance in daily life activity ............................................................................ 133 
9.2.10 Involvement in family, social life and social activities ....................................... 134 
9.2.11 Health ................................................................................................................. 138 
9.2.12 Knowledge, access to information and exposure to some common  
diseases ............................................................................................................. 144 

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10  Discussion ........................................................................................................................ 147 
10.1  Comparing households .................................................................................................. 147 
10.2  Activity limitations/disability ......................................................................................... 148 
10.3  Violence and abuse ....................................................................................................... 149 
10.4  Health, well‐being and health information ................................................................... 150 
10.5  Services .......................................................................................................................... 151 
10.6  Daily life and social inclusion ......................................................................................... 151 
10.7  Education ....................................................................................................................... 152 
10.8  Economic activity ........................................................................................................... 153 
10.9  Assistive devices ............................................................................................................ 153 
10.10 Gender ........................................................................................................................... 154 
10.11 The urban ‐ rural dimension .......................................................................................... 154 
11  Conclusion ....................................................................................................................... 155 

Appendix 
Questionnaire for Houshold Head 
Questionnaire for People WITH Disabilities 

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Living conditions among people with disability in
Nepal
A National Representative Study

1 Acknowledgements
This is a report from a National, representative household survey carried out in Nepal in
2014 – 2015. It is the first comprehensive disability survey in Nepal. The study was made
possible through the collaboration between The National Federation of the Disabled in
Nepal (NFDN) and The Norwegian Federation of Organizations of Disabled People
(FFO). Funding was provided by the Norwegian Agency for Development Cooperation
(NORAD) through the Atlas Alliance.

The accomplished study is first of all a credit to The National Federation of the Disabled in
Nepal (NFDN) who initiated the study and had a coordinating role during its
implementation. In particular, we want to thank the National President of NFDN, Mr.
Shudarsan Subedi, for his continuous interest and support, and to Mr. Bimal Paudel for
his enthusiastic and competent coordination of the study in addition to his important
contribution to this report. We are happy to have experienced that the whole leadership
of NFDN has strongly supported the generation of high quality data on disability in Nepal.
We are convinced that NFDN will utilise the opportunity given by this report and the data
that can be further utilised in the time to come, in their continuous advocacy for the
interests of individuals with disability.

The Steering Committee for the survey comprised Mr. Sankar Pathak: Ministry of Women,
Children and Social Welfare(MOWCSW), Mr. Nebinlal Shrestha: Central Bureau of
Statistics (CBS), Mr. Tankanath Lamsal: National Planning Commission (NPC), Mr.
Bhojraj Shrestha: Ministry of Education (MOE), Mr. Rudra Prasad Adhikari/Ganesh

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Paudel: Department of Education (DOE), Mr. Bharat Sharma: MOWCSW, Mrs. Humkala
Pandey: MOWCSW, Mr. Resham Kumar Khatri/Nim Prasad Bhattrai: MOWCSW, Mrs.
Renu Lohani: FFO-Norway, Mr. Shudarson Subedi: National Federation of the Disabled
Nepal (NFDN), Mr. Shailesh Neupane: Valley Research Group(VARG), Mr. Parva Prasad
Sapkota: Ministry of Health (MOH) and Mr. Bimal Paudel: NFDN. They should all be
thanked for their support and efforts to make this survey a useful tool for persons with
disability in Nepal in the years to come. The strong interest and involvement from several
ministries and the Planning Commission promises that the findings in the study will have
impact on policy and practices on the ground.

Valley Research Group (VaRG) in Kathmandu has been responsible for all elements of
the data collection; recruitment and training of research assistants, data collection, data
entry and cleaning. We are happy to say that this has been done in a highly competent
way and the result is data of very good quality. We thank in particular Mr. Shailes
Neupane, Executive Director of VaRG, for his contribution to a conducive collaboration
and an excellent result, which has led to further collaboration with SINTEF.

A number of individuals with disability have contributed in different roles. Not least has
this been an exercise that has proven the capabilities of disabled people, either in the
Steering Committee, in the coordinating role, or as research assistants. This study and
the report had not been possible without their enthusiastic participation. You have all
contributed tremendously, not least to change the role of disabled people from objectives
for research to actors and decision makers in research. This is a remarkable
achievement, given the difficult situation for many individuals with disabilities in Nepal.

We have experienced a strong interest in the research on living conditions among people
with disabilities in Nepal, not only from those who have been directly involved, but also
from a broad range of national and international stakeholders. With such a broad support
for this project, it has been a pleasure being a part of this comprehensive exercise. We
believe that the strong interest and the continued collaboration between NFDN and FFO
will lead to some tangible results for individuals with disability.

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