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A World Full Of Challenges: 4 Out Of 10 Children With Intellectual Disability Are Out Of School

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By Nivedita Parashar:

Children are the innocent future of every society. Countries around the world subscribe to their pre-eminent right to be nurtured and to be happy. And yet, in our 70-year-old India, one group – children with intellectual and developmental challenges (CwC) – find their needs unattended and their future uncertain.

Intellectual and developmental challenges include conditions such as autism, cerebral palsy, down syndrome and intellectual disability. The lack of research on children with these challenges has left them on the margins of policy and academia. The number of CwC in India is seriously under-counted, which has also led to their underestimation as a population group.

A few studies discussing the lived experiences of children with such conditions are available. In recognition of the need for empirical evidence on the social and service barriers faced by CwC and their parents and caregivers in accessing specialised services in Delhi, the Amrit Foundation of India collaborated with Amaltas on the Patang Project. The evidence gathered shines a light on the extent of denial of services and opportunities for CwC. It also helps us understand what needs to change and how to level the playing field for the CwC.

The Patang Project found that in Delhi, 75% of the CwC surveyed turn to government institutions to avail services. The onus is thus on the government to ensure accessible and quality services. However, service providers in the field argued that the government is simply not doing enough to provide good quality services to CwC. This allegation is corroborated by evidence, in that the Service Index measuring quality perception is much lower for government institutions than for private service providers and non-government organisations. The financial burden posed by the special needs of the CwC makes it difficult for their parents and caregivers to switch to better quality services. Nearly 70% of respondents for the project cited finances as a crucial barrier to accessing services. As many as 99% parents and caregivers of CwC rely on their personal savings and earnings to avail services, making their lives precarious and reducing the number of services accessed, low.

Coping with challenges has tangible consequences for caregivers’ lives. There is a financial cost – payments for services and transportation; a social cost – the experience of stigma and discrimination; and the emotional cost – the sense of despair. The amalgam of these costs shape the interactions of CwC and their caregivers with the society. Not only are CwC and caregivers sapped by the financial burden, but find themselves in a unaccommodating environment constructed to favour able bodied people. CwC and caregivers feel isolated. Stigma and discrimination leads caregivers to conceal the child’s condition and remain in denial as long as possible. This denial has a damaging effect on the CwC as they are unable to benefit from interventions at an early juncture.

The study found that in a knowledge vacuum, parents and caregivers do not know what to look for, or whom to approach. Most parents and caregivers are forced to rely on word-of-mouth to make crucial decisions regarding their course of action. When services are sought, they are just not available or accessible leading to poor utilisation. This is far worse for the poorest and for those with especially severe challenges. Not only do caregivers face crises at their workplace, they also lack support from all but the most immediate family. The neighbourhood, although not outrightly disruptive, is rarely supportive and prefers to avoid CwC.

Our society’s inability to create space for CwC has diminished the opportunities for CwC to learn and participate in their environment. The Patang project found that four out of 10 CwC between 6-18 years are out of school. Lack of easily available information on entitlements means that over 50% of the children requiring assessment have not seen a psychologist and more than 60% people with challenges do not have a disability certificate. This is a significant impediment to better outcomes, since a disability certificate is the gateway to many entitlements and services.

CwC face a world full of challenges. And yet if CwC could get the same level of support that other children do, the results might be remarkable. There are many examples that show that if CwC receive the care that they need, they can hold jobs, run businesses and become productive members of society. The Patang Project is a step towards ensuring a world full of challenges transforms into a world full of opportunities for CwC. For this to happen, we need good policies informed by high quality research and even moreso, by practice.

We look to our lawmakers, policy-setters, government services, civil society and service providers to ensure that governments take action based on legislative and policy changes. Wider awareness can encourage a groundswell of public support for the issues faced by CwC. These actions can transform the lives of parents and caregivers by empowering them with the information they need to get better services for their children.

It is time that we levelled the playing field.


(Amrit Foundation of India focuses on advocacy for the rights of children with challenges. Amaltas is a research and consulting organisation working on development issues and is based in Delhi. The Patang Project book was launched in October 2017 by Ms. Stuti Kacker, Chairperson, National Commission for Protection of Child Rights, India. Purchase your copy here.)

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An ambassador and trained facilitator under Eco Femme (a social enterprise working towards menstrual health in south India), Sanjina is also an active member of the MHM Collective- India and Menstrual Health Alliance- India. She has conducted Menstrual Health sessions in multiple government schools adopted by Rotary District 3240 as part of their WinS project in rural Bengal. She has also delivered training of trainers on SRHR, gender, sexuality and Menstruation for Tomorrow’s Foundation, Vikramshila Education Resource Society, Nirdhan trust and Micro Finance, Tollygunj Women In Need, Paint It Red in Kolkata.

Now as an MH Fellow with YKA, she’s expanding her impressive scope of work further by launching a campaign to facilitate the process of ensuring better menstrual health and SRH services for women residing in correctional homes in West Bengal. The campaign will entail an independent study to take stalk of the present conditions of MHM in correctional homes across the state and use its findings to build public support and political will to take the necessary action.

Saurabh has been associated with YKA as a user and has consistently been writing on the issue MHM and its intersectionality with other issues in the society. Now as an MHM Fellow with YKA, he’s launched the Right to Period campaign, which aims to ensure proper execution of MHM guidelines in Delhi’s schools.

The long-term aim of the campaign is to develop an open culture where menstruation is not treated as a taboo. The campaign also seeks to hold the schools accountable for their responsibilities as an important component in the implementation of MHM policies by making adequate sanitation infrastructure and knowledge of MHM available in school premises.

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Harshita is a psychologist and works to support people with mental health issues, particularly adolescents who are survivors of violence. Associated with the Azadi Foundation in UP, Harshita became an MHM Fellow with YKA, with the aim of promoting better menstrual health.

Her campaign #MeriMarzi aims to promote menstrual health and wellness, hygiene and facilities for female sex workers in UP. She says, “Knowledge about natural body processes is a very basic human right. And for individuals whose occupation is providing sexual services, it becomes even more important.”

Meri Marzi aims to ensure sensitised, non-discriminatory health workers for the needs of female sex workers in the Suraksha Clinics under the UPSACS (Uttar Pradesh State AIDS Control Society) program by creating more dialogues and garnering public support for the cause of sex workers’ menstrual rights. The campaign will also ensure interventions with sex workers to clear misconceptions around overall hygiene management to ensure that results flow both ways.

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MH Fellow Sabna comes with significant experience working with a range of development issues. A co-founder of Project Sakhi Saheli, which aims to combat period poverty and break menstrual taboos, Sabna has, in the past, worked on the issue of menstruation in urban slums of Delhi with women and adolescent girls. She and her team also released MenstraBook, with menstrastories and organised Menstra Tlk in the Delhi School of Social Work to create more conversations on menstruation.

With YKA MHM Fellow Vineet, Sabna launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society. As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

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A student from Delhi School of Social work, Vineet is a part of Project Sakhi Saheli, an initiative by the students of Delhi school of Social Work to create awareness on Menstrual Health and combat Period Poverty. Along with MHM Action Fellow Sabna, Vineet launched Menstratalk, a campaign that aims to put an end to period poverty and smash menstrual taboos in society.

As a start, the campaign aims to begin conversations on menstrual health with five hundred adolescents and youth in Delhi through offline platforms, and through this community mobilise support to create Period Friendly Institutions out of educational institutes in the city.

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A Computer Science engineer by education, Nitisha started her career in the corporate sector, before realising she wanted to work in the development and social justice space. Since then, she has worked with Teach For India and Care India and is from the founding batch of Indian School of Development Management (ISDM), a one of its kind organisation creating leaders for the development sector through its experiential learning post graduate program.

As a Youth Ki Awaaz Menstrual Health Fellow, Nitisha has started Let’s Talk Period, a campaign to mobilise young people to switch to sustainable period products. She says, “80 lakh women in Delhi use non-biodegradable sanitary products, generate 3000 tonnes of menstrual waste, that takes 500-800 years to decompose; which in turn contributes to the health issues of all menstruators, increased burden of waste management on the city and harmful living environment for all citizens.

Let’s Talk Period aims to change this by

Find out more about her campaign here.

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A former Assistant Secretary with the Ministry of Women and Child Development in West Bengal for three months, Lakshmi Bhavya has been championing the cause of menstrual hygiene in her district. By associating herself with the Lalana Campaign, a holistic menstrual hygiene awareness campaign which is conducted by the Anahat NGO, Lakshmi has been slowly breaking taboos when it comes to periods and menstrual hygiene.

A Gender Rights Activist working with the tribal and marginalized communities in india, Srilekha is a PhD scholar working on understanding body and sexuality among tribal girls, to fill the gaps in research around indigenous women and their stories. Srilekha has worked extensively at the grassroots level with community based organisations, through several advocacy initiatives around Gender, Mental Health, Menstrual Hygiene and Sexual and Reproductive Health Rights (SRHR) for the indigenous in Jharkhand, over the last 6 years.

Srilekha has also contributed to sustainable livelihood projects and legal aid programs for survivors of sex trafficking. She has been conducting research based programs on maternal health, mental health, gender based violence, sex and sexuality. Her interest lies in conducting workshops for young people on life skills, feminism, gender and sexuality, trauma, resilience and interpersonal relationships.

A Guwahati-based college student pursuing her Masters in Tata Institute of Social Sciences, Bidisha started the #BleedwithDignity campaign on the technology platform Change.org, demanding that the Government of Assam install
biodegradable sanitary pad vending machines in all government schools across the state. Her petition on Change.org has already gathered support from over 90000 people and continues to grow.

Bidisha was selected in Change.org’s flagship program ‘She Creates Change’ having run successful online advocacy
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