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Awareness of & Attitudes to Disability in Rural and Urban Communities of Andhra Pradesh, India -- A Comparative Study
by Allu Jeevan Rao, Mallenini Sharmila and N. Rishita
Introduction
Ignorance and negative attitudes are among the greatest obstacles that people with disabilities have to contend with. Over the past 10 to 15 years, there has been an increase in the level of awareness and recognition of disability in the community and also some attitudinal change. This increased awareness is largely due to the various programmes conducted by Government and Non Governmental Organizations for the welfare of the people with disabilities.
New approaches such as Community Based Rehabilitation and Home Based Rehabilitation have played a major role. These programs have contributed to the change in social perspective and have helped shape attitudes towards people with disabilities.
In addition, several other factors are responsible, including increased literacy levels, promotion of health care programs, change in status of woman, development in communication media, and the introduction of integrated and inclusive education programs for children with disabilities. Empowerment and advocacy too have taken a leap from the discussion stage to implementation.
Awareness is the most important contributor to help reduce disability in the community. It is not about an individual becoming aware of his or her disability but something that has to permeate the entire the community, so that it creates healthy attitudes towards people with disabilities.
The study aims to answer the following questions
- Has there been a change in awareness and attitudes in the community?
- Is there is a difference between urban and rural populations in understanding the ability and facilities of the people with disabilities?
- Does occupation play a major role in understanding the needs of people with disabilities?
Raising awareness on disabilities as a human rights and development issue
Disability awareness is not something that has been invented by experts or by people with disabilities. Rather, it is something that has been growing amongst us over the past 10 to 15 years. Awareness on disability is not about an individual becoming aware of his/her impairment. It is a collective identity among the community.
Methodology
The study was conducted through the interview method. The interviewees were selected from a series of random sampling procedures. First, household addresses were selected randomly from population census data from the local Mandal development office. A stratified random sample of households was obtained in proportion to the total number of household addresses from the population list. Second, random sampling procedure was employed to select members by their occupation in the sampled households.
Samples were selected randomly from four geographical areas comprising urban slums of Hyderabad and three different rural areas in Andhra Pradesh, i.e., Mudhol, Yacharam and Tudukurthy villages, using the above mentioned method. The sample of 100 persons from rural and urban areas included teachers, housewives, self-employed and unemployed persons, and students. A "Teacher" is a person whose occupation is teaching to impart knowledge or skill. A "Housewife" is the wife of a householder, the mistress of a family, the female head of a household. "Self-employed" refers to a person who relies on his/her business for the primary source of income, or a person who gets an income directly from his/her profits. An "Unemployed person" is a person who has no employment, or someone who is looking for a job. A "Student" is a person who studies, probably at an institution, such as school or university.
Five representatives were drawn from each occupational category; we included 25 persons from each of the geographical areas.
Thirty copies of a questionnaire were administered, with questions in six categories. The categories were Supernatural beliefs and misconceptions, Views on abilities of people with disabilities, Views on education of people with disabilities, Views on employment of people with disabilities, Views on available Rehabilitation services of the people with disabilities, and Views on the family life of people with disabilities. An average of five questions was administered in each category.
One way analysis of variance was used to compare the mean differences of each domain among three different age groups (£20, 20-40, ³40 years) and among different occupations. Post hoc tests were carried out with Bonferroni correction. Independent sample t test was performed to detect the significant mean difference between two categories of the factors (sex, economic level, literacy, and civic unit) for each domain separately. A p value less than 0.05 was considered statistically significant. Analyses were performed using SPSS 11.0 for windows (SPSS Inc, Chicago, IL, USA) software.
Results
The distribution in the three age groups was somewhat uneven, with 24 % of respondents from the < 20 years age group, 51 % between 20 to 40 years, and 25% from the >40 age group.
27% of the respondents were female and 73% were male. 32% of the respondents belonged to the low-income group and 68% to the middle income group. 70% were literate and 30% illiterate.
Figure 1 shows the percentage of given positive responses to questions on supernatural beliefs and misconceptions, views on ability of people with disabilities, views on education, employment, available services and family life of persons with disabilities. An average 74.57% of the participants reported their positive attitude towards the people with disabilities.
Misconceptions and supernatural beliefs (figure 2)
39.50% of the respondents reported that they agreed with the statement or did not know whether disability was a punishment, a curse of god and or if constant contact with people with disabilities makes one disabled.
The level of agreement among the different groups was highest for the statement whether a child with disability was a punishment to parents.
Views on abilities of the disabled persons (Figure 3)
47% of the participants disagreed that people with disabilities can perform most of the daily living activities independently.
Views on education of people with disabilities (figure 3)
While reporting views on education of people with disabilities 42% of the participants disagreed with the statement that people with disabilities could be educated in normal schools.
Views on employment of people with disabilities (figure 3)
17% of participants disagreed with the statement that a person with disabilities can become a professional and the same percentage disagreed that a person with disabilities could become an employee for a non-disabled person.
Views on family life of persons with disability (figure 3)
33% of the participants disagreed with the statement that people with disabilities could have a happy family life.
Effect of age (figure 4)
Respondents in the youngest and oldest age groups held more supernatural beliefs and misconceptions and had less awareness about the abilities, education and employment of people with disabilities. The difference in the average responses among the three age groups was significant.
The respondents of the youngest (< 20) and oldest age groups (>40) significantly differed in their responses to questions on supernatural beliefs and views on education of people with disabilities.
Participants in the age group 20 to 40 years and those above 40 showed significant difference in views on education and employment of people with disabilities.
Effect of Gender (figure 5)
Female respondents held more supernatural beliefs and misconceptions and showed a lower level of awareness about their abilities, education and employment of people with disabilities. The differences between genders were significant.
Effect of Economic Level (figure 6)
The low economic group respondents held more supernatural beliefs and misconceptions and had less awareness about education, employment and family life of people with disabilities.
Effect of Literacy (figure 7)
The illiterate respondents held more supernatural beliefs and misconceptions and had less awareness about education, employment and family life of people with disabilities.
Effect of Civic Unit (Urban/Rural) (figure 8)
There is no significant difference between urban and rural respondents in terms of the misconceptions, beliefs and views on education, employment and the family life of people with disabilities. However, respondents in urban and rural areas differed significantly in terms of views on the ability of persons with disabilities and family life of persons with disabilities
Effect of Occupation (figure 9)
There are significant differences among respondents belonging to the five occupational categories in terms of supernatural beliefs and misconceptions, and views on employment of people with disabilities. Housewives showed less awareness and they had a negative attitude towards people with disability.
Recommendations
Developing countries are now taking the lead in promoting the setting up of much needed services and bringing about a change in attitudes towards disability. Over the past 30 years there has been an increased recognition and changes in attitude due to various reasons (Stuart Aitken 1996). This study showed that there is an increase in the level of awareness and a positive change in attitude in the community. The younger generation had shown positive perceptions and an interest in understanding the needs and the problems of people with disabilities. A majority of the participants in the study were literate; this could be a reason for the increased level of awareness and positive attitudes.
People with more education would have increased access to television, movies, travel, and literature, all of which are factors that could influence their attitudes towards people with disabilities.
This study also has identified the population groups where the awareness level is still low and negative attitudes still exist towards disability, and has indicated that much of the community continues to have misconceptions and supernatural beliefs on disability. This is the main obstacle to full participation and equity for the people with disabilities in the community.
These supernatural beliefs exist to a greater extent among the less educated and lower economic groups. This demands a suitable plan of action to handle these misconceptions and supernatural beliefs in the community.
Even though the results show a positive change in level of awareness and attitudes towards people with disabilities, the study also showed that there is a less knowledge about education, employment and family life of people with disabilities.
The attitudes of Community Based Rehabilitation workers towards people with disabilities were not affected by age, gender, marital status, presence of a disability, CBR work experience, and contact with a person with a disability. Their attitudes are slightly more positive towards those with physical disabilities and more negative towards people with a visual impairment. The only significant influence on attitudes was the overall years of school attended, but not the amount of Community Based Rehabilitation education. (John Paterson 2000)
Attitudinal change does not happen automatically or spontaneously. It is a complex process, which involves moving, in a series of stages, from one set of attitudes to another. Public education and awareness are central to the changing of attitudes.
Raising Awareness
1) Awareness should be created in the community in different ways:
- The appointment of a person with disability as a Government representative is an important first step
- Promotion of human rights education pertaining to people with disabilities
- Personnel training - All training of personnel who deal with the public should contain a disability awareness component to create an understanding of the social model of disability and its implications
- Public holidays should be announced related to human rights promotion of the disabled. These would help increase our understanding of service delivery within the social model of rehabilitation of the disabled
- Parents of disabled children should be involved in the rehabilitation services and they need to take part in intervention programs
- Through different media, spot and short messages can be given to public. The press needs to be educated to present people with disabilities to the public in a positive manner
- Community Based Rehabilitation programs for the disabled can provide a platform for advocacy on issues concerning the disabled. Such programs should also facilitate the building of participatory skills and healthy integration of the disabled in the community through forming self help groups of people with disabilities
- Education curriculum should include disability rights from the primary level to foster equal participation in the community
- Orientation programs should be conducted for the local leaders, teachers and medical practitioners and other influential people in the community so they can address issues of equality and full participation in the local community
2) Disabled people can play an important role in promoting their own welfare and creating an awareness in the community in the following ways:
- Expressing their needs and knowing about their rights
- Being aware of their responsibilities as citizens and discharging the same effectively
- Successful people with disabilities can share their experiences and achievements with the community to emphasize their abilities and rights to participate more fully in society
- A successful worker with disability is the best ambassador of the other people with disabilities
Conclusion
Effective strategies and a sustained approach are needed to increase the awareness on disabilities in the community. Public education through community, government, non-governmental organizations, and families of people with disabilities can play an important role in increasing awareness in the community. In addition, people with disabilities themselves can play a major role in promoting their own welfare and creating awareness in the community.
Figures
References
1. Ahuja C. Suresh (1989), The role of disabled persons themselves and their families in the equalization for the disabled persons. Retrieved on 23rd February 2002 From http://www.independentliving.org/docs4/ahuja.html
2. Aitken Staurt (1996), The British Journal of Visual Impairment, Visual and Additional Impairment: Social perspectives and Attitudes. Retrieved on 23rd February 2002
From http://www.inlb.qc.ca/textes/infodoc/infodoc83.pdf
3. Finkelstein Vic (1989), The Evaluation of Disability, Strathclyde. Retrieved on 23rd February 2002
http://www.leeds.ac.uk/disability-studies/archiveuk/finkelstein/strathclyde.pdf
4. Machwene semenya (2002), Official opening of the Sport, Arts and culture festival for the disabled persons of the northen / Limpopo provence by Mec. Retrieved on 23rd February 2002. From http://www.limpopo.gov.za/docs/sp/showsp.asp?ID=191
5. World program of action concerning disabled persons (1980), International Classification of Impairments, Disabilities and Handicaps (ICIDH), WHO, Geneva. Retrieved on 23rd February 2002 From http://www.un.org/esa/isocdev/enable/diswpaol.htm
6. John Paterson (2000) Community-based rehabilitation workers of South India: their attitudes and their education, Asia Pacific Disability Rehabilitation Journal vol. 10, no. 1, 2000
Submitted by
Mallineni Sharmila,
Head, Rehabilitation Services and Allu Jeevan Rao, Fellow in Vision Rehabilitation Centers
L.V. Prasad Eye Institute, L.V. Prasad Marg,
Banjara Hills, Hyderabad 500 034
Andhra Pradesh India
Email: jeev2002@rediffmail.com
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