Sweta Pattnaik Jogesh Murmu Ritik Agrawal Tanveer Rehman Srikanta Kanungo ^* Sanghamitra Pati ^*

• Regional Medical Research Center (ICMR), Bhubaneswar, India

Abstract: "The overall prevalence of disability was 0.93% [(95% CI: 0.92-0.95), n=26,435] and 5.11% of households have one or more people with disability (PwD). Locomotor disabilities accounted for 44.73% of all disabilities (n=10,730), followed by mental disabilities (20.07%, n=4,814). Age 75 years and above (vs 0 to 14 years) [aPR: 26.35 (23.63-29.37)], male (vs female) [aPR: 1.58 (1.52-1.64)], no education (vs higher education) [aPR: 4.42 (4-4.87)], unmarried (vs married) [aPR: 8.85 (8.27-9.47)], seeking care of non-governmental organization (NGO) (vs other) [aPR: 1.34 (0.95-1.89)] were significant independent determinants. The highest overall prevalence of disability and locomotor was in Lakshadweep/UTs (1.68%) and Delhi (58.5%), respectively. Out of every hundred individuals in India, one has a disability, and five out of every hundred households have one or more people with a disability." Results: "The overall prevalence of disability was 0.93% [(95% CI: 0.92-0.95), n=26,435] and 5.11% of households have one or more people with disability (PwD) across all age groups in India. The prevalence was highest in the age group of 75 years and above at 1.96% (Table 2).” “Respondents aged 75 years and above had twenty-six times [aPR: 26.35 (23.63-29.37)] the prevalence of disability compared with 0 to 14 years (Table 2). Disability was 58% more among males [aPR: 1.58 (1.52-1.64)] than females. Regarding education, disability was four times more common among those who didn't have any form of schooling [aPR: 4.42 (4-4.87)] in contrast to those who have completed higher education. Unmarried people had eight times more disability [aPR: 8.85 (8.27-9.47)] than married people. Respondents belonging to the west region [aPR: 1.67 (1.55-1.81)] have 67% more prevalence of disability compared with the north-east region. People from other backward castes had a 35% more burden of disability compared to people from scheduled tribe [aPR: 1.35 (1.28-1.43)]. Disability was 55% higher in the poorest wealth quintile [aPR: 1.55 (1.43-1.68)] than in most affluent. Individuals with disabilities favoured NGOs or Trust hospitals/clinics for medical care [aPR: 1.34 (0.95-1.89)] over visiting pharmacies or taking home treatment.” “Of the total, locomotor disabilities accounted for 44.73% [(95% CI: 43.87-45.59), n=10,730] followed by mental [20.07% (95% CI: 19.38-20.77), n=4,814] and speech disabilities [13.74 % (95% CI:13.14-14.35, n=3,295] (Figure 1A). The detailed prevalence of individual disabilities is given in Supplementary File 2. The ages of 60-74, 15-29, and 0-14 years had the highest burden of locomotor disability (50.47%), mental disability (29.98%), and speech disability (23.06%) respectively.” “The preponderance of locomotor disability is highest among the 60-74 years age group. The prevalence pattern of various disabilities across the age groups is shown in Figure 1B.” “The detailed prevalence pattern of various disabilities across educational status is shown in Figure 1C. Higher educational attainment is associated with a higher prevalence of locomotor and visual disabilities, as well as a lower prevalence of mental and speech disabilities.” “Figure 2 (2A, 2B, 2C,2D) shows the burden of disability and its pattern across the states and UTs of India. The overall disability distribution given in Figure 2A indicates that it is more prevalent in Lakshadweep, UT (1.68%), followed by Tamil Nadu (1.26%) and Karnataka (1.22%). In the present study, the regional disparities could be because of the fact that composition of the population and the individuals with disability varies in different states. So, the prevalence of disability varies in different states and found to be higher in Lakshadweep where the total population is less as compared with other states and UTs. For national representativeness, we have used the weighted values for data. Similarly, the prevalence of locomotor disability (Figure 2B) was highest in Delhi (58.5%), followed by Punjab (55.51%) and Madhya Pradesh (53.47%). Figure 2C shows the prevalence of mental disabilities, with the highest in Lakshadweep (41.24%), followed by Mizoram (38.12%) and Goa (37.1%). Figure 2D shows the highest prevalence of speech disability in Sikkim (37%), followed by Tripura (22.66%) and Jharkhand (22.12%).” Discussion: In the first paragraph: “The overall prevalence of disability in India based on secondary data analysis of the NFHS-5 survey (2019-21) was 0.93% and 5.11% of households have one or more PwDs. Locomotor disabilities accounted for 44.73% of all disabilities, followed by mental and speech disabilities.” “The highest prevalence of locomotor, mental, and speech disability was in Delhi, Lakshadweep, and Sikkim, respectively, whereas the overall prevalence was highest in Lakshadweep/UTs.” In the second paragraph: “In the present study, the prevalence of disability was found to be 0.93%, with 5.11% of households including one or more PwDs. While our study shows a notably lower overall prevalence of disability compared to countries like Myanmar (4.6%) and South Africa (4.9%), the household prevalence of PwDs is comparable or even higher. For instance, despite lower overall prevalence rates, the household prevalence in our study exceeds that reported in countries such as Zimbabwe (2.9%) and Cambodia (4%), and is similar to, or even higher than, the rates observed in countries like Jordan (13%) and Zimbabwe (7%) at the household level [30,31]” In the third paragraph: “The present study highlights that locomotor disability was 286 highest among those aged 60-74 years [34].” In the eighth paragraph: “A study shows that formerly/ever-married and unmarried people tend to suffer more from functional limitations, which is in line with our findings.” In the ninth paragraph: “Topographically the southern part was found to be a potential domain for disability in our study.” In the tenth: “The study conducted in Chennai among minorities suggested that rates of disability were higher among those belonging to Scheduled Tribes and Scheduled Castes (STs and SCs). In contrast, our study found that disability was more prevalent among individuals belonging to Scheduled Castes (SCs) and Other Backward Classes (OBCs) [56].”