Evaluation of the Impact of the First Wave of COVID-19 and Associated Lockdown Restrictions on Persons with Disabilities in 14 States of India
Abstract
:1. Introduction
Objective
2. Methods
2.1. Quantitative Study
2.1.1. Participants
2.1.2. Data Collection Tool
2.1.3. Data Analysis
2.2. Qualitative Study
2.2.1. Participants
2.2.2. Data Collection
2.2.3. Data Analysis
3. Results
3.1. Quantitative Findings
3.1.1. Medical and Rehabilitation Services
3.1.2. Mental Health
3.1.3. Education and Livelihood
3.2. Qualitative Findings
3.2.1. Difficulties in Daily Life and Management
“It was as such a gradual journey for Persons with disability to become self-dependent. Their livelihood got affected very seriously due to lockdown. They began losing hope and motivation which was gained after years of hard work”.(NGO in-charge, Male)
“I ask them to wash the hands but not everyone pays heed. Only few of them wash their hands for 20 s. When I ask them to wear the masks, they don’t listen, saying that nothing happens to us, it’s a disease from another country, when time comes, everyone has to die!”(Caregiver, Female)
3.2.2. Access
“Some persons with disability have not eaten food for 8 days”,(PRI Member and Caregiver, Female)
“Those who are on medication for mental health or serious disorders were completely dependent on free medicines. Their supplies had dried up, but they were not allowed to go the district hospital for refills”.(Program Manager, Male)
3.2.3. Services
“Not everyone has motorcycle or a bicycle, there are difficulties in reaching the hospitals”.(ASHA and Caregiver, Female)
“Parents are worried. Their child was happy earlier, going on a wheelchair to school. Since schools are closed, their child cannot interact with other children”.(Program Officer, NGO, Female)
3.2.4. Participation
“If the Persons with disability was not a government employee, they lost their jobs”.(Program Officer, NGO, Male)
“COVID-19 has broken our confidence, if 5 PwD are sitting in a group, joking and laughing, and somebody coughs or sneezes, automatically, they may not tell on the outside, but they fear about getting corona”.(Govt Official, Male)
3.2.5. Communication
“The biggest challenge was to reach Persons with disability and fulfil their needs. We developed a helpline number with a psychologist for counselling and guidance”.(Govt Official, Female)
3.2.6. Networks
“Our biggest strength is our DPO. The investment that we did over the years to build their capacity has helped us a lot during this time”.(Program Manager, Female)
“They are still doing it, if someone is hungry, somebody will ensure that that person is fed”.(Senior Advisor, NGO, Female)
3.2.7. Compassion and Government Response
“Government is not prepared for the next wave. They should involve Gram sabhas and bring in different agendas including disability, it they are serious about planning for next disaster”.(NGO in-charge, Person with disability)
“If the government considers Persons with disability’s problems as that of its own family’s, then nobody will be unhappy”.(ASHA, PRI Member and Caregiver, Female)
3.2.8. Finances
“My child fell ill and I had no money, I save money without my husband’s knowledge, which I had to take out and use. My husband would have earned if there was no lock down and I would never have utilized my savings, but that could not happen because of the situation. Lockdown has affected very badly economically. The whole root cause is the poor economic situation!”(ASHA, PRI Member and Caregiver, Female)
3.2.9. Positive Impact
“Children got to see a different face/personality of their parents”(Program Manager, Ngo, Male)
“Yes, as we are not buying many things from the market, we are saving some money.”(ASHA, PRI Member and Caregiver, Female)
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variables | Categories | n (%) |
---|---|---|
Age in years, median (IQR) | 28 (19, 36.5) | |
Sex, n (%) | Male | 243 (60.3%) |
Female | 160 (39.7%) | |
Type of Impairment, n (%) | Physical | 208 (51.6%) |
Visual | 65 (16.1%) | |
Intellectual | 44 (10.9%) | |
Speech and Hearing | 37 (9.2%) | |
Multiple † | 37 (9.2%) | |
Developmental | 7 (1.7%) | |
Mental | 5 (1.2%) | |
Occupation, n (%) | Employed | 184 (63.4%) |
Student | 37 (12.8%) | |
Unemployed | 69 (23.8%) | |
Region of India, n (%) | Central | 121 (30.0%) |
East | 84 (20.8%) | |
West | 70 (17.4%) | |
North | 59 (14.6%) | |
North East | 37 (9.2%) | |
South | 32 (7.9%) | |
Marital status, n (%) | Never married | 143 (49.3%) |
Married | 141 (48.6%) | |
Divorced | 3 (1.0%) | |
Widowed | 3 (1.0%) | |
Number with children, n (%) | 126 (89.4%) | |
Disability pension per month, INR, median (IQR) | 700 (500, 1000) |
Services | Categories | During Lockdown n (%) | Post Lockdown n (%) | p Value |
---|---|---|---|---|
Outpatient clinics | Yes | 29 (27.2%) | 30 (28.0%) | 0.19 |
No | 21 (19.5%) | 9 (8.4%) | ||
Did not need | 57 (53.2%) | 68 (63.5%) | ||
Emergency medical services | Yes | 15 (14.0%) | 2 (1.8%) | <0.001 * |
No | 12 (11.1%) | 5 (4.6%) | ||
Did not need | 80 (74.7%) | 100 (93.4%) | ||
Medicines | Yes | 19 (17.9%) | 20 (18.8%) | 0.73 |
No | 29 (27.3%) | 24 (22.6%) | ||
Did not need | 58 (54.7%) | 62 (58.5%) | ||
Rehabilitation services | Yes | 13 (12.1%) | 5 (4.6%) | 0.03 * |
No | 13 (12.1%) | 15 (14.0%) | ||
Did not need | 81 (75.6%) | 87 (81.2%) | ||
Regular BP monitoring | Yes | 1 (0.9%) | 2 (1.8%) | - |
No | 3 (2.8%) | 0 (0.0%) | ||
Did not need | 103 (96.2%) | 105 (98.1%) | ||
Regular sugar monitoring | Yes | 3 (2.7%) | 1 (0.9%) | <0.001 * |
No | 4 (3.7%) | 2 (1.8%) | ||
Did not need | 100 (93.5%) | 104 (97.2%) | ||
Surgical procedures | Yes | 1 (0.9%) | 0 (0.0%) | - |
No | 5 (4.7%) | 0 (0.0%) | ||
Did not need | 101 (94.4%) | 107 (100.0%) | ||
Routine medicines | Yes | 32 (35.2%) | 38 (41.8%) | 0.38 |
No | 16 (17.6%) | 8 (8.8%) | ||
Did not need | 43 (47.3%) | 45 (49.5%) | ||
If online consultation was useful | Yes | 8 (7.5%) | 7 (6.6%) | 0.14 |
No | 10 (9.3%) | 1 (0.9%) | ||
Did not need | 89 (83.2%) | 99 (92.5%) |
Being Bothered by: | Categories | During Lockdown n (%) | Post Lockdown n (%) | p Value |
---|---|---|---|---|
Fear of Infection | Not at all | 26 (24.3%) | 9 (8.4%) | <0.001 * |
Moderately | 56 (52.3%) | 57 (53.3%) | ||
A lot | 25 (23.4%) | 41 (38.3%) | ||
Interruption of support from caregivers | Not at all | 78 (86.7%) | 80 (88.9%) | <0.001 * |
Moderately | 8 (8.9%) | 10 (11.1%) | ||
A lot | 4 (4.4%) | 0 (0.0%) | ||
Gender based violence | Not at all | 94 (89.5%) | 102 (97.1%) | 0.02 |
Moderately | 7 (6.7%) | 3 (2.9%) | ||
A lot | 4 (3.8%) | 0 (0.0%) | ||
Fear of infecting others | Not at all | 35 (32.7%) | 35 (32.7%) | 0.82 |
Moderately | 63 (58.9%) | 61 (57.0%) | ||
A lot | 9 (8.4%) | 11 (10.3%) | ||
Fear of dying | Not at all | 47 (43.9%) | 55 (51.4%) | 0.37 |
Moderately | 56 (52.3%) | 46 (43.0%) | ||
A lot | 4 (3.7%) | 6 (5.6%) | ||
Lack of support | Not at all | 54 (50.5%) | 52 (48.6%) | 0.40 |
Moderately | 45 (42.1%) | 43 (40.2%) | ||
A lot | 8 (7.5%) | 12 (11.2%) | ||
Loss of income | Not at all | 37 (35.9%) | 33 (32.0%) | 0.32 |
Moderately | 33 (32.0%) | 29 (28.2%) | ||
A lot | 33 (32.0%) | 41 (39.8%) |
Variables | Categories | Negative IMPACT | |||||||||
---|---|---|---|---|---|---|---|---|---|---|---|
Medical | p Value | Rehabilitation | p Value | Mental Health | p Value | Education, Livelihood | p Value | Social Empowerment | p Value | ||
Yes | Yes | Yes | Yes | Yes | |||||||
Age (yr) | <40 | 323 (81.8%) | 0.31 F | 351 (88.9%) | 0.14 F | 342 (86.6%) | 0.19 F | 341 (86.3%) | 0.20 F | 190 (52.5%) | 0.68 F |
≥40 | 4 (66.7%) | 4 (66.7%) | 4 (66.7%) | 4 (66.7%) | 2 (40.0%) | ||||||
Sex | Male | 203 (83.5%) | 0.17 | 214 (88.1%) | 0.67 | 207 (85.2%) | 0.40 | 214 (88.1%) | 0.16 | 111 (50.0%) | 0.28 |
Female | 125 (78.1%) | 143 (89.4%) | 141 (88.1%) | 133 (83.1%) | 82 (55.8%) | ||||||
Type of impairment | Developmental | 7 (100.0%) | 0.05 F | 4 (57.1%) | 0.005 F | 5 (71.4%) | 0.64 F | 6 (85.7%) | 0.24 F | 2 (33.3%) | 0.03 F |
Intellectual | 28 (63.6%) | 32 (72.7%) | 35 (79.5%) | 33 (75.0%) | 22 (62.9%) | ||||||
Mental | 4 (80.0%) | 4 (80.0%) | 5 (100.0%) | 5 (100.0%) | 0 (0.0%) | ||||||
Multiple | 176 (84.6%) | 189 (90.9%) | 180 (86.5%) | 180 (86.5%) | 110 (56.1%) | ||||||
Physical | 31 (83.8%) | 34 (91.9%) | 33 (89.2%) | 34 (91.9%) | 13 (38.2%) | ||||||
Speech and Hearing | 54 (83.1%) | 60 (92.3%) | 57 (87.7%) | 59 (90.8%) | 26 (42.6%) | ||||||
Visual | 28 (75.7%) | 34 (91.9%) | 33 (89.2%) | 30 (81.1%) | 20 (60.6%) | ||||||
Occupation | Employed | 191 (86.4%) | 0.003 F | 203 (91.9%) | 0.05 | 202 (91.4%) | 0.005 | 188 (85.1%) | 0.75 | 131 (60.9%) | <0.001 |
Unemployed | 67 (79.8%) | 72 (85.7%) | 67 (79.8%) | 72 (85.7%) | 33 (44.6%) | ||||||
Student | 66 (70.2%) | 78 (83.0%) | 76 (80.9%) | 83 (88.3%) | 27 (35.5%) | ||||||
Marital status | Married | 122 (85.9%) | 0.08 | 131 (92.3%) | 0.08 | 125 (88.0%) | 0.45 | 126 (88.7%) | 0.25 | 65 (47.8%) | 0.21 |
Single | 204 (78.8%) | 224 (86.5%) | 221 (85.3%) | 219 (84.6%) | 126 (54.5%) | ||||||
Children | Yes | 114 (83.8%) | 0.007 | 123 (90.4%) | 0.001 | 118 (86.8%) | 0.001 | 119 (87.5%) | 0.73 | 58 (45.7%) | 0.51 |
No | 85 (69.7%) | 91 (74.6%) | 90 (73.8%) | 105 (86.1%) | 40 (41.2%) | ||||||
Pension | No | 214 (83.9%) | 0.09 | 231 (90.6%) | 0.03 F | 228 (89.4%) | 0.60 | 223 (87.5%) | 0.04 | 139 (56.7%) | 0.006 |
Yes | 43 (93.5%) | 46 (100.0%) | 43 (93.5%) | 35 (76.1%) | 36 (78.3%) |
IDIs | FGDs | Total | ||
---|---|---|---|---|
Number of IDIs and FGDs | 11 | 4 | 15 | |
Total Number of participants | 11 | 16 | 27 | |
Sex | Male | 9 | 13 | 22 |
Female | 2 | 3 | 5 | |
Age | 20–40 years | 3 | 8 | 11 |
41–60 years | 8 | 8 | 16 | |
Sector | Government Official | 3 | 2 | 5 |
Program Managers/Advisor/NGO-In charge | 5 | 8 | 13 | |
Persons with disabilities | 3 | - | 3 | |
Carers | - | 6 | 6 |
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Tetali, S.; Kamalakannan, S.; Sadanand, S.; Lewis, M.G.; Varughese, S.; Hans, A.; Murthy, G.V.S. Evaluation of the Impact of the First Wave of COVID-19 and Associated Lockdown Restrictions on Persons with Disabilities in 14 States of India. Int. J. Environ. Res. Public Health 2022, 19, 11373. https://doi.org/10.3390/ijerph191811373
Tetali S, Kamalakannan S, Sadanand S, Lewis MG, Varughese S, Hans A, Murthy GVS. Evaluation of the Impact of the First Wave of COVID-19 and Associated Lockdown Restrictions on Persons with Disabilities in 14 States of India. International Journal of Environmental Research and Public Health. 2022; 19(18):11373. https://doi.org/10.3390/ijerph191811373
Chicago/Turabian StyleTetali, Shailaja, Sureshkumar Kamalakannan, Shilpa Sadanand, Melissa Glenda Lewis, Sara Varughese, Annie Hans, and G. V. S. Murthy. 2022. "Evaluation of the Impact of the First Wave of COVID-19 and Associated Lockdown Restrictions on Persons with Disabilities in 14 States of India" International Journal of Environmental Research and Public Health 19, no. 18: 11373. https://doi.org/10.3390/ijerph191811373