1.

INTRODUCTION:
Human Rights are the basic right which is being provided by every constitution of every
State and every individual in this globe born with the inherent right of Human Right.
They are most basic right which an individual can ask to have from its nation. They have
never given away any kind of unfairness towards any individual or group of people or
they havent been any discrimination made on the basis of caste, sex, religion etc with
any individual under any nation. . They only sponsor the welfare and well-being of all
persons with equal behaviour.. However, the socio-economic, political and cultural
diversities, prevailing in each state across the world, and politics of the nation states,
take away the free effect of human rights to a certain number of people.

The major problem faced by every developing nation is that the large number of human
sector falls under the poverty line. They are deprived of adequate access in the basic
needs of life such as health, education, housing, food, security, employment, justice and
equity which also include issues related to sustainable livelihood, social and political
participation of the vulnerable groups exists as the major problem in the developing
nations.

All social groups should have equal access to the services provided by the State and
equal opportunity should be provided for their upward economic and social mobility. The
government of every nation should also ensure that should not be any sort of
discrimination against any section of our society. In India, certain social groups such as
the SCs, STs, OBCs and Minorities have in the past been deprived and vulnerable for
human rights. There are certain other groups which may be discriminated against and
which suffer from handicaps and the groups include persons with disabilities, older
persons, street children, beggars and victims of substance abuse. Our Constitution
contains various provisions for the enlargement of such marginalized groups, for
instance, Article 341 for SCs, Article 342 for STs, Article 340 for OBCs, Article 30 which
provides the right to minorities to establish and administer educational institutions, and
various other statutes. Their individual and collective growth, however, cannot be
ensured without improving their surroundings and providing clean drinking water, toilets
and educational opportunities.

The Constitution of India guaranteed to all the people of India the civil, political,
economic, social, and cultural rights for their realization by all sections of the polity
without any kind of discrimination. However, due to poverty, customary and cultural
practices prevailing in the country, there have not much opportunity offered to various
groups and which lead to deprive them of beig treated equally as the other sections of
the society. There are various disadvantaged groups of people such as women,
children, Scheduled Castes, Scheduled Tribes, Linguistic Minorities, Religious
Minorities, Sexual Minorities etc. In order to expand their rights, the Constitution of India
has provided a number of concessions to protect them from exploitation by other
groups.

2. VULNERABLE GROUPS:
The meaning of vulnerable is highly evasive. There does not any specific definition of
this word or rather this term hasnt been anywhere specifically defined in any statute
precisely. Vulnerable groups are those groups of people who may find it difficult to lead
a comfortable life, and lack developmental opportunities due to their disadvantageous
position. However, in common understanding, people who are easily susceptible to
physical or emotional injury, or subject to unnecessary criticism, or in a less valuable
position in any society may be defined as vulnerable people. Further, due to adverse
socio-economical, cultural, and other practices present in each society, they find it
difficult many a times to exercise their human rights fully.

Vulnerable groups are the groups which would be vulnerable under any circumstances
(e.g. where the adults are unable to provide an adequate livelihood for the household
for reasons of disability, illness, age or some other characteristic), and groups whose
resource endowment is inadequate to provide sufficient income from any available
source.
In India there are multiple socio-economic disadvantages that members of particular
groups experience which limits their access to health and healthcare. Besides there are
multiple and complex factors of vulnerability with different layers and more often than
once it cannot be analysed in isolation. The present document is based on some of the
prominent factors on the basis of which individuals or members of groups are
discriminated in India, i.e., structural factors, age, disability and discrimination that act
as barriers to health and healthcare. The vulnerable groups that face discrimination
include- Women, Scheduled Castes (SC), Scheduled Tribes (ST), Children, Aged,
Disabled, Poor migrants, People living with HIV/AIDS and Sexual Minorities.
Sometimes each group faces multiple barriers due to their multiple identities. For
example, in a patriarchal society, disabled women face double discrimination of being a
women and being disabled.
3.VARIOUS VULNERABLE GROUPS IN INDIA:
(i).Women and Girls:
Women and girls are the most essential part of our society as there cannot be any
society exist without them but there are many sectors where they are not considered as
humans also and for them their does not exists the concept of human rights as they are
not aware about their rights. The scenario in the developing countries is quite different
as the society is changing day by day and as we are adopting each other cultures and
in a modern era they are getting aware of about their human rights and they are in a
more disadvantageous position due to abject poverty, other social, cultural, and
derogatory customary practices adopted in each country.[1] Women face double
discrimination being members of specific caste, class or ethnic group apart from
experiencing gendered vulnerabilities as they have little control on the resources . In
India, early marriage and childbearing affects womens health adversely. About 28 per
cent of girls in India get married below the legal age and experience pregnancy. These
have serious repercussion on the health of women. Maternal mortality is very high in
India. The average maternal mortality ratio at the national level is 540 deaths per
100,000 live births. It varies between states and regions, i.e., rural-urban. The rural
MMR is 617 deaths of women age between 15-49 years per one lakh live births as
compared to 267 maternal deaths per one lakh live births among the urban population
and the end result of that is the death ratio is quite high. A large percentage of women is
reported. In India, social norms and cultural practices are embedded in a highly
patriarchal social order where women are expected to hold on to strict gender roles
about what they can and cannot do and to have received no antenatal care and there
are various institutions which have delivered lowest among women from the lower
economic class as against those from the higher class. During infancy and growing
years a girl child faces different forms of violence like infanticide, neglect of nutrition
needs, education and healthcare. As adults they face violence due to unwanted
pregnancies, domestic violence, sexual abuse at the workplace and sexual violence
including marital rape and honour killings. In the case of internal migration in India, they
suffer greater vulnerability due to reduced economic choices and lack of social support
in the new area of destination.
Major schemes for Women[2] Indira Gandhi Matritva Sahyog Yojana (IGMSY) Rajiv
Gandhi Scheme for Empowerment of Adolescent Girls (RGSEAG) Swadhar Yojna
STEP (Support to Training and Employment Programme for Women) (20th October
2005) Stree Shakti Puraskaar Yojna Short Stay Home For Women and Girls (SSH)
UJJAWALA : A Comprehensive Scheme for Prevention of trafficking and Rescue,
Rehabilitation and Re-integration of Victims of Trafficking and Commercial Sexual
Exploitation General Grant-in-Aid Scheme in the field of Women and Child
Development.
(ii) STRUCTURAL DISCRIMINATION (Scheduled Castes, Scheduled Castes, Dalits,
Scheduled Tribes)
Every society is curtailed with different groups and every group has its own rules,
regulations and norms. There is no such particular definition and essentials elements
that will be considered as norms. The norms can be understood as things which act as
structural barriers giving rise to various forms of inequality. Structural norms are
attached to the different relationships between the subordinate and the dominant group
in every society. A groups status may for example, be determined on the basis of
gender, ethnic origin, skin colour, etc. The Access to health and healthcare for the
subordinate groups is reduced due to the structural barriers. The concept of Structural
discrimination can be understand as the rules, norms, which are generally being
accepted approaches and behaviours in institutions and other social structures that
amounts to certain obstacles for subordinate groups to the equal rights and
opportunities possessed by dominant groups. Such discrimination may be visible or
invisible, and it may be intentional or unintentional. The right to health obliges
governments to ensure that health facilities, goods and services are accessible to all
especially the most vulnerable group or marginalized section of the population, in law
and in fact, without discrimination. In India, members of gender, caste, class, and ethnic
identity practice structural discrimination as an impact on their health and access to
healthcare. Among the Scheduled Castes and the Scheduled Tribes the most
vulnerable are women, children, aged, those living with HIV/AIDS, mental illness and
disability. These groups face rigorous forms of discrimination that denies them access to
cure and prevents them from achieving a better health status. In India, Girl child and
women from the marginalized groups are more vulnerable to violence. The dropout and
illiteracy rates among them are high. Early marriage, trafficking, forced prostitution and
other forms of exploitation are also reportedly high among them. Further, there is a
flawed, inflexible notion that they lack merit and are incompatible for formal employment
and due to the lack of access to fixed sources of income and high incidence of wage
labour associated with high rate of under-employment and low wages SC households
are often faced with low incomes and high incidence of poverty. In 200405, about
36.80% of SC persons were BPL in rural areas as compared to only 28.30% for others
(non-SC/ST

Constitutional aspect of these vulnerable groups:

There are various constitutional provisions which are dealing with the problem of
discrimination on the basis of Caste. They are as follows:

Art. 15(4) : Clause 4 of article 15 is the fountain head of all provisions regarding
compensatory discrimination for SCs/STs. This clause was added in the first
amendment to the constitution in 1951 after the SC judgement in the case of
Champakam Dorairajan V. State of Madras[3]. It says thus, Nothing in this article or in
article 29(2) shall prevent the state from making any provisions for the advancement
of any socially and economically backward classes of citizens or for Scheduled Castes
and Scheduled Tribes. This clause started the era of reservations in India.
The basic aim or objective of making these articles is to make the socially and
economically people to fall in the same category as the other sections of the
society is treated and make them feel comfortable about their position in the society. In
the case of Balaji V. State of Mysore, the SC held that reservation cannot be more than
50%. Further, that Art. 15(4) talks about backward classes and not backward castes
thus caste is not the only criterion for backwardness.
Finally, in the case of Indra Sawhney V. Union of India[4], SC upheld the decision
given under Balaji V. State of Mysore that reservation should not exceed 50%
except only in special circumstances. It further held that it is valid to sub-
categorize the reservation between backward and more backward classes.
However, total should still not exceed 50%. It also held that the carry forward
rule is valid as long as reservation does not exceed 50%.
Art. 15(5): This clause was added in 93rd amendment in 2005 and allows the state to
make special provisions for backward classes or SCs or STs for admissions in private
educational institutions, aided or unaided.

(iii).VULNERABILITY OF CHILDREN AND AGED

Mortality and morbidity among children are caused and compounded by poverty, their
sex and caste position in society. All these will lead to have penalty on their nutrition
intake, access to healthcare, environment and education. The factors which directly
impacts are as follows: food security, education of parents and their access to correct
health information and access to health care facilities. The important causes of death
among children from poor families is Malnutrition and chronic hunger which include
Diarrhoea, acute respiratory diseases, malaria and measles and most of which are
either avoidable or treatable with low-cost intervention. The vulnerability among the
elderly is not only due to an increased incidence of illness and disability, but also due to
their economic dependency upon their spouses, children and other younger family
members. According to the 2001 census, 33.1 per cent of the elderly in India live without
their spouses.

Child faces discrimination and disparity access to nutritious food and gender based
aggression is evident from the falling sex ratio and the use of technologies to get rid of
or abolish the girl child. Surrounded by children the health indicators vary between the
different social groups. High mortality and morbidity is reported among children from
Scheduled Castes, Scheduled Tribes and Other Backward Classes as compared to the
general population. Infant mortality is higher among the rural population (Rural-62,
Urban 42 per one thousand live births in the last five years, National Family Health
Survey 3, Fact Sheets). The injection coverage is very poor among children who live in
rural India. Injection coverage among children between 12-23 months who have
received the suggested vaccines is only 39 per cent in rural India in contrast to 58 per
cent in urban India. In India, childrens vulnerabilities and practice to violations of their
protection rights remain spread and multiple in nature. The manifestations of these
violations are various, ranging from child labour, child trafficking, to commercial sexual
exploitation and many other forms of violence and abuse. With an estimated 12.6 million
children engaged in hazardous occupations. In India, however there is a huge gap in
the industry-specific and exposure-specific epidemiological evidence. Most of the
studies are small-scale and community-based studies and the population is growing
promptly and is emerging as a serious area of concern for the government and the
policy planners. According to data on the age of Indias population, in Census 2001,
there are a little over 76.6 million people above 60 years, constituting 7.2 per cent of the
population. The number of people over 60 years in 1991 was 6.8 per cent of the
countrys population.
Constitutional provisions of this group:
Art. 19 A: Education up to 14 yrs has been made a fundamental right. Thus, the state is
required to provide school education to children so as to maintain the integrity of the
principle under which these laws are made and also to maintain the equal treatment of
child under the constitution and in the eyes of law as well as society.

In the case of Unni Krishnan V. State of AP[5], SC held that right to education for
children between 6 to 14 yrs of age is a fundamental right as it flows from Right to
Life. After this decision, education was made a fundamental right explicitly through
86th amendment in 2002. Art. 24: Children have a fundamental right against
exploitation and it is prohibited to employ children below 14 yrs of age in factories and
any hazardous processes. Recently the list of hazardous processes has been
update to include domestic, hotel, and restaurant work. Several PILs have been filed
in the benefit of children. For example, MC Mehta V. State of TN[6], SC has held that
children cannot be employed in match factories or which are directly connected with the
process as it is hazardous for the children.
Art. 45: Urges the state to provide early childhood care and education for children up to
6 yrs of age. Age and high levels of economic reliance combine to create high levels of
vulnerability to chronic poverty. While old age pension schemes are in place neither the
small amounts made available nor the aggravated form of accessing them make this a
resolution to the trouble of chronic poverty between the elderly. With the high incidence
of chronic ailments and health care needs of the elderly, declining family size, migration
and breakdown of traditional family structures that provided support, this group of the
population is extremely vulnerable to poverty.

(iv).VULNERABILITY DUE TO DISABILITY

Disability poses greater challenges in obtaining the needed range of services. Persons
with disabilities face several forms of discrimination and have compressed access to
education, employment and other socioeconomic opportunities. The percentage of
disabled inhabitants to the total inhabitants is about 2.13 per cent. There are two broad
categories of disability, one is acquired which means disability acquired because of
accidents and medical reasons and the other is disability since the origin of birth.
According to the National Sample Survey Organisation Report (58th Round), about one-
third of the disabled population have disability since their birth and there are various
interstate and interregional differences in the disabled population. The disabled face
various types of barriers while looking for access to health and health services. In the
middle of those who are disabled women, children and aged are more vulnerable and
need attention. Five out of ten leading causes of disability and premature death
worldwide are due to psychiatric conditions which also include deadly diseases like
Depression and anxiety are the most common mental disorders. The other area of
concern is the mental health of women and the elderly. Neurotic and stress connected
cases are allegedly higher among women than men, though among men there is
exposure of higher number of cases of serious illness. In spite of such proportion of
mental illness, the health care necessities for persons with mental illness are very poor
in India. People with mental illness face severe forms of human rights violations. There
is social stigma attached to mental illness. Women with mental illness are subjected to
physical and sexual abuse both within families and the institutions. Psychiatric
medicines are complete only in a few primary health centres, community centres and
district hospitals. Services like child guidance and rehabilitative services are also
obtainable only in mental hospitals and in big cities. Several states do not have mental
hospitals. The Persons with Disabilities (Equal Opportunities, Protection of Rights and
Full Participation) Act 1995, commonly referred as the PWD Act came into force on Feb.
7, 1996. Mental illness has been considered in the Act, but there is no reference to any
provision within the Act to be given or set aside for people with mental illness.

Constitutional provisions of this group:

The Constitution of India ensures equality, freedom, justice and dignity of all
individuals and implicitly mandates an inclusive society for all including the persons
with disabilities. The Constitution in the schedule of subjects lays direct responsibility
of the empowerment of the persons with disabilities on the State Governments
Therefore, the primary responsibility to empower the persons with disabilities rests
with the State Governments.
Under Article 253 of the Constitution read with item No. 13 of the Union List, the
Government of India enacted The Persons with Disabilities (Equal Opportunities,
Protection of Rights and Full Participation) Act, 1995, in the effort to ensure
equal opportunities for persons with disabilities and their full participation in
nation-building. The Act extends to whole of India except the State of Jammu
and Kashmir. The Government of Jammu & Kashmir has enacted The Persons
with Disabilities (Equal Opportunities, Protection of Rights & Full Participation Act,
1998.
(v).VULNERABILITY DUE TO MIGRATION
Migrants and their denial of human rights have to be understood from the dynamic
contradictions within and across countriesfrom skilled and voluntary migrants at one
end of the variety to the poor and unskilled migrant population on the other end
designed to be excluded from the fabric of the host nation. The correlation of human
rights and migration is a depressing one and also has bad experiences all the way
through the migratory life cycle, in areas of origin, journey or transit and destination.
The correlation of health and human rights has becomes even more complex because
of irregular or illegal migration clashes with the interest of the area of target. All these
things have direct impact on the rights of individual migrants. India has a large number
of international migrants. Neighbouring countries are the major sources of foundation of
the international migrants to India with the size of these migrants approaching from
Bangladesh, followed by Pakistan and Nepal, but all these migrants who have
entered the country legally. Migrants and mobile people become more vulnerable to
HIV/AIDS and it creates the situation of encountered and behaviours possibly occupied
in during the mobility or migration that increases vulnerability and risk. Migrant and
mobile people may have little or no access to HIV information, anticipation, health
services. This creates a negatively impact on their ability to access suitable treatment
and care and also there is stigma linked with mental illness due to which they practice
discrimination in many other aspects of their lives which are affecting their various rights
such as right to employment, adequate housing, education etc. There are many who
enter the country illegally and are one of the most vulnerable to abuse and exploitation
by employers, migration agents, corrupt bureaucrats and criminal gangs. In many
situations, migrants do not know what rights they are entitled to and still less how to
claim them hence the cases of abuse go unrecorded. Another area where development
is rampant and is forced labour which takes place in the illicit underground economy
and hence tends to escape national statistics. Illegal migrants often live on the margins
of society, trying to avoid contact with authorities and have little or no legal access to
prevention and healthcare services. They tend to face higher risks of exposure to have
unsafe working conditions. Many frequent they do not approach the health system of
the host countries for fear of their status being discovered. Internal migration of poor
labourers has also been on the rise in India.

(vi).VULNERABILITY DUE TO STIGMA AND DISCRIMINATION

People living with HIV/AIDS, Sexual Minorities:
There are certain attitudes and perceptions towards certain kinds of illnesses and
sexual orientation which results in discrimination against individuals/groups. This
section faces the stigma and discrimination faced by the People living with HIV/AIDS
and Sexual Minorities. These groups face various kinds of discrimination and have
reduced access to healthcare. Stigma is the supreme barrier of health and healthcare in
their context. Negative responses and attitude of the society towards these groups are
strongly linked to peoples observation of the causes of HIV / AIDS and sexual
orientation. The rights of People living with HIV/AIDS are violated when they are
deprived of access to have health, education, and services. They suffer when their close
or extended families and friends fail to provide them the support that they need. Indias
National AIDS Control Organization (NACO) estimated in 2005 that there were 5.206
million HIV infections in India, of which 38.4 per cent occurred in women and 57 per
cent Stigma refer to attitudes that certain groups are lesser in one or many ways
based on their membership in a group. The term discrimination is used whenever
people are treated negatively, either by treating them differently where they should be
treated the same or by treating them same where they should be treated in a different
way. Discrimination is the breach of human rights obligation and which leads to
violence, torture, and exclusion from the society. Treating people equally does not
essentially mean that people should be treated the same and occurred in rural areas.
There are many experts argue that the current figures are gross underestimations and
that a significant number of AIDS cases go unreported. Prevalence estimates are based
primarily on guard surveillance conducted at public sites. The national information
system for collecting HIV testing information from the private sector is very weak.
Vulnerability to HIV is also increased by the lack of power of individuals and
communities to minimize or adjust their risk of exposure to HIV infection and once
infected, to receive satisfactory care and support. Some individuals are more vulnerable
to the infection than others. Low status of woman may force a monogamous woman to
engage in exposed sex with her spouse even if he is charming in sex with others.
Similarly youngster girls and boys may be vulnerable to HIV by being denied access to
preventive information, education, and services. Sex workers may have greater
vulnerability to HIV if they cannot access services to prevent, diagnose, and treat
sexually transmitted infections, particularly if they are afraid to come forward because of
the stigma associated with their occupation. There are strong perceptions of the causes
of AIDS, routes of transmission, and their level of knowledge about the illness. These
are compounded by the marginalization and stigmatization on the basis of such
attributes as gender, migrant status or behaviours that may be perceived as risk factors
for HIV infection. For example, women whose husbands have died of AIDS are rejected
by their own and their husbands families and they are denied property inheritance of
their husbands.

Constitutional provisions of this group:

Art. 15(1) : The State shall not discriminate against any citizen on grounds only of
religion, race, caste, sex, place of birth or any of them.
4.WHAT CONSTITUTES VIOLATION OF RIGHT TO HEALTH FOR VULNERABLE
GROUPS?[7]
The violation of the right to health of vulnerable groups may result from direct
government action, from failure of the government to fulfil its minimum core obligations
and from the patterns of systematic discrimination. The specific examples of violations
of right to health of vulnerable groups would be:

Deliberate preservation or twisting of information on the health status of deprived

groups that may have been necessary for the prevention and treatment of illness
or disability.
Impressive discriminatory practices touching the groups health status and
needs. Adopting laws and policies that interfere with the rights of the groups, for
example, womens reproductive rights.
Failure to protect women against violence is often systematic and serious
enough to require women to seek hospital treatment for injuries and involve other
health difficulty related to violence. When governments fail to take pre-emptive
steps to prevent and treat victims of violence it is tantamount to violation of right.
Failure of government to provide adequate public health measures against
infectious diseases that affect the disadvantaged groups.
Government policies and practices creating imbalances in providing health
services, i.e., poor infrastructure in rural areas or predominantly tribal areas.
Systematic discrimination in access to medicines and essential drugs for
particular groups, i.e., HIV/AIDS drugs, reproductive health services for particular
groups like women living in poverty, in rural areas, belonging to marginalized
communities.
5.SCOPE AND LIMITATIONS OF THE INDIAN STATE VIS-A VIS RIGHT TO HEALTH
The Constitution of India and the other various laws do not accord health and
healthcare as rights to the population in general. While civil and political rights are
enshrined as fundamental rights that are permissible, social and economic rights like
health, education, livelihoods etc. exist as Directive Principles for the State and are
hence not permissible. There are however so many instances in which cases have been
filed in the various High Courts of states and Supreme Court of India on the right to life,
Article 21 of the Indian Constitution or on the various directive principles to demand
access to healthcare, particularly in emergency situations. International safeguard of
human rights is only effective when they are made viable by national protection. The key
factors in rights being operationalised for individuals and groups within a nation are
National-level legislation, policies and enforcement mechanism in which National laws
offer variable degrees of protection against human rights violation and enables national
bodies to hear cases of denial and enforce the norms. At present there is a problem of
justifiability of the Right to health in Indian Constitution since the same is not protected
by national legislation. Though India has ratified the Treaty on the Economic Social and
Cultural Right which covers Right to Health (Article 12), that cannot be efficiently used
to advocate for right to health in India. The Courts or petitioners can merely derive
motivation from the treaties on the cases on contradiction on right to health but may not
be able to use it efficiently to deliver justice. The international treaties have only an
suggestive significance unless protected by national legislation. Absence of national
legislation on right to health in India is the main reason why it cannot be realized. Health
and human rights support in India needs to intensify the attempts towards transforming
the critical principles of the Directive principles on health and work into independent
rights through rigorous judicial activism, i.e., filing Public Interest Litigations, gathering
testimonials for denial on right to health, etc. There needs to be a concerted move
towards making a national legislation on right to health.

6.CONCLUSION:
In the Constitution of India, the three pillars of human rights are
(a). the right to equality including the prohibition of discrimination in any form
(b). the six vital freedoms of citizens (including the right to speech and expression)
(c). the right to life guaranteed to all persons.
These rights have been recognized to be inalienable, unalterable and part of the basic
structure of the Constitution which cannot be abrogated. Indias Supreme Court has
interpreted the right to life as including the right to live with dignity, right to health,
education, human environment, speedy trial and privacy, to name a few. Much of the
focus of governmental activity has been to improve the provision of services through
grass-roots local self-governance institutions, particularly in rural areas. India has taken
an important initiative for the empowerment of women by reserving one-third of all seats
for women in urban and local self-government, bringing over one million women at the
grassroots level into political decision making. India has guaranteed human rights to all
persons in India including the protection of minorities. India has secured their right to
practice and preserve their religious and cultural beliefs as a part of the Chapter on
Fundamental Rights. Legislative and executive measures have been taken for the
effective implementation of safeguards provided under the Constitution for the
protection of the interests of minorities. India has been deeply conscious of the need to
empower the Scheduled Castes and Scheduled Tribes and is fully committed to tackle
any discrimination against them at every level. The Constitution of India abolished
untouchability and forbids its practice in any form. There are also explicit and
elaborate legal and administrative provisions to address caste-based discrimination in
the country. India stated that at independence, after the departure of the colonizers, all
the people, including its tribal people, were considered as indigenous to India. This
position has been clarified on various occasions, including while extending Indias
support to the adoption of the United Nations Declaration on the Rights of Indigenous
Peoples at the Human Rights Council and the General Assembly.
 Vulnerable Groups in India- Status, Schemes, Constitution of India

Vulnerable groups are the groups which would be vulnerable under any circumstances
(e.g. where the adults are unable to provide an adequate livelihood for the household
for reasons of disability, illness, age or some other characteristic), and groups whose
resource endowment is inadequate to provide sufficient income from any available
source.

In India there are multiple socio-economic disadvantages that members of particular

groups experience which limits their access to health and healthcare. The task of
identifying the vulnerable groups is not an easy one. Besides there are multiple and
complex factors of vulnerability with different layers and more often than once it cannot
be analysed in isolation. The present document is based on some of the prominent
factors on the basis of which individuals or members of groups are discriminated in
India, i.e., structural factors, age, disability and discrimination that act as barriers to
health and healthcare. The vulnerable groups that face discrimination include- Women,
Scheduled Castes (SC), Scheduled Tribes (ST), Children, Aged, Disabled, Poor migrants,
People living with HIV/AIDS and Sexual Minorities. Sometimes each group faces multiple
barriers due to their multiple identities. For example, in a patriarchal society, disabled
women face double discrimination of being a women and being disabled.

VULNERABLE GROUPS FACING STRUCTURAL DISCRIMINATION (WOMEN, SCHEDULED

CASTES, DALITS, SCHEDULED TRIBES)
What are weaker sections?
SCs/STs
Due to the caste system prevailing in India, the sudras have been exploited for the
ages. They were denied the right to education and thus were left languishing behind,
socially and economically. Such people have been categorized into Scheduled Castes.
Tribal communities, who never mixed with the main society, are similarly challenged
and are categorized into Scheduled Tribes.

Backward Classes
The constitution does not define the term backward classes. It is up to the center and
the states to specify the classes that belong to this group. However, it is understood
that classes that are not represented adequately in the services of the state can be
termed backward classes. Further, the President can, under Art. 340, can constitute a
commission to investigate the condition of socially and educationally backward classes.
Based on this report, the president may specify the backward classes.

Structural norms are attached to the different relationships between the subordinate
and the dominant group in every society. A groups status may for example, be
determined on the basis of gender, ethnic origin, skin colour, etc. The norms act as
structural barriers giving rise to various forms of inequality. Access to health and
healthcare for the subordinate groups is reduced due to the structural barriers.

Structural Discrimination Faced by Groups

In India, members of gender , caste, class, and ethnic identity experience structural
discrimination that impact their health and access to healthcare. Women face double
discrimination being members of specific caste, class or ethnic group apart from
experiencing gendered vulnerabilities. Women have low status as compared to men in
Indian society. They have little control on the resources and on important decisions
related to their lives. In India, early marriage and childbearing affects womens health
adversely. About 28 per cent of girls in India, get married below the legal age and
experience pregnancy (Reproductive And Child Health District level Household Survey
2002-04, August 2006). These have serious repercussions on the health of women.
Maternal mortality is very high in India. The average maternal mortality ratio at the
national level is 540 deaths per 100,000 live births (National Family Health Survey-2,
2000). It varies between states and regions, i.e., rural-urban. The rural MMR (Maternal
Mortality Rate) is 617 deaths of women age between 15-49 years per one lakh live
births as compared to 267 maternal deaths per one lakh live births among the urban
population (National Family Health Survey-2, 2000). In most cases the deaths occur
from preventable causes. A large proportion of women is reported to have received no
antenatal care. In India, institutional delivery is lowest among women from the lower
economic class as against those from the higher class.

A major proportion of the lower castes and Dalits are still dependent on others for their
livelihood. Dalits does not refer to a caste but suggestsa group who are in a state of
oppression, social disability and who are helpless and poor. They were earlier referred as
untouchables mainly due to their low occupations i.e., cobbler, scavenger, sweeper.7
In a caste-dominated country like India, Dalits who comprises more than one-sixth of the
Indian population (160 million approx), stand as a community whose human rights have
been severely violated. Literacy

rates among Dalits are only about 24 per cent. They have meager purchasing power;
have poor housing conditions; lack or have low access to resources and entitlements. In
rural India they are landless poor agricultural labourers attached to rich landowners
from generations or poor casual labourers doing all kinds of available work. In the city
they are the urban poor employed as wage labourers at several work sites, beggars,
vendors, small service providers, domestic help, etc., living in slums and other
temporary shelters without any kind of social security. The members of these groups
face systemic violence in the form of denial of access to land, good housing, education
and employment. Structural discrimination against these groups takes place in the form
of physical, psychological, emotional and cultural abuse which receives legitimacy from
the social structure and the social system. Physical segregation of their settlements is
common in the villages forcing them to live in the most unhygienic and inhabitable
conditions. All these factors affect their health status, access to healthcare, and quality
of health service received. There are high rates of malnutrition reported among the
marginalized groups resulting in mortality, morbidity and anaemia. Access to and
utilization of healthcare among the marginalized groups is influenced by their socio-
economic status within the society.

Structural discrimination directly impedes equal access to health services by way of

exclusion. The negative attitude of the health professionals towards these groups also
acts as a barrier to receiving quality healthcare from the health system. In the case of
women, discrimination increases by the complex mix of two factors-being a women and
being a member of the marginalized community. A large proportion of Dalit girls drop
out of primary school inspite of reservations and academic aptitude, because of
poverty, humiliation, isolation or bullying by teachers and classmates and punishment
for scoring good grades (National Commission Report for SC/ST, 2000). The scavenger
community among the Dalits is vulnerable to stress and diseases with reduced access to
healthcare. The Scheduled Tribes like the Scheduled Castes face structural
discrimination within the Indian society. Unlike the Scheduled Castes, the Scheduled
Tribes are a product of marginalization based on ethnicity. In India, the Scheduled Tribes
population is around 84.3 million and is considered to be socially and economically
disadvantaged. Their percentages in the population and numbers however vary from
State to State. They are mainly landless with little control over resources such as land,
forest and water. They constitute a large proportion of agricultural labourers, casual
labourers, plantation labourers, industrial labourers etc. This has resulted in poverty
among them, low levels of education, poor health and reduced access to healthcare
services. They belong to the poorest strata of the society and have severe health
problems. They are less likely to afford and get access to healthcare services when
required. The health outcomes among the Scheduled Tribes are very poor even as
compared to the Scheduled Castes. The Infant Mortality Rate among Scheduled Castes
is 83 per 1000 live births while it is 84.2 per 1000 per live births among the Scheduled
Tribes.

Need for development of the weaker sections the SCs STs OBCs and
Minorities
The SCs STs OBCs and Minorities, have been forced to remain as the Weaker Sections of
India, and the Women confined or oppressed to be the most and multiply exploited
sections of the Country, for nearly four millenniums. This bad situation, can not and
should not continue anymore. Definitely not in the Twenty-first Century of the third
millennium, in an age of fast travel and mass communication.

There is a need for the Government to do something special and tangible, to free and
liberate the Weaker Sections, from the cobwebs of oppression, marginalisation and
backwardness. They have to be uplifted to the levels of normal human-beings of the
World.

Constitutional Provisions for the SC/ST/OBC and minorities

Art. 15(4) : Clause 4 of article 15 is the fountain head of all provisions regarding
compensatory discrimination for SCs/STs. This clause was added in the first amendment
to the constitution in 1951 after the SC judgement in the case of Champakam
Dorairajan vs State of Madras. It says thus, "Nothing in this article or in article 29(2)
shall prevent the state from making any provisions for the advancement of any socially
and economically backward classes of citizens or for Scheduled Castes and Scheduled
Tribes." This clause started the era of reservations in India.

In the case of Balaji vs State of Mysore, the SC held that reservation cannot be more
than 50%. Further, that Art. 15(4) talks about backward classes and not backward
castes thus caste is not the only criterion for backwardness and other criteria must also
be considered.

Finally, in the case of Indra Sawhney vs Union of India, SC upheld the decision given
under Balaji vs State of Mysore that reservation should not exceed 50% except only in
special circumstances. It further held that it is valid to sub-categorize the reservation
between backward and more backward classes. However, total should still not exceed
50%. It also held that the carry forward rule is valid as long as reservation does not
exceed 50%.

Art. 15 (5) : This clause was added in 93rd amendment in 2005 and allows the state to
make special provisions for backward classes or SCs or STs for admissions in private
educational institutions, aided or unaided.
Art. 16(4): This clause allows the state to reserve vacancies in public service for any
backward classes of the state that are not adequately represented in the public
services.

Art. 16 (4A): This allows the state to implement reservation in the matter of promotion
for SCs and STs.

Art. 16(4B): This allows the state to consider unfilled vacancies reserved for backward
classes as a separate class of vacancies not subject to a limit of 50% reservation.

Art. 17: This abolishes untouchability and its practice in any form. Although the term
untouchability has not been defined in the constitution or in any act but its meaning is
to be understood not in a literal sense but in the context of Indian society. Due to the
varna system, some people were relegated to do menial jobs such as cleaning toilets.
Such people were not to be touched and it was considered a sin to even touch their
shadow. They were not even allowed to enter public places such as temples and shops.
The constitution strives to remove this abhorring practice by not only making the
provision a fundamental right but also allows punishment to whoever practices or abets
it in any form. Towards this end, Protection of Civil Rights Act 1955 was enacted. It has
implemented several measures to eradicate this evil from the society. It stipulates up to
6 months imprisonment or 500 Rs fine or both. It impresses upon the public servant to
investigate fully any complaint in this matter and failing to do so will amount to abetting
this crime. In the case of State of Kar. vs Appa Balu Ingle, SC upheld the conviction for
preventing a lower caste person from filling water from a bore well.

In Asiad Projects Workers case, SC has held that right under Art 17 is available against
private individuals as well and it is the duty of the state to ensure that this right is not
violated.

Art. 19(5): It allows the state to impose restriction on freedom of movement or of

residence in the benefit of Scheduled Tribes.

Art. 40: Provides reservation in 1/3 seats in Panchayats to SC/ST.

Art. 46: Enjoins the states to promote with care the educational and economic interests
of the weaker sections, specially SC and STs.

Art. 164: Appoint special minister for tribal welfare in the states of MP, Bihar, and Orrisa.

Art. 275: Allows special grant in aids to states for tribal welfare.

Art. 330/332: Allows reservation of seats for SC/ST in the parliament as well as in state
legislatures.

Art. 335: Allows relaxation in qualifying marks for admission in educational institutes or
promotions for SCs/STs.

In the case of State of MP vs Nivedita Jain, SC held that complete relaxation of qualifying
marks for SCs/STs in Pre-Medical Examinations for admission to medical colleges is valid.

Art. 338/338A/339: Establishes a National Commission of SCs and STs. Art. 339 allows
the central govt. to direct states to implement and execute plans for the betterment of
SC/STs.

Art. 340: Allows the president to appoint a commission to investigate the condition of
socially and economically backward classes and table the report in the parliament.

Constitutional Provisions for Women

Art. 15(3): It allows the state to make special provisions for women and children.
Several acts such as Dowry Prevention Act have been passed including the most recent
one of Protection of women from domestic violence Act 2005.

Art. 23: Under the fundamental right against exploitation, flesh trade has been banned.

Art. 39: Ensures equal pay to women for equal work.

In the case of Randhir Singh vs Union of India, SC held that the concept of equal pay for
equal work is indeed a constitutional goal and is capable of being enforced through
constitutional remedies under Art. 32.

Art. 40: Provides 1/3 reservation in panchayat.

Art. 42: Provides free pregnancy care and delivery.

Art. 44: It urges the state to implement uniform civil code, which will help improve the
condition of women across all religions. It has, however, not been implemented due to
politics. In the case of Sarla Mudgal vs Union of India, SC has held that in Indian
Republic there is to be only one nation i.e. Indian nation and no community could claim
to be a separate entity on the basis of religion. There is a plan to provide reservation to
women in parliament as well.

SCHEDULED CASTES/TRIBES WELFARE SCHEMES-

NGOs Schemes-
Scheme of Grant in Aid to Voluntary Organisations working for Scheduled Castes

Ministrys Schemes-
Central Sector Scheme of 'Rajiv Gandhi National Fellowship' for Providing Scholarships
to Scheduled Caste Students to persue Programmes in Higher Education such as M.Phil
and Ph.D (Effective from 01-04-2010)

Interviews for final Selection of awardees under the Scheme of National Overseas
Scholarship for SC etc. Candidates for the Selection Year 2009-10.

Centrally-sponsored Pilot Scheme of PRADHAN MANTRI ADARSH GRAM YOJANA

(PMAGY)

State, District and Block wise abstract of villages selected under PMAGY

Babu Jagjivan Ram Chhatrawas Yojana (Letter, Annexures, and National Allocation for
2009-10)

Post-Matric Scholarship for SC Students

 Pre-Matric Scholarships for the Children of those Engaged in Unclean Occupations

Central Sector Scholarship Scheme of Top Class Education for SC Students (Effective
from June 2007)

Self Employment Scheme for Rehabilitation of Manual Scavengers

National Overseas Scholarships for Scheduled Castes (SC) etc. Candidates for Selection
Year 2010-2011

Form for the Scheme of National Overseas Scholarship for SC etc. Candidates for the
Selection Year 2010-11.

Special Educational Development Programme for Scheduled Castes Girls belonging to

low Literacy Levels

Upgradation of Merit of SC Students

Scheme of free Coaching for SC and OBC Students

National Scheduled Castes Finance & Development Corporation (NSFDC)

National Safaikaramcharis Finance & Development Corporation (NSKFDC)

Assistance to Scheduled Castes Development Corporations (SCDCs)

Supporting Project of All India Nature of SCs

National Comission for Safai Karamcharis

The major schemes/programme of the Ministry of Tribal Affairs are-

Special Central Assistance & Grants Under Article 275(1) Of The Constitution

Scheme Of Development of Primitive Tribal Groups(Ptgs)

Tribal Research Institutes

Girls / Boys Hostels for Sts

Ashram Schools In Tribal Sub-Plan Areas

Vocational Trainig Centres in Tribal Areas

Grants-in-aid to State Tribal Development Cooperative Corporations and others

Village Grain Bank Scheme

Major schemes for Women-

Indira Gandhi Matritva Sahyog Yojana (IGMSY)

Rajiv Gandhi Scheme for Empowerment of Adolescent Girls (RGSEAG)

 Swadhar Yojna

STEP (Support to Training and Employment Programme for Women) (20th October
2005)

Stree Shakti Puraskaar Yojna

Short Stay Home For Women and Girls (SSH)

UJJAWALA : A Comprehensive Scheme for Prevention of trafficking and Rescue,

Rehabilitation and Re-integration of Victims of Trafficking and Commercial Sexual
Exploitation

General Grant-in-Aid Scheme in the field of Women and Child Development.

STREET CHILDREN AND ORPHANS

Street children are those for whom the street more than their family has become their
real home, a situation in which there is no protection, supervision, or direction from
responsible adults. Human Rights Watch estimates that approximately 18 million
children live or work on the streets of India. Majority of these children are involved in
crime, prostitution, gang related violence and drug trafficking.

Status of Orphans/ Street Children in India

India is the worlds largest democracy with a population of over a billion-400 million of
which are children.

Approximately 26% of the Indian population lives below the poverty line and 72 % live
in rural areas.

Even though the percentage of the Indian population infected with HIV/AIDS is 0.9%,
(5) it has the second largest number of people infected with HIV/AIDS in the world, the
first being South Africa.

Despite the many recorded gains in the recent past, issues such as gender inequity,
poverty, illiteracy and the lack of basic infrastructure play an important role in hindering
HIV/ AIDS prevention and treatment programs in India. The impact of the AIDS crisis has
not begun to fully emerge in India and AIDS related orphaning has not been
documented.

Yet, it is estimated that India has the largest number of AIDS orphans of any country
and this number is expected to double in the next five years.

Out of the 55,764 identified AIDS cases in India 2,112 are children.

It is estimated that 14% of the 4.2 million HIV/AIDS cases are children below the age of
14.

A study conducted by the ILO found that children of infected parents are heavily
discriminated-35% were denied basic amenities and 17% were forced to take up petty
jobs to augment their income.

Child labor in India is a complex problem and is rooted in poverty.

 Census 1991 data suggests that there are 11.28 million working children in India.

Over 85% of this child labor is in the countrys rural areas and this number has risen in
the past decade.

Conservative estimates state that around 300, 000 children in India are engaged in
commercial sex. Child prostitution is socially acceptable in some sections of Indian
society through the practice of Devadasi. Young girls from socially disadvantaged
communities are given to the 'gods' and they become a religious prostitute. Devadasi is
banned by the Prohibition of Dedication Act of 1982. This system is prevalent in Andhra
Pradesh, Karnataka,Tamil Nadu,Kerala, Maharashtra,Orissa, Uttar Pradesh and Assam.
More than 50 % of the devadasis become prostitutes: of which nearly 40 per cent join
the sex trade in urban brothels and the rest are involved in prostitution in their
respective villages. According to the National Commission on Women an estimated
250,000 women have been dedicated as Devadasis in Maharashtra-Karnataka border. A
study conducted in 1993 reported that 9% of the devadasis are HIV positive in Belgaum
district in Karnataka.

Schemes for children

The Integrated Child Protection Scheme (ICPS)

National Awards For Child Welfare

National Child Awards For Exceptional Achievements

Rajiv Gandhi Manav Seva Award For Service To Children

Balika Samriddhi Yojana (BSY)

Kishori Shakti Yojana (KSY)

Nutrition Programme for Adolescent Girls (NPAG)

Early Childhood Education for 3-6 Age Group Children Under the Programme of
Universaliation of Elementary Education.

Scheme for welfare of Working Children in need of Care and Protection

Central Adoption Resource Agency (CARA)

Rajiv Gandhi National Creche Scheme For the Children of Working Mothers

UJJAWALA : A Comprehensive Scheme for Prevention of trafficking and Rescue,

Rehabilitation and Re-integration of Victims of Trafficking and Commercial Sexual
Exploitation

General Grant-in-Aid Scheme in the field of Women and Child Development.

Constitutional Provisions for children

Art. 19 A: Education up to 14 yrs has been made a fundamental right. Thus, the state is
required to provide school education to children.
In the case of Unni Krishnan vs State of AP, SC held that right to education for children
between 6 to 14 yrs of age is a fundamental right as it flows from Right to Life. After this
decision, education was made a fundamental right explicitly through 86th amendment
in 2002.

Art. 24: Children have a fundamental right against exploitation and it is prohibited to
employ children below 14 yrs of age in factories and any hazardous processes. Recently
the list of hazardous processes has been update to include domestic, hotel, and
restaurant work.

Several PILs have been filed in the benefit of children. For example, MC Mehta vs State
of TN, SC has held that children cannot be employed in match factories or which are
directly connected with the process as it is hazardous for the children.

In the case of Lakshmi Kant Pandey vs Union of India, J Bhagvati has laid down
guidelines for adoption of Indian children by foreigners.

Art. 45: Urges the state to provide early childhood care and education for children up to
6 yrs of age.

Age, and high levels of economic dependence and/or disability combine to create high
levels of vulnerability to chronic poverty. While old age pension schemes are in place
neither the small amounts made available nor the hassle of accessing them make this a
solution to the problem of chronic poverty among the elderly. With the high incidence of
chronic ailments and health care needs of the elderly, declining family size, migration
and breakdown of traditional family structures that provided support, this group of the
population is extremely vulnerable to poverty.

The 1991 census showed that approximately 7.6% of India's rural and 6.3% of India's
urban population was above the age of 60. 7.8% males and 7.4% females in rural and
6.2% males and 6.6% females in urban areas were in the category of the aged. The
proportion of old-old (70 plus) in India is expected to increase from 2.40 percent in 1991
to 3.75 percent by 2021. The total number of elderly persons in India is projected to
increase to 136 million by 2021 from the current level of 55 million in 1991. This has
significant implications for social security policies.

The NSS data show that in both rural and urban areas, roughly 50% of aged persons
were fully dependent on others, 13 to 16 % were partially dependent and only 30%
were economically independent. Economic independence was far greater among males
than among females. Close to half the elderly males and only 12% of elderly females
were economically independent. In contrast, more than 70% of older females and only
about 30% of older males were fully dependent on others. High levels of economic
dependence at low household income levels mean that meager resources need to be
stretched thinner and thereby increase vulnerability to poverty of physically and
financially dependent older persons. Inadequate financial resources are a major concern
of the Indian elderly (Desai 1985 cited in Rajan et. al., 2000) and more so among the
female elderly (Dak and Sharma 1987 cited in Rajan et. al., 2000). In many situations,
the rural elderly continue to work though their number of working hours comes down
with increasing age (Singh, Singh and Sharma 1987 cited in Rajan et.al.,2000). Financial
problems are more common among widows and among the elderly in nuclear families.
Economic insecurity was the sole concern of the elderly in barely sustainable
households in rural India (Punia and Sharma 1987 cited in Rajan et. al.,2000).

Constitutional provisions for aged-

In Constitution of India, entry 24 in list III of Schedule IV deals with the Welfare of
Labour, including conditions of work, provident funds, liability for workmens
compensations, invalidity and Old age pension and maternity benefits.

Further, Item No. 9 of the State List and Item No. 20, 23 and 24 of the Concurrent List
relates to old age pension, social security and social insurance, and economic and social
planning.

Article 41 of the Directive Principle of the State Policy has particular relevance to Old
Age Social Security. According to this Article, the State shall, within the limits of its
economic capacity and development, make effective provision for securing the right to
work, to education and to public assistance in case of undeserved want.

Schemes for aged-

Major scheme-

National Social Assistance Programme (NSAP)

The National Social Assistance Programme (NSAP) which came into effect from 15th
August, 1995 represents a significant step towards the fulfillment of the Directive
Principles in Article 41 and 42 of the Constitution. It introduces a National Policy for
Social Assistance benefit to poor households in the case of old age, death of primary
bread-winner and maternity. The Programme has three components, namely:-

* National Old Age Pension Scheme (NOAPS)

* National Family Benefit Scheme (NFBS)
* National Maternity Benefit Scheme (NMBS)
These Schemes were partially modified in 1998 based on the suggestions received from
various corners and also on the basis of the feedback received from the State
Governments.

Other schemes-

Technology Interventions for Elderly (TIE) Concessions and Other incentives

Programme for Older Persons Insurance Policies and Benefits

Annapurna Scheme Mediclaim/Health Insurance

Free Legal Aids National Policy on Older Person

Rebates Health Facilities

PERSONS WITH DISABILITIES

According to the Census 2001, there are 2.19 crore people with disabilities in India who
constitute 2.13 per cent of the total population. This includes persons with visual,
hearing, speech, locomotor and mental disabilities.Seventy five per cent of persons with
disabilities live in rural areas, 49 per cent of disabled population is literate and only 34
per cent are employed. The earlier emphasis on medical rehabilitation has now been
replaced by an emphasis on social rehabilitation. The Disability Division in the Ministry
of Social Justice & Empowerment facilitates empowerment of the persons with
disabilities.

Disability data as per National Sample Survey Organisation (NSSO) 2002

Disability Percentage Among Total Population

Movement 51%

Seeing 14%

Hearing 15%

Speech 10%

Mental 10%

Source: National Sample Survey Organisation 2002

Constitutional Provisions for disabled persons

The Constitution of India ensures equality, freedom, justice and dignity of all individuals
and implicitly mandates an inclusive society for all including the persons with
disabilities. The Constitution in the schedule of subjects lays direct responsibility of the
empowerment of the persons with disabilities on the State Governments Therefore, the
primary responsibility to empower the persons with disabilities rests with the State
Governments.

Under Article 253 of the Constitution read with item No. 13 of the Union List, the
Government of India enacted The Persons with Disabilities (Equal Opportunities,
Protection of Rights and Full Participation) Act, 1995, in the effort to ensure equal
opportunities for persons with disabilities and their full participation in nation-building.
The Act extends to whole of India except the State of Jammu and Kashmir. The
Government of Jammu & Kashmir has enacted The Persons with Disabilities (Equal
Opportunities, Protection of Rights & Full Participation) Act, 1998.

A multi-sectoral collaborative approach, involving all the Appropriate Governments i.e.

Ministries of the Central Government, the State Governments/UTs, Central/State
undertakings, local authorities and other appropriate authorities is being followed in
implementation of various provisions of the Act.

India is a signatory to the Declaration on the Full Participation and Equality of People
with Disabilities in the Asia Pacific Region. India is also a signatory to the Biwako
Millennium Framework for action towards an inclusive, barrier free and rights based
society. India signed the UN Convention on Protection and Promotion of the Rights and
Dignity of Persons with Disabilities on 30th March, 2007, the day it opened for signature.
India ratifies the UN Convention on Ist October, 2008.

Government schemes-
Assistance to Disabled Persons for Purchase/ Fitting of Aids and Appliances
(ADIP Scheme)
The main objective of the Scheme is to assist the needy disabled persons in procuring
durable, sophisticated and scientifically manufactured, modern, standard aids and
appliances that can promote their physical, social and psychological rehabilitation, by
reducing the effects of disabilities and enhance their economic potential. The aids and
appliances supplied under the Scheme must be ISI.

The quantum of assistance and income limit under the ADIP scheme is as follows:

Total Income Amount of Assistance

(i) Up to Rs. 6,500/- per month (i) Full cost of aid/appliance

(ii) Rs. 6,501/- to Rs. 10,000/- per (ii) 50% of the cost of aid/appliance
month

The scheme is implemented through implementing agencies such as the NGOs, National
Institutes under this Ministry and ALIMCO (a PSU).

Scheme of National Scholarships for Persons with Disabilities

Under the Scheme of National Scholarships for Persons with Disabilities, every year 500
new scholarships are awarded for pursuing post matric professional and technical
courses of duration more than one year. However, in respect of students with cerebral
palsy, mental retardation, multiple disabilities and profound or severe hearing
impairment, scholarship are awarded for pursuing studies from IX Std. onwards.
Advertisements inviting applications for scholarships are given in leading
national/regional newspapers in the month of June and also placed on the website of the
Ministry. State Government/ UT Administrations are also requested to give wide publicity
to the scheme.

Students with 40% or more disability whose monthly family income does not exceed Rs.
15,000/-are eligible for scholarship. A scholarship of Rs. 700/- per month to day scholars
and Rs. 1,000/- per month to hostellers is provided to the students pursuing Graduate
and Post Graduate level technical or professional courses. A scholarship or Rs. 400/- per
month to day scholars and Rs. 700/- per month to hostellers is provided for pursuing
diploma and certificate level professional courses. In addition to the scholarship, the
students are reimbursed the course fee subject to a ceiling of Rs. 10,000/- per year.
Financial assistance under the scheme is also given for computer with editing software
for blind/ deaf graduate and postgraduate students pursuing professional courses and
for support access software for cerebral palsied students

National Institutes/Apex Level Institutions

In consonance with the policy of empowerment of persons with disabilities and in order
to effectively deal with their multi dimensional problems, the following National
Institutes/Apex level institutions have been setup in each major area of disability:-

(i) National Institute for the Visually Handicapped, Dehradun

(ii) National Institute for the Orthopaedically Handicapped, Calcutta.
(iii) Ali Yavar Jung National Institute for the Hearing Handicapped, Mumbai
(iv) National Institute for Mentally Handicapped, Secunderabad.
(v) National Institute for Rehabilitation Training and Research, Cuttack.
(vi) Institute for the Physically Handicapped, New Delhi.
(vii) National Institute for Empowerment of Persons with Multiple Disabilities (NIEPMD),
Chennai

MIGRANTS
Internal migration of poor labourers has also been on the rise in India. The poor
migrants usually end up as casual labourers within the informal sector. This population
is at high risk for diseases and faces reduced access to health services. In India, 14.4
million people migrated within the country for work purposes either to cities or areas
with higher expected economic gains during the 2001 census period. Lakh number of
migrants are employed in cultivation and plantations, brick-kilns, quarries, construction
sites and fish processing (NCRL, 2001). Large numbers of migrants also work in the
urban informal manufacturing construction, services or transport sectors and are
employed as casual labourers, head loaders, rickshaw pullers and hawkers. The rapid
change of residence due to the casual nature of work excludes them from the
preventive care and their working conditions in the informal work arrangements in the
city debars them from access to adequate curative care. In India, there are a large
number of international women migrants. Female migration to India constitutes 48 per
cent of the total inmigration from other countries.

Among the migrants who are vulnerable, the Internally Displaced People (IDPs) deserve
mention. In India, the Internally Displaced People are estimated to be around 6 lakhs
(IDMC, 2006). Internal displacement arises out of ethnic conflicts, religious conflicts,
political reasons, development projects, natural disaster etc. The Internally Displaced
People are vulnerable to access government social security schemes.
Schemes-
The Inter-State Migrant Workmen (Regulation Of Employment And Conditions Of
Service) Act, 1979 - An Act to regulate the employment of inter-State migrant workmen
and to provide for their conditions of service and for matters connected therewith.

SEXUAL MINORITIES
Another group that faces stigma and discrimination are the sexual minorities. Those
identified as gay, lesbian, transgender, bisexual, kothi and hijra, experience various
forms of discrimination within the society and the health system. Due to the dominance
of heteronomous sexual relations as the only form of normal acceptable relations within
the society, individuals who are identified as having same-sex sexual preferences are
ridiculed and ostracized by their own family and are left with very limited support
structures and networks of community that provide them conditions of care and
support. Their needs and concerns are excluded from the various health policies and
programmes. Only the National AIDS Prevention and Control Policy recognize sexual
minority and homosexuals in the context of identifying high risk behaviour. But
pervasive discrimination from the health providers delays or deters their health seeking.
Hence they remain excluded from the process of government surveillance carried
among the high risk population in the context of HIV/AIDS. The surveillance amongst
MSM or men who have sex with men, is usually carried out by NGOs and through
support groups, i.e. amongst males who are accessible to NGOs and who are willing to
identify with categories, such as kothi, around which support groups are structured.
They also undergo considerable amount of psychological stress.

Constitutional Provisions for sexual minorities

Art. 15(1) : The State shall not discriminate against any citizen on grounds only of
religion, race, caste, sex, place of birth or any of them.

Other-

National AIDS Prevention and Control Policy.

CONCLUSION
In the Constitution of India, the three pillars of human rights are (a) the right to equality
including the prohibition of discrimination in any form, (b) the six vital freedoms of
citizens (including the right to speech and expression) and (c) the right to life
guaranteed to all persons. These rights have been recognized to be inalienable,
unalterable and part of the basic structure of the Constitutionwhich cannot be
abrogated. Indias Supreme Court has interpreted the right to life as including the right
to live with dignity, right to health, education, human environment, speedy trial and
privacy, to name a few. Much of the focus of governmental activity has been to improve
the provision of services through grass-roots local self-governance institutions,
particularly in rural areas. India has taken an important initiative for the empowerment
of women by reserving one-third of all seats for women in urban and local self-
government, bringing over one million women at the grassroots level into political
decision making. India has guaranteed human rights to all persons in India including the
protection of minorities. India has secured their right to practice and preserve their
religious and cultural beliefs as a part of the Chapter on Fundamental Rights. Legislative
and executive measures have been taken for the effective implementation of
safeguards provided under the Constitution for the protection of the interests of
minorities. India has been deeply conscious of the need to empower the Scheduled
Castes and Scheduled Tribes and is fully committed to tackle any discrimination against
them at every level. The Constitution of India abolished untouchability and forbids its
practice in any form. There are also explicit and elaborate legal and administrative
provisions to address caste-based discrimination in the country. India stated that at
independence, after the departure of the colonizers, all the people, including its tribal
people, were considered as indigenous to India. This position has been clarified on
various occasions, including while extending Indias support to the adoption of the
United Nations Declaration on the Rights of Indigenous Peoples at the Human Rights
Council and the General Assembly.

**********************************
# http://www.fao.org/ag/wfe2005/glossary_en.htm accessed on October 8, 2011 at 4:21
p.m.

# Structural discrimination refers to rules, norms, generally accepted approaches and

behaviours in institutions and other social structures that constitute obstacles for
subordinate groups to the equal rights and opportunities possessed by dominant
groups. Such discrimination may be visible or invisible, and it may be intentional or
unintentional.

# Only 16 per cent of the women in India received all the antenatal care i.e., atleast 3
antenatal check-ups, and at least one tetanus toxoid injection and supplementary iron in
the form of iron folic acid tablets/syrups daily for 100 days as recommended by the RCH
Programme. (RCH-DLHS-3,2002-04)

# In India, the percentage of home delivery is highest (59 percent), whereas

institutional delivery (public and private health institutes) accounts for only 40.5 per
cent. Home delivery assisted by skilled birth attendants accounts for 7.1 per cent.
Institutional delivery by background characteristics shows that only 22 per cent
childbirths of Scheduled Tribes women takes place in institutions as compared to 33 per
cent births to Scheduled Caste women. (RCH-DLHS-3,2002-2004, pg 98)

# Dalits in India, are poor, deprived and socially backward. They have faced severe
forms of human rights violation. They have been involved in a long struggle to abolish
untouchability and caste discrimination.
# Fractile group constitutes of monthly per capita consumption expenditure (MPCE).
Population is classified into seven fractile groups. 0-10 is the lowest consumption group
while 90-100 is the highest consumption group.
# Womens Health, Booklet for National Health Assembly II, Complied by Sama Resource
Group for Women and Health, New Delhi, October 2006.
# National Health Policy 2002, Government of India.
# AIR 1951 Mad 120
# 1963 AIR 649
# AIR 1993 SC 477
# AIR 1993 SC 1126
# AIR 1982 SC 1473
# 1981 AIR 2045
# 1982 AIR 879
# 1995 AIR 1531
# http://cira.med.yale.edu accessed on October 9, 2011 at 6.55 p.m.
# http://en.wikipedia.org/ accessed on October 9, 2011 at 6.59 p.m.
# 1993 AIR 217
# (1991) 1 SCC 283
# (1984) 2 SCC 244
# Aging in India: Its Socioeconomic and Health: By H.B. Chanana and P.P. Talwar,
ImplicationsAsia-Pacific Population Journal, Vol. 2, No. 3 37
# http://www.oldagesolutions.org/Facilities/ConstProv.aspx accessed on October 10,
2011 at 6.55 p.m.
# http://www.disabilityindia.com/html/facts.html October 10, 2011 at 9.10 p.m.
# http://www.disabilityindia.com/ and Min of Social Justice accessed on October 11,
2011 at 4.00 p.m.
# Vulnerable Groups in India by Chandrima Chatterjee an Gunjan Sheoran, CEHAT,
Mumbai.
# Vulnerable Groups in India by Chandrima Chatterjee an Gunjan Sheoran, CEHAT,
Mumbai, pg. 20.
# http://lib.ohchr.org/HRBodies/UPR/Documents/Session1/IN/A_HRC_8_26_India_E.pdf
accessed on October 10, 2011