2025, Vol. 6, Issue 2, Part A

Background: Persons with Intellectual Disabilities (PwIDs) represent one of the most marginalized populations in India, requiring holistic support systems that encompass education, healthcare, skill development, livelihood, and social integration. Historically, institutional care models dominated India’s rehabilitation framework, primarily focusing on providing shelter, protection, and structured routines. However, over the past three decades, the emergence of Community-Based Rehabilitation (CBR), aligned with the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD, 2006) ^[2] and the Rights of Persons with Disabilities (RPwD) Act, 2016, has reshaped disability care. This paradigm shift emphasizes inclusion, empowerment, and dignity, making it critical to evaluate the comparative outcomes of these two approaches.
Objective: The study aims to conduct a comparative analysis of institutional care and community-based rehabilitation (CBR) models for PwIDs in India. The goal is to examine their effectiveness in improving independent living, social inclusion, family involvement, skill acquisition, employment opportunities, quality of life, and rights protection.
Methods: This research adopts a qualitative comparative review based on policy documents, statutory frameworks, and secondary literature. Data sources include the RPwD Act (2016), National Trust Act (1999), WHO CBR Guidelines, NALSA annual reports, NSSO survey findings, and peer-reviewed studies. A comparative framework was designed to analyze five core dimensions:

· Independence and daily living skills

· Social participation and inclusion

· Cost-effectiveness and sustainability

· Quality of life and personal dignity

· Alignment with a rights-based approach as per UNCRPD standards.

Results: The findings reveal significant contrasts between the two models. Institutional care ensures safety, structured supervision, and medical management, particularly for individuals with severe or profound disabilities. However, it often results in segregation, dependency, and limited opportunities for community engagement. In contrast, CBR models demonstrate higher success in fostering independence, vocational integration, peer participation, and family empowerment. CBR’s cost-effectiveness and sustainability make it a more viable solution for rural and resource-constrained settings. Nonetheless, challenges persist, including resource gaps, lack of trained personnel, and uneven implementation across states.
Conclusion: The study concludes that CBR is more effective and sustainable than institutional care in promoting independence, dignity, and social inclusion for PwIDs in India. However, institutional care continues to play a crucial role for individuals requiring intensive, round-the-clock support. Therefore, an integrated hybrid model leveraging institutional expertise alongside community-driven rehabilitation is essential to meet the diverse needs of persons with intellectual disabilities. A coordinated policy framework, adequate funding, family participation, stakeholder capacity-building, and localized service delivery are imperative to achieve inclusive development and full compliance with the RPwD Act and UNCRPD obligations.