India is one of the developing country in the world having 1.

3 billion population, of which 66% of

population resides in rural area and 34% resides in urban area. According to World Health Organization
(WHO), Universal Health Coverage (UHC) is to enable all people and communities to use promotive,
preventive, curative, rehabilitative, and palliative health care services they need, of sufficient quality to be
effective, while also ensuring that the use of these services does not expose the user

India stands as a developing nation with a vast population of 1.3 billion, where 66% of people live in rural
areas and 34% in urban areas. The World Health Organization (WHO) defines Universal Health Coverage
(UHC) For India as the provision of accessible, high quality healthcare services, encompassing
promotive, preventive, curative, rehabilitative, and palliative care, with the additional emphasis on
ensuring that utilizing these services doesn't pose a financial burden on the users to financial hardship. It
incorporates equity in access, quality, and financial risk protection.

A significant portion of both urban and rural populations in India manage their health expenses By
resorting to bank loans or selling their assets. The 2014 World Health Organization (WHO) health profile
report highlighted that due to high out of pocket expenditures, 3.2% of Indians annually fall below the
poverty line, with 3/4 of the population spending their entire income on healthcare and medicines.To
address the issue and promote Universal Health Coverage (UHC), The Indian government introduced the
comprehensive healthcare scheme “ Ayushman Bharat, “ consisting of two main components: Pradhan
Mantri Jan Arogya Yojana (PMJAY) and Health and Wellness Centers (HWCs). PMJAY, A publicly
funded health insurance initiative, targets socioeconomically deprived rural and specific urban
occupational categories. It aims to cover 100 million households, approximately 500 million people,
constituting around 40% of the total population. Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana
(AB-PMJAY) was launched by the Prime Minister, Shri Narendra Modi on 23rd September, 2018 at
Ranchi, Jharkhand.

The PMJAY Benefits package offers cashless treatment up to ₹5,00,000 annually per family on a family
floater basis. The scheme encompasses about 1350 medical and surgical procedures, covering almost all
secondary and a significant portion off tertiary care procedures and includes the treatment of major
illnesses like cancer, dialysis, etc. Beneficiaries can access free services from either public hospitals or
empaneled private hospitals, with coverage extending to pre-existing diseases, and hospitals are
prohibited from charging any fees.

The implementation of the PMJAY scheme is authorized by state governments, allowing them to continue
existing programs concurrently with the national program or align them with the new scheme.

To address the surge in chronic non communicable diseases such as hypertension and diabetes, Ayushman
Bharat is working to enhance the healthcare system by incorporating traditional medical practices
alongside allopath at Public Health Centers (PHCs). As a health insurance initiative, it stands as a
dependable approach to offer financial protection to enrolled families. Given the novelty of this scheme,
limited awareness exists prompting this study to explore its coverage, utilization, and overall impact.

Study design
This is a community based cross-sectional study.

Study area and population

The survey based study was conducted in the urban area of Maldahiya and rural area of Shivpur in
Varanasi. Simple random sampling was used to select the households. After obtaining consent, the head of
the family or in his/her absence the eldest adult in the households were taken as respondents. Sample of
thirty households are taken and the households constitute of the general population and not the
beneficiaries.

Inclusion criteria

The study includes all the households selected through sampling method.

Exclusion criteria

The individuals who did not give consent or the households which did not have any member above 18
years or the households that was locked at the time of survey were excluded from the study and the next
house fitting the inclusion criteria was selected.

Study period
The study was carried out during the period of December 2023 and January 2024.

Data analysis
Data entry was done and the descriptive statistics were presented in graphs.

Ethical approval and informed consent

The study proposal was approved by the CMO Office, Varanasi and Informed consent was obtained from
all the study participants before administering the study questionnaire.

Result
This study is conducted to estimate the coverage, and impact of Ayushman Bharat Scheme in the rural and
urban areas of Varanasi among 30 households. The findings are described below using graphs.
FINDINGS

From this study it was found that among 30 households, 93.27% of the households were aware of
Ayushman Bharat scheme. 54.74% households have been covered under the scheme while 45.26% of the
households were not covered under the scheme. Amongst the beneficiaries, 42.33% are females and
57.67% are males. Lack of awareness and knowledge about Ayushman Bharat scheme plays a key role in
the households not covered under Ayushman Bharat. In this study it was found that, among the
households covered under Ayushman Bharat scheme (30), 47.24% of the households availed the scheme
in the past 1 year.

Utilization and impact of Ayushman Bharat scheme among who is covered under
the scheme

It is found that 47.24% of them who are covered under Ayushman Bharat scheme has availed the scheme
in the past 1 year while 52.76% of them who are covered under Ayushman Bharat scheme has not availed
the scheme in the past 1 year. Among the families availed Ayushman Bharat scheme in the past 1 year,
about 16.67% of them availed for medical conditions, 51.66% of them availed for surgical conditions and
31.67% availed for both medical and surgical conditions.