CHAPTER-1

CHAPTER-1

INTRODUCTION
BACKGROUND OF THE STUDY

The Pradhan Mantri Jan Arogya Yojana [PM-JAYJ] is a part of Ayushman Bharat Yojana which is a health
insurance initiative introduced by Prime Minister Narendra Modi on 23 September 2018 at Rachi Jharkhand.
The program launched by the Ministry of Health and Family welfare [WHFW] in September 2018 part of
the national Health Policy of the country.

Ayushman Bharat Pradhan Mantri Jan Arogya Yojana [ABPMJAY] is the world’s largest. Government
funded healthcare coverage for 50 crore people in India up to 5 lakh rupees per family per year.

Pradhan Mantri Jan Arogya Yojana [PMJAY] covers medical care and hospitalisation expenses for
secondary and tertiary care procedures, including surgeries, treatment for serious illness and pre-existing
disease.

At the National level, the National Health Agency [ NHA] has registered societies under the societies
registration. Act 1860, to implement the scheme. The National Health Agency is responsible for all
operational matter of Pradhan Mantri Jan Arogya Yojana, from 2015 – 16 to 2019 – 2020, infant mortality
rate was decline by 12% that did not adopt the Pradhan Mantri Jan Yojana and by 20% in those that adopted
it. The mortality rate for children under 5 years of age has reduced by 14% and similarly the sates that
adopted it have seen a 19% reduction. This means that Pradhan Mantri Jan Yojana has improved various
care of mother and their Childrens. It covers 3 days of pre-hospitalization including diagnostic tests and
treatment well as expenses on medicine. Private hospital will also give the benefits of the scheme to eligible
candidates. So far, 28301 hospitals have joined the scheme. It will provide cashless and paperless service to
the beneficiary at the point of services. The 75th round of the National Sample Survey Organization [NSSO]
found that 85.9% of rural households and 22% urban households do not have access to health insurance.

Opportunities of ABPMJAY-

 As the program has received widespread public and media attention, implementation will be
expedited.
  Government hospitals lacking infrastructure will also compromise the goal of ensuring affordable
and accessible health care.
 Generated and analyses real-time data a further strengthen. The experience existing plans Rashtriya
Swasthya Bima Yojana [RSBY] and gained from other such schemes can be used for faster
development.
 Greater care system potential to strengthen the entire health.

Ayushman Bharat hospital list in Lakhimpur Kheri-

The list of all enrolled government and private hospital and CHC under Pradhan Mantri Jan Arogya Yojana
scheme in Lakhimpur Kheri are private hospitals :- Ayush nursing home, Anupam nursing home, DR.
Shroffs charity eye hospital, Mohan eye care hospital, Nice nursing home, Saluja nursing home, Shiv Lok
hospital, Srajan hospital, SS hospital, One beat hospital, Umaprabha Netrataya, Tandan eye hospital, DR.
SK Majumdar clinic, Chandrani hospital, Shri Raghunath ji hospital, CHC Gola, CHC Palia, CHC
Bankeyganj, CHC Padgawan, CHC Phoolbehar, CHC Bijua, CHC Mitauli, CHC Nakaha, CHC Hardhan,
CHC Behjam, CHC Dhaurahra, CHC Khamaria, CHC Ramya behara, CHC Nighasan, CHC Mohamadi.

 In government hospital district male and female.

Key features of Pradhan Mantri Jan Arogya Yojana-

 Pradhan Mantri Jan Arogya Yojana is the largest medical insurance in the world that is sponsored by
the Indian government.
 This scheme covers 1,393 procedures that include the treatment charge room bill, doctor fees,
operation theatre, diagnostic test, surgery, intensive care unit charges also.
 Under this scheme to provide facilities 3 days pre- hospitalization and 15 days after hospitalization
including all drugs and laboratory tests.
 The treatment provided in both public and private enrolled hospitals in India.
 Provide both secondary and tertiary care hospitalization provide cashless hospitalization treatment to
beneficiaries.
 Pradhan Mantri Jan Arogya Yojana has not any restrictions regarding family size, age, gender this
scheme covers the existing diseases.

These benefits are available any enrolled public and private hospital and you can benefit the cashless and
paperless treatment.
 NEED FOR STUDY

Pradhan Mantri Jan Arogya Yojana [PMJAY] is scheme that launched by the prime minister on 23
September 2018. Main objective of the scheme to provide financial protection to weaker section of the
society who need health care facilities and who cannot afford the high cost of the treatment. It is largest
health care programme, offering services to 50 crore [500 million] people for the treatment and
hospitalizations.

India is the one of the developing Country in the world having 1.3 billion population of which 66% of
population lived in rural areas and 34% lived in urban areas according to WHO Universal health coverage is
allows all people and communities to use promotive, prevention, curation, rehabilitative and palliative health
care services regarding their needs.

While use of these services does not expose the uses financial hardship. The health profile data report
release by the WHO in 2014. Some state that in India because of high-cost expenditure annually about 3.2%
Indians fall below the poverty line and also 3 rd and 4th losing their whole income on obtaining health care &
take drugs.

To identify & enrol eligible and beneficiaries of despite efforts there have been representative care of
exclusive errors, where eligible individual have been rules out from the scheme due to this logistical or
executive issues. These exclusion errors is necessary to ensure that all eligible individual can reach to the
benefits or advantage of Pradhan Mantri Jan Arogya Yojana.

LANGUAGE AND CULTURAL BARRIERS :

It may be obstruct effective communication of information about the Pradhan Mantri Jan Arogya Yojana
scheme, leading to misunderstanding to participate among some communities it is important to implement
communication strategies to diverse cultural and communication concept to leading all eligible beneficiaries.

The effective and significant barriers to the implementation of a Pradhan Mantri Jan Arogya Yojana is
inappropriate health care infrastructure, particularly in rural and remote areas, lack of many health-care
facilities, medical facilities, trained and educated staff for deliver quality care and lack of essential
equipment or articles.

The scheme covers up to Rs 5 lakhs in free treatment at state government and private hospitals at state
government and private hospitals. The government of India also cover up to 15 days of hospital costs.

The critical illness coverage under Pradhan Mantri Jan Arogya Yojana includes medical conditions

such as:-

 Cancer
 Burn injury
 Heart disease
 Liver disease
 Mental disease
 Kidney disease
 Respiratory disease
 Neurological disease

We identify the whole knowledge about the scheme Pradhan Mantri Jan Arogya Yojana and We identify the
whole what are the benefits of this scheme in the rural areas and to identify eligible people and create
awareness among people residing the scheme Pradhan Mantri Jan Arogya Yojana.

 There is no awareness about Pradhan Mantri Jan Arogya Yojana scheme is some people.
 People rural areas have some trust issues regarding the Pradhan Mantri Jan Arogya Yojana scheme.
 There is not any proper implementation of this Pradhan Mantri Jan Arogya Yojana scheme at
ground level as there are so many beneficiaries who are eligible but they don’t know the process
how to make the Pradhan Mantri Jan Arogya Yojana card.

Ayushman Bharat Pradhan Mantri Jan Arogya Yojana is one of the ambitious program planned to provide
financial support to people benefit of secondary and tertiary level health care this program has been started
in few years ago so some people are not aware, special in rural communities this study was planned to
expand the awareness and implementation of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana.
 STATEMENT OF THE PROBLEM

“A DESCRIPTIVE STUDY TO ASSESS THE KNOWLEDGE AND ELIGIBILITY OF AYUSHMAN

BHART PRADHAN MANTRI JAN AROGYA YOJANA AMONG SOME SELECTED
COMMUNITIES’’.

OBJECTIVES OF STUDY

 To identify eligible people of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana.
 To assess their knowledge regarding Ayushman Bharat Pradhan Mantri Jan Arogya Yojana.
 To educate the people about Ayushman Bharat Pradhan Mantri Jan Arogya Yojana.
 To find association between knowledge regarding Ayushman Bharat Pradhan Mantri Jan Arogya
Yojana of selected demographic variables such as- Age, Occupation, Locality, Monthly income.

OPERATIONAL DEFINITION

ASSESS:

In this study assess refers to the process of evaluating the knowledge and eligibility of people
regarding Ayushman Bharat Pradhan Mantri Jan Arogya Yojana.

KNOWLEDGE:

In this study knowledge refers to the awareness of people regarding Ayushman Bharat Pradhan
Mantri Jan Arogya Yojana.

ELIGIBILITY:

In this study eligibility refers to how many peoples are qualify or suitable for benefiting this
scheme Ayushman Bharat Pradhan Mantri Jan Arogya Yojana.

AYUSHMAN BHARAT PRADHAN MANTRI JAN AROGYA YOJANA:

 Ayushman Bharat Pradhan Mantri Jan Arogya Yojana is a scheme that was launched by the
prime minister on 23rd September 2018. That is provide financial support to weaker section of the society,
who cannot afford the high cost of treatment. If aims to provide free health coverage of up to 5 Lakh per
year per family over 10.75 crore people. This scheme is the world’s largest government funded health care
program.

ASSUMPTIONS

A1: Most of the rural community members may not have adequate knowledge regarding Ayushman Bharat
Pradhan Mantri Jan Arogya Yojana.

A2: There may be many people who are eligible for Ayushman Bharat Pradhan Mantri Jan Arogya Yojana.

A3: Many people may come forward to avail the benefits of Ayushman Bharat Pradhan Mantri Jan Arogya
Yojana.

HYPOTHESIS

H1: Many people in villages are eligible of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana.

H2: Many people in villages are not having adequate knowledge on Ayushman Bharat Pradhan Mantri Jan
Arogya Yojana.

H3: There is significant association between knowledge on Ayushman Bharat Pradhan Mantri Jan Arogya
Yojana with its selected demographic variables.

VARIABLES

 Dependent variables- knowledge regarding Ayushman Bharat Pradhan Mantri Jan Arogya Yojana.
 Independent variables- Survey regarding Ayushman Bharat Pradhan Mantri Jan Arogya Yojana.
 Demographic variables- Age of the person, Locality of the person, Monthly income of the person,
Occupation of the person, family with no male members age [16-60].

INCLUSION CRITERIA
  Families without any male members [16-59 years].
 Landless households.
 Monthly income less than Rs.10,000.
 People with red card, white card, PM letter.
 The study participants will be both male and female those who are willing to participate in this study.

EXCLUSION CRITERIA

 Those people who are in government job.

 Monthly income more than Rs. 10.000.
 Those who are not willing to give consent for including in the study.

DELIMITATIONS OF THE STUDY

1. The study is limited to

2. The study is limited to sample size of 150.

PILOT STUDY

CONCEPTUAL FRAMEWORK OF THE STUDY

The conceptual framework is a group of related ideas, statement or concepts. The term conceptual model is
often used to interchangeable with conceptual framework and sometimes with grand theories that articulate a
board range of the significant relationship among the concepts of a discipline.

Following the demographic variable over which the study is based. These are described as follows-

1. Gender- Gender refers that whether both men and women can be enrolled under Ayushman
Bharat Pradhan Mantri Jan Arogya Yojana or not, so both gender can be enrolled.
 2. Income- Income refers that whether there is a specific limitation of income, so the families
having monthly income under 10,000 can be enrolled under Ayushman Bharat Pradhan Mantri
Jan Arogya Yojana.
3. Social group- This Yojana is available for both urban and rural groups.
4. Geography- The area we have selected is Behajam block, Lakhimpur Kheri, Uttar Pradesh.

ENROLLMENT

Those families who fulfil the criteria of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana, and fulfilling
all the demographic variables can be enrolled under Ayushman Bharat Pradhan Mantri Jan Arogya Yojana
and those who are not fulfilling the criteria cannot be enrolled.

UTILIZATION

Utilization refers that Ayushman Bharat Pradhan Mantri Jan Arogya Yojana can be utilized or used in which
sectors, because all the government schemes are not applicable on private sectors and on semi government
sectors but the Ayushman Bharat Pradhan Mantri Jan Arogya Yojana can be utilized in both public and
private sectors.

Public sector- Ayushman Bharat Pradhan Mantri Jan Arogya Yojana can be utilized under all government
funded hospitals. Those people having Ayushman card can get free treatment of certain medical conditions.

Private sector- Ayushman Bharat Pradhan Mantri Jan Arogya Yojana can also be utilized under all private
and semi government hospitals. These hospitals also no offering free treatment of certain medical
conditions.

FINANCLAL RISK PROTECTION

Financial risk protection define as households’ access to needed healthcare services without experiencing
undue financial hardship, is a critical health system target, particularly in low- and middle-income area.
Nowadays, cost of treatment is rising very high and people with low income are dealing with this problem
so to treat this problem government has launched this scheme Ayushman Bharat Pradhan Mantri Jan Arogya
Yojana.

1. Out of pocket expenditure out of refers that the extra percentage of treatment a patient has to
give after enrolling the free treatment.
2. Catastrophic health expenditure.
It refers the financial burden which the community is facing and it is impossible for them to
avail the treatment that’s why government has launched this scheme Ayushman Bharat
Pradhan Mantri Jan Arogya Yojana for helping these peoples.