Awareness, Perception, Utilization, and Challenges of Ayushman Bharat-Pradhan Mantri Jan Arogya Yojana Among Peri-Urban Residents of Kanpur, Uttar Pradesh: A Community-Based Cross-Sectional Study

BackgroundAyushman Bharat-Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) is the world's largest publicly funded health assurance scheme aimed at reducing catastrophic health expenditure and improving access to secondary and tertiary healthcare services among economically vulnerable populations.Despite its wide coverage, awareness and utilization of the scheme vary across regions of India.This study aimed to assess the awareness, perceptions, utilization, and challenges related to AB-PMJAY among peri-urban residents of Kanpur and to identify factors associated with awareness of the scheme. MethodsA community-based cross-sectional study was conducted among 214 adults residing in the peri-urban areas of Mandhana and Chaubeypur, Kanpur, Uttar Pradesh.A multistage random sampling technique was used for participant selection.Data were collected using a pretested semi-structured questionnaire through faceto-face interviews.Awareness regarding PM-JAY was assessed using a composite awareness score.Data were analyzed using jamovi Version 2.3.18(The jamovi project (2023); retrieved from https://www.jamovi.org).Descriptive statistics were expressed as frequencies and percentages, and the chi-squared test was applied to determine associations.A p-value of <0.05 was considered statistically significant. ResultsAmong the 214 participants, 127 (59.3%) demonstrated good awareness regarding AB-PMJAY.The highest awareness was observed regarding ₹5 lakhs annual family coverage (75.7%), whereas awareness regarding post-discharge benefits was very low (3.7%).Among the eligible participants, 77.3% had obtained PM-JAY cards; however, only 45.1% had utilized PM-JAY services.Out-of-pocket expenditure despite PM-JAY utilization was reported by 39.1% of PM-JAY users, and 26.1% experienced delays in healthcare services.Educational status and possession of a ration card were significantly associated with awareness of PM-JAY.Most participants expressed a positive perception of the improvement in healthcare access under PM-JAY. ConclusionThe study found moderate awareness and good enrolment regarding AB-PMJAY among peri-urban residents; however, actual utilization remained suboptimal.Significant gaps existed in the awareness of specific scheme benefits, particularly post-discharge benefits and family coverage provisions.Strengthening community-based awareness activities and addressing implementation-related barriers such as out-ofpocket expenditure and service delays may improve effective utilization of AB-PMJAY services.Education status and possession of ration cards were significantly associated with awareness.