Role of awareness, support systems, and sociodemographic factors in determining utilization of Ayushman Bharat Pradhan Mantri Jan Arogya Yojana among beneficiaries in Gujarat, India

Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), the carefully designed health insurance scheme for about 107.4 million of the poorest and most vulnerable Indian families, has the potential to address their secondary and tertiary health care needs. However, there is wide variation in the uptake of this program across geographical and socio-demographic landscapes which limit equitable access to healthcare. This study examined how socio-demographic variables, awareness levels among potential beneficiaries, and community-level support mechanisms in three districts of Gujarat, India, influence utilization trends of AB-PMJAY. Building on these objectives, the researchers conducted a community-based cross-sectional study among 1,152 eligible beneficiaries selected through multistage random sampling from three districts of Gujarat. Data on awareness, enrolment, support systems, and PMJAY utilization were collected using structured interviews. Binary logistic regression analysis was performed among 588 beneficiaries who required hospitalization or treatment to identify independent predictors of PMJAY utilization. Among beneficiaries requiring hospitalization or treatment, higher awareness and stronger community support systems were independently associated with significantly greater utilization of AB-PMJAY services, whereas socio-demographic characteristics were not significant predictors after adjustment. These findings highlight the importance of information dissemination and local support mechanisms in improving effective utilization of the scheme. The study identifies specific policy actions needed to improve AB-PMJAY utilization: increase beneficiary awareness, strengthen community support systems, and community-based implementation support to improve equitable access to healthcare.