INTRODUCTION

India’s GDP was estimated to have increased 6.6 per cent in 2017-18 and was expected to grow 7.3 percentin 2018-19. With approximately 1.33 billion population, India has a huge rural urban population divide with almost 70% of the population living in rural area. With such a large proportion of population still residing in rural India, it faces a dual health care problem of communicable and non communicable diseases. Some of the reasons for increased morbidity In India are lack of access and poor quality of medical treatment and huge out of pocket expenditure ranged from a thousand rupees to crores of rupees. [1]

The divide can be seen in the data provided by the Indian Consumer 360 Survey which details that an Indian spends Rs.9,373 annually on medical expenses. The consumer living in rural area spent Rs. 6,371 annually while those living in Urban area spent Rs. 11,387 on medical expenses. In India, around 6% do not seek health care due to financial reasons, [2] and about 30% of the rural population did not avail any medical services and the reason given was financial constraint. Even in the WHO report it is highlighted that because of high OOP expenditure 3.2% of Indians fall below poverty line. [3]

Several steps have been taken by Government of India in accordance with the National Health Policy 2017 to ensure Universal Health Coverage mainly through health insurance and increasing government health expenditure as percentage of gross domestic product from current 1.15% to 2.5% by 2025. [4] Insurance Regulatory and Development Authority (IRDA) documented that in the year 2017 about 76% of Indians do not have a health insurance. The Government of India announced an Ayushman Bharat Yojana- National Health Protection Scheme (AB-NHPM) in the year 2018 that was rolled out across all states/UTs in all districts of the country. The aim of this programme is to providing a service to create a healthy, capable and content new India and it has two goals: 1. To creating a network of health and wellness infrastructure across the nation to deliver comprehensive primary healthcare services; 2. To provide health insurance cover to at least 40% of India's population which is deprived of secondary and tertiary care services. Under this scheme all types of medical treatments are being provided except organ transplantation for those eligible families. [5-7]

This scheme will cover poor below poverty line (BPL) families, deprived rural families and identified occupational category for urban families as per 2011 Socio-Economic Caste Census (SECC) data. The Ayushman Bharat–National Health Protection Mission (AB-NHPM) will cover about 10 crore poor and vulnerable families (approximately 50 crore beneficiaries) providing coverage up to 5 lakhrupees per family per year for secondary and tertiary care hospitalization.The benefit cover will also include pre and post-hospitalisation expenses and there will be no restriction on the size and age of the covered beneficiary family. The payment for medical treatment will be made on the basis of approved package rate, (as defined by the Government) basis. The package rates include all costs associated with treatment and transactions of money to the beneficiary is paperless and cashless. The beneficiaries can avail benefits in both public and empanelled private hospitals. The estimated cost for the scheme is about Rs.250 billion over 2018-19 and 2019-20 years for both centre and states. This scheme covers poor below poverty line (BPL) families, deprived rural families and identified occupational category for urban families as per 2011 Socio-Economic Caste Census (SECC) data. This scheme covers over 10 crore families (approx. 50 crore citizens) across the country with a health insurance coverage upto 5 lakh rupees per family per year for secondary and tertiary care hospitalization. [5-7]

Since Ayushmann Bharat, is flagship programme of Government of India and much publicized but how much detail has been translated to the ground level has not been documented. Also, the earlier scheme like RSBY had not taken off as expected. Hence, a study was conducted to assess general awareness about AB-PMJAY scheme among patients coming to Outpatient department at AIIMS, New Delhi.