Want to generate your own paper instantly?
Create papers like this using AI — craft essays, case studies, and more in seconds!
Implementational Effectiveness of Ayushman Bharat on Rural Healthcare in Rajasthan
1. Introduction
1.1 Background of Ayushman Bharat
Ayushman Bharat, launched in 2018 under the National Health Policy 2017, is India’s flagship scheme aimed at achieving Universal Health Coverage through two pillars: Health and Wellness Centres and Pradhan Mantri Jan Arogya Yojana (PM-JAY). The latter provides cashless secondary and tertiary care hospitalization cover up to ₹5 lakh per family per annum for the bottom 40% of the population (National Health Authority [NHA], n.d.-a).
1.2 Rural healthcare challenges in Rajasthan
Rural communities in India face severe shortages in qualified medical personnel, infrastructure deficits, and high out-of-pocket expenditures. In Rajasthan’s villages, where residents often travel over 100 km for care, nearly 90% lack insurance and rely on out-of-pocket payments, leading to significant financial and access barriers (Player, 2019).
1.3 Objectives of the literature review
This review examines the implementation effectiveness of Ayushman Bharat in rural Rajasthan by assessing policy frameworks, enrollment trends, impacts on health outcomes and expenditures, and identifying strengths, gaps, and comparative insights to inform future policy and research.
2. Theoretical Background
2.1 Health policy implementation frameworks
PM-JAY employs flexible implementation models—assurance/trust, insurance, or mixed—allowing states like Rajasthan to tailor operations. Financial risk under the trust model is borne by the government, while under the insurance model, risk and profit limits are shared between state authorities and insurers (NHA, n.d.-a).
2.2 Socioeconomic determinants of healthcare access
Poverty, low literacy, and cultural factors influence rural healthcare utilization. Financial hardship forces many to sell assets or incur debt for care. Misconceptions and limited health literacy further delay care-seeking, contributing to underutilization of available services despite PM-JAY’s benefits (Player, 2019).
3. Key Findings
3.1 Coverage and enrollment trends in Rajasthan
While PM-JAY targets over 12 crore families nationally, state-specific enrollment data for Rajasthan are limited in available sources. The scheme’s eligibility relies on Socio-Economic Caste Census criteria, with central-to-state funding shared 60:40 in states like Rajasthan (NHA, n.d.-a).
Note: This section includes information based on general knowledge, as specific supporting data was not available.
3.2 Impact on health outcomes and out-of-pocket expenditure
Evidence suggests continued high out-of-pocket payments and awareness gaps. In rural Maharashtra, patients report unclear services and resort to private insurance when PM-JAY access fails (IndiaSpend, 2025). Among cancer patients in rural Jodhpur, 31% discontinued treatment, citing financial burden, misconceptions, and lack of screening awareness (“Health Seeking Behaviour among Cancer Patients…,” n.d.).
4. Evaluation
4.1 Strengths of program implementation
PM-JAY’s key strengths include a generous ₹5 lakh cover, cashless care at empaneled hospitals, portability across states, no family size limit, and inclusion of pre-existing conditions from day one, enhancing financial protection for rural families (NHA, n.d.-a).
4.2 Identified gaps and challenges
Low awareness and complex admission processes hinder utilization. Beneficiaries frequently incur unauthorized payments, and delayed reimbursement to hospitals undermines participation, risking service delivery in remote areas (IndiaSpend, 2025).
4.3 Comparative insights from other states
States like Tamil Nadu and Kerala demonstrated improved rural healthcare through early e-health systems—Health Management Information Systems and unique patient IDs—that streamlined records and referrals well before national rollout (Velan et al., 2024).
5. Conclusion
5.1 Summary of key insights
PM-JAY’s financial safeguards offer substantial potential for rural Rajasthan. However, enrollment data remain opaque, and persistent barriers in awareness, service clarity, and provider reimbursement weaken impact.
5.2 Policy recommendations
To enhance effectiveness, targeted outreach through ASHAs, NGOs, and Aarogya Mitras is critical to raise scheme awareness. Streamlining admission protocols and accelerating claim settlements will bolster hospital participation in rural districts (IndiaSpend, 2025).
5.3 Future research directions
Future studies should generate state-level enrollment and health outcome metrics, assess service utilization patterns in Rajasthan’s districts, and evaluate long-term financial protection among rural beneficiaries.
References
Health Seeking Behaviour among Cancer Patients with the aid of Geographic Information System: A Mixed-Methods Study from Western India. (n.d.). PubMed. https://pubmed.ncbi.nlm.nih.gov/40542783/
IndiaSpend. (2025, August 21). Low awareness, unclear services and out-of-pocket expenses are affecting patients seeking care, even as hospitals grapple with delayed payments. IndiaSpend.
National Health Authority. (n.d.-a). About Pradhan Mantri Jan Arogya Yojana (PM-JAY). https://nha.gov.in/PM-JAY
Player, J. (2019). Healthcare Access in Rural Communities in India. Ballard Brief. https://ballardbrief.byu.edu/issue-briefs/healthcare-access-in-rural-communities-in-india
Velan, D., Mohandoss, H., Valarmathi, S., Sundar, J. S., Kalpana, S., & Srinivas, G. (2024). Digital health in your hands: A narrative review of exploring Ayushman Bharat’s digital revolution. World Journal of Advanced Research and Reviews, 23(03), 1630–1641. https://doi.org/10.30574/wjarr.2024.23.3.2762