A quasi-experimental study to assess the effectiveness of planned teaching program on knowledge regarding Ayushman Bharat Yojana among community people in Panchayatan village, Greater Noida, Uttar Pradesh

INTRODUCTION

Ayushman Bharat is a holistic solution for a healthy India-PM Narendra Modi. The universal health care project Ayushman Bharat’s major goal is to expand access to basic, secondary, and tertiary healthcare in India. It also aims to increase both the affordability and accessibility of these services.¹

To aid economically disadvantaged families, the Indian government launched the Ayushman Bharat Yojana, commonly known as the Pradhan Mantri Jan Arogya Yojana (PMJAY), in September 2018.² According to the World Health Organization, universal health coverage (UHC) is an idea that enables people and communities to have secure access to the preventive, therapeutic, rehabilitative, and supportive health services they need. The overarching principle of Ayushman Bharat is that flexibility and cooperative federalism are the characteristics of a state.³

Rastriya Swasthya Bima Yojana (RSBY) and the Senior Citizen Health Insurance Scheme (SCHIS) are two on-going, centrally financed health insurance programs that will be used to implement the Ayushman Bharat Yojana-National Health Protection Scheme (AB-NHPM). The underprivileged and marginalized segments of the population who could not offered both tertiary and secondary could get financial aid from this insurance program.⁴

More than 10.74 million poor and vulnerable households are beneficiaries of India’s government-funded health care program, Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY). The Pradhan Mantri Jan Arogya Yojana (PMJAY), while beneficial to combat state disparities in health care spending, has not been able to fully make up for the poorer states’ inadvertent economic challenges.⁵ This initiative was developed to accomplish the sustainable development goals (SDGS) and its unquestioning promises, which is to “leave no one behind”. Ayushman Bharat represents a shift away from a sectoral and fragmented approach to a comprehensive, tailored system of healthcare. The Ayushman Bharat Yojana is broken into two primary phases in order to accomplish the objectives. The first two are health and wellness centres, while the second is the national health protection scheme.⁶

On the occasion of Independence Day 2018, Indian prime minister honourable Narendra Modi announced the launch of his ambitious universal social health scheme, ‘Ayushman Bharat’, from red fort, the capital of New Delhi. The Ayushman Bharat health care scheme has been introduced with the intention of providing affordable healthcare to an estimated 200,000 people. There are 500 million economically poorer Indian citizens.⁷

The health care initiative’s main goal is to lessen the economic strain placed on the poor and vulnerable populations as a result of an unexpected need for medical treatment or hospitalization brought on by an accident or other acute reasons. The scheme aims to provide affordable healthcare services to the needy around the world. Four out of every five Indian citizens are financially poor and are often under financial strain as a result of a medical crisis.⁸

Ayushman Bharat- Pradhan Mantri Jan Arogya Yojana (PM-JAY) has the following characteristics:

The plan intends to reach about 500 million Indians. It provides around 1350 hospital services, covering surgery, surgical and day care services, medication and diagnostics costs, as well as a hospitalization fee of up to Rs. 50,000 per month. To those who are eligible, 5,00,000 per family per year is provided.⁹

The program does not necessitate formal enrolment or registration. There are no restrictions on the size of the family or existing illnesses under the plan. All public and accredited private hospitals in India are eligible to use the program’s benefits for tertiary care as well as secondary hospitalization.

The entitlement to the scheme is based on the socio-economic caste census (SECC) 2011 data that showed who the impoverished were, deprived rural families approximating to around 10.74 crores and also certain occupational category of urban worker’s families. The families enrolled under the scheme of Rastriya Swasthaya Bima Yojana (RSBY) which were not covered under SECC data have also been included in the scheme.¹⁰

An easy way to assess the eligibility has been included. Individuals can check their eligibility by visiting www.mera.pmjay.gov.in or calling the toll-free number 14555.

In furthermore, the government has laid out necessities for the clan families who will not be eligible for program benefits. Homes with a motorized 2/3/4-wheeler or fishing boat, automated three- or four-wheeled agricultural equipment, and farmers with a kisan credit card with a credit limit of more than Rs. 20,000 are a few examples of these. A family member is regarded as a government employee if they make more than Rs. 50,000 annually, paying revenue taxation or professional taxation, owning a home with three or more rooms with pucca walls and roof, having a refrigerator and a landline phone, and having more than 2.5 acres of property that is irrigated with one irrigation system, among other things.⁶ 12 million individuals in the western Pacific region lost their lives to NCDs in 2019.

Despite improvements in lowering NCD-related premature mortality from 2000 to 2010, progress in several nations over the past ten years has been undone by new risk factors and shifting environmental conditions.⁷

More than 1 lakh beneficiaries have been served by the scheme, which includes more than 14,000 empanelled hospitals, within a month of its inception.

The goal of this study was to inform the residents of Panchayatan Village in Greater Noida about the Ayushman Bharat Yojana. With the help of this scheme many people and their family members of this village can register themselves. Whenever needed, people can avail of its benefits and utilize the scheme.

Objectives of the study

To assess the level of knowledge regarding Ayushman Bharat Yojana among community people in Panchayatan village, Greater Noida, Uttar Pradesh. To evaluate the effectiveness of planned teaching program on knowledge regarding Ayushman Bharat Yojana among community in Panchayatan village, Greater Noida, UP. To find out association between level of knowledge regarding Ayushman Bharat Yojana with selected demographic variables among community people in Panchayatan village, Greater Noida, UP.

METHODS

Research approach

The research approach selected for present study was the quantitative research approach.

Research design

In this study a quasi-experimental (one group pre-test and post-test) research design is used to assess the effectiveness of knowledge regarding Ayushmann Bharat scheme among people of Panchayatan village greater Noida, Uttar Pradesh.

Research setting

This study was conducted at Panchayatan village of Greater Noida, Uttar Pradesh.

Sample size

The samples for present study were 59 people of Panchayatan village, Greater Noida.

Inclusive criteria

People of Panchayatan village, Greater Noida. Participants who all were willing to participate in the study. People available at the time of data collection. Participants who can read and write Hindi and English.

Sampling technique

In this study convenience sampling technique was used.

Description of the tool

Tool consists of part A and Part B.

Part A: socio demographic variables

The socio demographic variables included in the study are age, religion, gender, educational, marital status, family income, housing, previous knowledge and source of information.

Part B: self-structured questionnaire on Ayushmann Bharat Yojana

Self-structured questionnaire was developed to assess the level of knowledge regarding Ayushmann Bharat Yojana. The questionnaire consists of 20 questions. Researcher have interviewed the participants using self-structured questionnaire. Score was given as 1 for each correct answer and 0 for every wrong answer.

Pilot study

After obtaining the formal ethical permission from the committee of SSNSR, Sharda University, Greater Noida, the pilot study was conducted from 22 February 2023 to 29 February 2023. 11 people from Rauni village were selected for the study. Pre-test was conducted on 22 February 2023 by using self-structured knowledge questionnaire. The average time taken by each person to fill the questionnaire was 10 to 15 minutes. Post test was conducted after one week of intervention further study i.e., on 29 February 2023. Investigator proceeded with the actual data collection for the main study.

Reliability of the tool

Reliability of structured knowledge questionnaire was assessed by using Cronbach’s alpha which was found to be 0.96.

Ethical consideration

The ethical Clearance was obtained from ethical committee Sharda University, Greater Noida prior to the commencement of data collection and is as listed below:

Data collection procedure

After attaining ethical permission from Sharda School of Nursing Science and Research, Sharda University, samples were selected on the basis of inclusion criteria and by convenient sampling technique. The purpose of the study was explained to the participant and informed consent was taken from them. The interview was taken using self-structured questionnaire from the people of Panchayatan village Greater Noida.

Plan for data analysis

Data analysis plan was divided into 3 sections:

Section-I: Description of socio demographic variables.

Section-II: Effectiveness of planned teaching program on knowledge regarding Ayushman Bharat Yojana among community people in Panchayatan.

Section-III: Association between knowledge score with selected demographic variable.

Data analysis and interpretation

The study’s chosen objectives were taken into consideration when conducting the analysis and interpretation. Data was transferred to a master data sheet after data collection. Descriptive and inferential statistics were used for data analysis and interpretation.

Hypothesis

Hypothesis is the explanation of the relationship between two variables. It suggests that an independent and dependent variable have a predictable connection.

Ho: There would be no significant association between the knowledge regarding Ayushman Bharat Yojana Scheme and socio demographic variables at 0.05 level of significance.

H1: There would be a significant association between knowledge regarding Ayushman Bharat Yojana Scheme and socio demographic variables at 0.05 level of significance.

RESULTS

Findings were organized under the following sections: Section-I: Description of Socio demographic variables. Section-II: Knowledge score of participants. Section-III: Effectiveness of planned teaching program on knowledge regarding Ayushman Bharat Yojana among community people in Panchayatan. Section-IV: Association between knowledge score with selected demographic variable.

Section-I: description of socio demographic variables

Table 1 shows that, (64.4%) of the participants were in the age group of 16-35 years, most (96.6%) of them belong to Hinduism, (67.8%) were females, (30,5%) were educated till primary school certificate, (32.2%) were having monthly income above Rs. 7770, (71.2%) were married, (84.7%) were residing in Pacca houses, (83.1%) have no previous knowledge regarding Ayushman Bharat Yojana and (86.4%) have no source of information regarding Ayushman Bharat Yojana.

Section-II: knowledge score of participants

Table 2 shows that the majority of the participants were having poor knowledge (62.71%) and 33.90% were having average knowledge.

Table 3 shows that the mean knowledge score of the participants was 11.7±4.1.

Section-III: effectiveness of planned teaching program on knowledge regarding Ayushman Bharat Yojana among community people of Panchayatan village

Table 4 shows the comparison of pre-test and post-test knowledge scores regarding Ayushman Bharat Yojana among community people in Panchayatan. Paired t-test was computed to find out the significant mean differences. It shows that there was highly significant (p<0.05) mean difference noted among community people. It indicates planned teaching program was an effective intervention in enhancing the knowledge of community people regarding Ayushman Bharat Yojana.

Section-IV: association between knowledge score with selected demographic variable

Table 5 shows the association between the knowledge scores (pre-test) with selected demographic variables of the community people. Paired t-test was computed to find the significant association. It shows that the association between knowledge score and age was highly significant (p=0.051) and between knowledge score and monthly income was highly significant (p=0.019).

(p<0.05-Significance level, S: Significant).

(p<0.05-Significant level).

Major findings of the study

Most of the samples (64.4%) were between the age group of 16-35 years, (96.6%) were Hindus, (67.8%) were female, (30.5%) were educated till primary school, (71.2%) were married, (64.4%) were having monthly income above Rs. 7770, (84.7%) were living in pacca house, (83.1%) were having no previous knowledge and (86.4%) were having no source of information. The findings show mean value was 11.7±4.16 of level of knowledge regarding Ayushman Bharat Yojana Scheme.

Objective-I

To assess the level of knowledge regarding Ayushman Bharat Yojana among community people in Panchayatan village, Greater Noida, UP.

The mean knowledge score was 11.7 and according to knowledge profile: 3.38% participants were having good knowledge; 33.89% participants were having average knowledge; 62.71% participants were having poor knowledge

Objective-II

To review the effectiveness of planned teaching program on knowledge regarding Ayushman Bharat Yojana among community people in Panchayatan village, Greater Noida, UP.

The data was compared between pre-test and post-test knowledge scores using Paired t-test regarding Ayushman Bharat Yojana among community people of Panchayatan village. It showed that the mean knowledge score (post-test) was 13.7 and for (pre-test) was 9.6. It indicates that the planned teaching program was an effective intervention in enhancing the knowledge of the community people regarding Ayushman Bharat Yojana.

Objective-III

To find out association between levels of knowledge regarding Ayushman Bharat Yojana with selected demographic variables among community people in Panchayatan village, Greater Noida, UP.

Chi-square test was used to find out significant association. It showed that there was a significant association found between the knowledge scores (post-test) with age (p=0.051) and between the knowledge score and monthly income (p=0.019). Hence researcher rejected null hypothesis (Ho). There was a significant association between knowledge score and selected demographic variables.

DISCUSSION

The knowledge score in our study according to the criteria states that 3.3% participants were having good knowledge, 33.8% participants were having average knowledge and 62.7% were having poor knowledge. A similar study conducted by Menon et al reported that 62% of samples were having poor knowledge, 22% were having average knowledge and 16% were having good knowledge about Ayushman Bharat Yojana.¹¹

The findings of our study show that the post-test mean score was 13.7 which is greater than the pre-test mean score 9.6. Paired t-test shows that there was significant association found between the knowledge scores (post-test) with age (p=0.051) and between the knowledge score and monthly income (p=0.019). Therefore, this study concluded that planned teaching program on knowledge regarding Ayushman Bharat Yojana give significant result among community people in Panchayatan village.

This study has some limitations. Generalizability is limited because of small sample size. Study is limited to only one village.

Implications

Ayushman Bharat can be used in in-service education as a method of teaching program to improve the knowledge of the staff regarding Ayushman Bharat Yojana Scheme. By bringing services closer to communities and being able to meet the needs of the most marginalized through the primary health care team, health and wellness centers will fundamentally alter how responsive the health system is to the needs of its patients.

CONCLUSION

The findings conclude that the planned teaching program on knowledge regarding Ayushman Bharat Yojana among community people in Panchayatan village, Greater Noida, UP was effective in increasing the knowledge among community people.

ACKNOWLEDGEMENTS

Authors would like to thank their college management, Dr. Uppu Praveen, HOD of community health nursing, professor cum principal Sharda School of Nursing Science and Research, Sharda University.

Funding: No funding sources

Conflict of interest: None declared

Ethical approval: The study was approved by the Institutional Ethics Committee

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