Publication:

Digital literacy barriers and data privacy concerns in Ayushman Bharat Digital Mission: a community-based observational study in Tinwari village, Dehradun

Background The Ayushman Bharat Digital Mission (ABDM), launched in September 2021, aims to create a unified digital health ecosystem across India. Despite significant infrastructural growth, grassroots adoption among rural and vulnerable populations remains critically low. This study aimed to assess ABDM and ABHA awareness levels, identify barriers to adoption across demographic groups, and examine data privacy concerns among community members in Tinwari Village, Dehradun, Uttarakhand, India.

Methods A cross-sectional observational study was conducted in Tinwari Village (January to March 2024). A total of 120 community members were purposively selected: senior citizens (60+ years; n=25), women (n=35), adults 25-59 years (n=38), and adolescents 13-24 years (n=22). Data were collected via structured informal interviews and field observations. No personal identifying information was recorded.

Results Of 120 participants, 100 (83.3%) had zero awareness of ABDM or the ABHA application, despite all being confirmed mobile phone users. Among the 20 (16.7%) with some awareness, none were actively using the platform. The five principal barriers were: absence of community outreach (n=100, 83.3%), fear of Aadhaar-linked data fraud (n=94, 78.3%), entertainment-only digital behaviour (n=85, 70.8%), deferred adoption attitudes (n=78, 65.0%), and technology anxiety (n=66, 55.0%). Senior citizens demonstrated the highest non-awareness rate (24/25, 96.0%), followed by women (31/35, 88.6%), adults (30/38, 78.9%), and adolescents (15/22, 68.2%).

Conclusions ABDM adoption failure reflects a systemic communication and outreach failure rather than an infrastructural one. Structured ASHA/ANM training in ABDM facilitation, plain-language multilingual data privacy communication, and population-specific awareness strategies targeting senior citizens and women are urgently needed.