Barriers and Facilitators for the Utilization of Ayushman Bharat Arogya Karnataka: A Mixed-Methods Study, Malur, Karnataka

Ayushman Bharat Arogya Karnataka (ABArK) is a government-funded health insurance scheme designed to provide universal health coverage and reduce catastrophic healthcare expenses for families. With limited literature examining the implementation of ABArK, this study was conducted to assess the utilization of ABArK and to examine barriers and facilitators in availing ABArK among adults visiting a secondary care hospital in rural Karnataka through a mixed-methods approach. Study conducted in Malur, rural Karnataka, in 2023. Quantitative data, comprising sections on characteristics of study participants, awareness, and utilization of ABArK, were collected using a semi-structured questionnaire. For the qualitative component, in-depth interviews were conducted to explain the quantitative findings through the perceptions and experiences of services under ABArK. Among the 270 participants, 149 (55%) were aware of the ABArK scheme, and 60 (22.2%) possessed ABArK cards. Utilization in the previous year was reported by 27 participants (10%), of whom 10 (37%) had incurred additional expenses. Interviews highlighted systemic barriers for migrants and out-of-pocket expenditure. Facilitators included collaboration and positive patient experiences. ABArK utilization was low; recommendations include raising awareness, sharing positive experiences, and enhancing migrant accessibility by ensuring eligibility for all Indians.