District-Level Analysis of Ayushman Bharat: Evaluating Health Justice and Universal Health Coverage Implementation in India

This study examines the implementation and impact of Ayushman Bharat, India's flagship universal health coverage program, through a comprehensive district-level analysis focusing on health justice outcomes. Launched in 2018, Ayushman Bharat represents the world's largest government-funded health insurance scheme, comprising two key pillars: Pradhan Mantri Jan Arogya Yojana (PM-JAY) providing financial protection for hospitalization, and Health and Wellness Centres (HWCs) delivering preventive and primary care services.

Using a mixed-methods approach combining household surveys, government health system data, PM-JAY administrative records, and Geographic Information Systems (GIS) mapping, this research analyzes access, utilization, and health outcomes across 750+ districts in India. The study reveals significant disparities in program implementation and benefits distribution, with urban areas and well-governed states demonstrating higher utilization rates while rural, tribal, and marginalized communities face persistent barriers to access.

Key findings indicate that while Ayushman Bharat has provided financial protection to millions and established thousands of HWCs, substantial inequities persist along geographic, socioeconomic, gender, and caste lines. The research concludes with evidence-based policy recommendations for achieving true health justice through targeted interventions, strengthened local governance, and equity-focused implementation strategies.