Factors Affecting Acceptability of Ayushman Bharat Health Account (ABHA) Digital Health ID: A Multicentre Study

Abstract

Causes of refusal from the community for the Government of India to create unique health IDs, Ayushman Bharat Health Account Numbers (ABHA) ID of every citizen using digital tools needs attention to improve acceptability in the community. Approach: The Government of India has created an ABHA identity number. It will ensure intersectoral coordination among the health ecosystem of the country. Since we all avail the facility, services and interact with the health infrastructure throughout our lives, the government has envisaged that every citizen should have an ABHA ID for that. However, there seems to be reluctance/lethargy among the population. This study surveyed 6898 families across six states of India to increase the penetration of ABHA registration and the problems the population is facing in getting ABHA ID. Ground situations: Among 6898 family heads interviewed from November 2022 to January 2023, 812 (11.7%) households (HH) had accepted ABHA ID, and 6086 (88.3%) HH did not accept citing various reasons. Reasons recorded in layman/local language as narrated in open text format are categorized into 12 types for quantitative analysis. Among the most common reason (34.9%) for non-acceptability were the Aadhaar available yet not connected to the mobile number which is mandatory for ABHA ID. 36.7% were not aware or interested to know for perceived benefits, some other reasons are the non- availability of mobile phones (8.2%) and non- availability of internet/electricity/lack of Aadhaar, technical knowledge to use mobile/non-availability of Android features in phone/indifference/no felt need of ABHA ID. Relevant changes: We dropped the idea of using ABHA ID, and study-specific IDs made online/offline both ways were used for baseline situation survey in our ongoing study. Lessons learned: Considering the refusal, the need for midcourse correction in ABHA scheme was identified. In place of a 100% digital, both offline- online (hybrid) provisions may increase the number of ABHA ID holders.