Awareness Without Uptake

Abstract

Background. Under-utilisation of targeted entitlements in rural India is routinely attributed to information deficits, and the information campaign is the default policy response. That attribution is difficult to test, because utilisation is almost always studied one scheme at a time and compared across populations, which confounds the delivery architecture of a scheme with the characteristics of the people receiving it. This study asks what constrains utilisation once awareness is close to universal. Methods. Cross-sectional household survey in Bodh Gaya block, Gaya district, Bihar, January 2025, in a village saturated by a resident community intermediary. Fifty-one households reported awareness and utilisation of four co-located schemes: JEEViKA (livelihoods), PDS (food), ICDS (child nutrition) and AB-PM-JAY (hospital insurance). Measuring all four schemes in the same households in a single round holds demand side characteristics such as poverty, literacy and distance constant by construction, so that remaining variation is attributable to how each scheme is administered. We define entitlement conversion as utilisation divided by awareness, a descriptive diagnostic of the compliance costs a household faces after it knows a benefit exists, and report 95% Wilson score intervals with bootstrap intervals for the ratio. Results. Awareness was high and comparatively flat, from 64.7% (PDS; 95% CI 51.0–76.4) to 100% (JEEViKA; 93.0–100.0). Conversion varied far more. The three schemes obtained at a point inside the village converted at 0.79 to 0.98. AB-PM-JAY, which requires documented enrolment at an office outside the village, converted at 0.42 (0.26–0.58) despite being better known than PDS; receipt of this scheme is episodic and partly reflects need for inpatient care, which we address in the limitations. Among 26 households not receiving benefits, the barriers reported most often were procedural complexity (69.2%) and administrative distance (57.7%); lack of information ranked third (30.8%) and none attributed exclusion to the intermediary. Ninety-four per cent named the resident JEEViKA worker as their information source for all four schemes, including three she does not administer. Conclusions. Where a resident intermediary has achieved near-universal reach, the observed loss occurs after the household knows a scheme and before it obtains the benefit, and is associated with where enrolment must be completed and what documents it requires rather than with how well the scheme is known. The design cannot identify why awareness is high, so this speaks to the current margin rather than to campaign effectiveness. Comparing schemes within households converts a question about populations into a question about architectures, which is the object policy can act on.

In short

Four government schemes, measured in the same 51 households in one round, so poverty, literacy and distance are held constant by construction. Awareness is high and flat. What varies is conversion into actual receipt, and it varies with where enrolment has to be completed rather than with how well the scheme is known.

Findings

• Awareness was high and comparatively flat across all four schemes, from 64.7% for PDS to 100% for JEEViKA. Conversion of that awareness into actual receipt varied far more
• The three schemes obtainable at a point inside the village converted at 0.79 to 0.98. AB-PM-JAY, which requires documented enrolment at an office outside it, converted at 0.42 despite being better known than PDS
• Among the 26 households receiving no benefit, procedural complexity (69.2%) and administrative distance (57.7%) were the barriers named most often; lack of information ranked third at 30.8%, and none attributed exclusion to the intermediary
• 94% named the same resident JEEViKA worker as their information source for all four schemes, including the three she does not administer
• Measuring four schemes in the same households holds poverty, literacy and distance constant by construction, so the remaining variation is attributable to how each scheme is administered rather than to who is receiving it