Introduction
Population ageing is a significant new demographic challenge for India in the twenty-first century. India will undoubtedly transition from a young to an ageing nation during the coming decades.[1] A nation is considered to be "ageing" when 7% of the population is over the age of 60.[2] India’s life expectancy in 2021 was 70.42 years, with 69.16 years for men and 71.80 years for women.[3]
As per World Health Organization (WHO), it is expected that proportion of the world’s population over 60 years will double from about 12% to 22% by 2050.[4] Similarly, the number of people aged 80 years or older will rise from 125 million to 434 million in same period. With the world ageing at a rapid rate, it is estimated that by 2030 there will be 34 nations with over 20% population above 65years.[5,6]
According to Longitudinal Ageing of India study, More than half of the elderly population is aware of the Indira Gandhi National Old Age Pension Scheme (IGNOAPS) (55%), while awareness of the Annapurna scheme remains limited (12%). Awareness of IGNOAPS is higher among the rural elderly (58%) compared to their urban counterparts (49%). According to Gender, awareness of IGNOAPS (59% among men and 52% among women) and the Annapurna scheme is lower among elderly women (9%) than among elderly men (16%). With respect to religion, 46% of elderly Muslims are not aware of IGNOAPS, and more than 92% are not aware of the Annapurna scheme. Awareness of concessions is higher among the elderly residing in urban areas (37%) than those in rural areas (25%). A higher proportion of elderly men (33%) compared to elderly women (24%) report awareness of concessions. The level of awareness of concessions increases with education, ranging from 18% among elderly women with no formal education to 54% among those with 10 or more years of schooling. Overall, about 11.7% of the elderly are aware of the Senior Citizens Act, with higher awareness observed in urban areas (17.7%) than in rural areas (9.2%).
Approximately 29% of rural elderly individuals from Below Poverty Line (BPL) households report receiving benefits under IGNOAPS. The reasons cited for non-utilisation of social security schemes include perceived lack of need, ineligibility or non-applicability, absence of required documents, non-application, cumbersome procedures for obtaining benefits, and other related factors.[7]
Article 41 of the constitution requires the States to provide public assistance to their citizens in the event of unemployment, old age, sickness, or disability, as well as in situations of other unjustified need, within the limits of their economic capacities and progress.[8] The National Plan for Health Care of the Elderly (NPHCE), developed by the Ministry of Health and Family Welfare in 2011, is another example of how ageing can be taken into account in sectoral programmes.[9]
A number of social security scheme are launched by the government to fulfil the needs of the elderly. National old age scheme was launched in 1995 and later in 2007 it was named as IGNOAPS by Ministry of Rural Development, under this scheme, a monthly pension of Rs 200 and Rs 500 is given to elderly aged 60-79 years and > 80 years to BPL families respectively.[10]
Annapurna scheme was launched in 2000 by Ministry of Rural Development to give benefits to senior citizens of BPL family, under this scheme 10 kg of food grains per person per month is given free of cost.[11]
Delhi Old Age Pension Scheme was implemented by Department of Social welfare, Government of Delhi and under this scheme, financial assistance of Rs. 2000 per month for the age group between 60 to 69 years and those who are above the age of 70 years, Rs. 2500 per month will be provided. The Government also provides an additional amount of Rs. 500 per month to SC/ST/Minority community beneficiaries.[12]
The Pradhan Mantri Vaya Vandana Yojana (PMVVY), launched in 2017 by the Ministry of Finance, provides senior citizens with an assured return ranging from 7% to 9% over a period of 10 years, with beneficiaries receiving a minimum pension of ₹1,000 and a maximum pension of ₹10,000 per month.[13]
Rastriya Vayoshri Yojana was launched in 2017 by Ministry of Social Justice and Empowerment. It is a Scheme for providing Physical Aids and Assisted Living Devices for Senior Citizens below poverty line & with the family income not exceed to Rs. 15,000/- per month.[14]
Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) was launched in 2018 by Ministry of Health & Family welfare, Government of India (GOI). All senior citizens aged 70 and above will receive health coverage, regardless of their income. This expansion is set to benefit around 4.5 crore families, including 6 crore senior citizens, by providing them with free health insurance coverage of up to Rs 5 lakh per family.
Senior citizens within families already covered by AB PM-JAY will receive an additional top-up cover of up to Rs 5 lakh per year.[15]
These social security programs are essential and may be the only source of support for the elderly. In order to create improvements in the future, it is critical to understand the level of understanding and the practical difficulties that senior individuals have when utilizing such measures.
Aims and Objectives
Primary objective
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To e assess the awareness of social welfare schemes and social security measures among elderly.
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To study the sociodemographic factors associated with awareness regarding various social welfare schemes.
Secondary objective
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To assess additional benefit expected from these government schemes.
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To determine the barriers in availing the social welfare schemes among elderly.
Methodology
The current study was a community based cross sectional study which was conducted at field practice area of UHTC Sarojaninagar (In Pillanji village, kali barimarg, Dhobi Ghat and Sarojini Nagar). The data collection lasted for 3 months (June, July and August) in 2024. Ethical approval was taken from institutional ethics committee no 691(05/2024)/IEC/ABVIMS/RMLH/422 dated 20.06.2024. Sample size was calculated using the formula, N = Zα2 PQ / D2 where prevalence of awareness of social security schemes was 86.9% based on a study conducted by Goswami et al.,[16] with relative precision of 10% and 95% confidence interval. The final minimum sample size came out to be 65 after taking into account 10% of non-response rate. A total of 92 elderly were selected using simple random sampling method. Random number table was used to select participants. Elderly populations aged 60 and above residing in pillanji for at least past 1 year were included. Those suffering from any debilitating disease were excluded from the study.
A predesigned, semi-structured, pretested questionnaire was used for the study. It was translated to Hindi and pretested on 10% of the population. Suitable modifications were done to get the desired answer and were retranslated back to English. The data was collected using an interview schedule, which consists of Socio-demographic details of the study subjects, awareness of social welfare schemes, social security measures, source of information, Barriers in availing the social welfare schemes and additional benefits expected from government. Socioeconomic status was determined by Modified Kuppuswamy Scale updated for year 2022.[17] Simple random technique using the random number table was used to recruit the study subjects. House-to- house visit was done and data was collected using an interview schedule after getting written informed consent. Before conducting the study, the purpose of the study was explained to each study subject in Hindi language and consent forms were signed. If the house was found locked even after the next two subsequent visits, the next household was taken for the study. Only one elderly from each household was recruited.
Social security measures are society's organized efforts to protect people from economic risks like old age, disability, sickness, unemployment, and maternity by providing income support, healthcare, and benefits through insurance or assistance programs. Social welfare measures are government programs that promote general well-being by offering non-contributory help for basic needs such as food, housing, education, health, and poverty relief to improve living standards for vulnerable groups.
Financial dependency status was assessed using the standardized three-category measure adapted from the National Sample Survey (NSS) 75th Round. Fully independent was defined as requiring no financial support (self-funded via pensions/savings); partially dependent as needing some support (e.g., supplements for medical/food expenses); and fully dependent as complete reliance on others without personal resources.[18]
Statistical analysis
The collected data was entered in MS-excel and was analyzed using Statistical package for social sciences, SPSS-25 version. Qualitative data was expressed in frequencies and percentages and relationship between qualitative data was assessed by chi-square test or fisher’s exact test for comparison. Quantitative data was expressed in terms of mean and standard deviation for a normally distributed data. For non-normally distributed data, median with inter quartile range was used. A p value of < 0.05 was considered as statistically significant.
Results
| Sociodemographic details | Frequency | Percentage | |
| Gender | Male | 67 | 72.8 |
| Female | 25 | 27.2 | |
| Age | 60-69 years | 71 | 77.2 |
| 70-79 years | 13 | 4.1 | |
| 80-89 years | 8 | 8.7 | |
| Education | Illiterate | 42 | 45.7 |
| Primary school | 24 | 26.1 | |
| Senior school | 13 | 14.1 | |
| Senior secondary | 4 | 4.3 | |
| Graduates | 5 | 5.4 | |
| Post graduates | 4 | 4.3 | |
| Socioeconomic status | Upper | 4 | 4.3 |
| Upper middle | 13 | 14.1 | |
| Lower middle | 20 | 21.7 | |
| Upper lower | 16 | 17.4 | |
| Lower | 39 | 42.4 | |
| Marital status | Married | 71 | 77.2 |
| W Widow/widower | 21 | 22.8 | |
| Residence | Own house | 35 | 38.0 |
| Rented house | 46 | 50.0 | |
| Homeless | 11 | 12.0 | |
| Below Poverty Line status | Yes | 46 | 50.0 |
| No | 46 | 50.0 | |
| Financial dependency status | Independent | 48 | 52.2 |
| Partially dependent | 16 | 17.4 | |
| Completely dependent | 28 | 30.4 |
Table 1 shows that the mean age of the study participants was 66.36 ± 6.24 years, ranging from 60 to 85 years. The study population consisted of 67 (72.8%) males and 25 (27.2%) females. Most of the participants belonged to the 60–69 years age group, accounting for 71 (77.2%). Illiteracy was observed among 42 (45.7%) participants, while 45 (48.9%) were currently working. The majority of the study subjects were Hindu, comprising 84 (91.3%). An equal proportion of participants, 42 (45.7%) each, were living in nuclear and joint family settings. Most of the elderly, 42 (45.7%), belonged to the lower socioeconomic class. Marital status showed that 71 (77.2%) participants were married. Housing status revealed that 46 (50%) participants were residing in rented accommodation, and an equal proportion were having Below Poverty Line (BPL) cards. About 48 (52.2%) of the study participants were financially independent. About 65.2% of the study subjects were aware of any of the social welfare schemes of elderly while 34.8% were not aware about any scheme existent for them 42(45.7%).
| Characteristics | IGNOAPS n=37 | Annapurna scheme n=48 | Delhi old age pension scheme n=49 | PMVVY n=14 | Rastriya vayoshri yojana n=11 |
| N (%) | N (%) | N (%) | N (%) | N (%) | |
| Gender | |||||
| Male | 26(38.8) | 32(47.8) | 38(56.7) | 9(13.4) | 6(9.1) |
| Female | 11(44) | 16(64) | 11(44) | 5(20) | 5(20) |
| P value* | 0.81 | 0.16 | 0.277 | 0.435 | 0.133 |
| Chi square value | 7.46 | 1.92 | 1.18 | 0.609 | 2.2 |
| Age | |||||
| 60-69 years | 27(38) | 36(50.7) | 38(53.5) | 12(16.9) | 8(11.6) |
| 70-79 years | 7(53.8) | 8(61.5) | 8(61.5) | 2(15.4) | 2(15.4) |
| 80-89 years | 3(37.5) | 4(50) | 3(37.5) | 0 (0) | 1(12.5) |
| P value* | 0.57 | 0.77 | 0.560 | 0.451 | 0.929 |
| Fisher exact value# | NA | NA | NA | NA | NA |
| Education | |||||
| Illiterate | 11(26.2) | 20(47.6) | 18(42.9) | 7(16.7) | 6(14.3) |
| Primary school | 13(54.2) | 15(62.5) | 9(37.5) | 4(16.7) | 2(8.7) |
| Senior school | 4(30.8) | 3(23.1) | 9(69.2) | 1(7.7) | 0 (0) |
| Senior secondary | 3(75) | 3(75) | 4(100) | 2(50) | 1(25) |
| graduates | 4(80) | 3(60) | 5(100) | 0 (0) | 0 (0) |
| Post graduates | 2(50) | 4(100) | 4(100) | 0 (0) | 2(50) |
| P value* | 0.045 | 0.06 | 0.005 | 0.302 | 0.037 |
| Fisher exact value# | NA | NA | NA | NA | NA |
| Occupation status | |||||
| Never worked | 6(35.3) | 11(64.7) | 6(35.3) | 2(11.8) | 0(0) |
| Currently working | 18(40) | 24(53.3) | 22(48.9) | 10(22.2) | 7(15.9) |
| Retired | 13(43.3) | 13(43.3) | 21(70) | 2(6.7) | 4(13.3) |
| P value* | 0.86 | 0.36 | 0.052 | 0.16 | 0.24 |
| Chi square value | 0.29 | 2.03 | 5.92 | NA | NA |
| Religion | |||||
| Hindu | 35(41.7) | 46(54.8) | 43(51.2) | 14(16.7) | 10(12.2) |
| Muslim | 1(14.3) | 2(28.6) | 5(71.4) | 0 | 1(14.3) |
| Christian | 1(100) | 0 | 1(100) | 0 | 0 |
| P value* | 0.17 | 0.24 | 0.377 | 0.456 | 0.920 |
| Chi square value | 3.51 | NA | NA | NA | NA |
| Type of family | |||||
| Nuclear | 16(38.1) | 22(52.4) | 20(47.6%) | 5(11.9) | 2(4.8) |
| Joint | 19(45.2) | 25(59.5) | 24(57.1%) | 8(19.0) | 8(20) |
| Staying alone | 2(25) | 1(12.5) | 5(62.5) | 1(12.5) | 1(12.5) |
| P value* | 0.52 | 0.05 | 0.587 | 0.644 | 0.109 |
| Chi square value | 1.29 | 5.95 | 1.06 | NA | NA |
| Socioeconomic status | |||||
| Upper | 2(50) | 3(75) | 4(100) | 0 | 2(50) |
| Upper middle | 6(46.2) | 8(61.5) | 10(76.9) | 3(23.1) | 1(7.7) |
| Lower middle | 12(60) | 12(60) | 6(30) | 4(20.0) | 1(5) |
| Upper lower | 5(31.3) | 10(62.5) | 8(50) | 1(6.3) | 2(12.5) |
| Lower | 12(30.8) | 15(38.5) | 21(53.3) | 6(15.4) | 5(13.2) |
| P value* | 0.232 | 0.25 | 0.028 | 0.61 | 0.049 |
| Chi square value | 5.58 | 5.40 | 10.85 | NA | NA |
| Marital status | |||||
| Married | 26(36.6) | 35(49.3) | 40(56.3) | 9(12.7) | 7(10.1) |
| Widow/widower | 11(52.4) | 13(61.9) | 9(42.9) | 5(23.8) | 4(19) |
| P value* | 0.196 | 0.31 | 0.277 | 0.212 | 0.275 |
| Chi square value | 1.67 | 1.03 | 1.18 | 1.55 | NA |
| Residence | |||||
| Own house | 19(54.3) | 23(65.7) | 24(68.6) | 8(22.9) | 9(26.5) |
| Rented house | 17(37) | 21(45.7) | 21(45.7) | 5(10.9) | 1(2.2) |
| Homeless | 1(9.1) | 4(36.4) | 4(36.4) | 1(9.1) | 1(9.1) |
| P value* | 0.023 | 0.108 | 0.06 | 0.276 | 0.005 |
| Chi square value | NA | NA | NA | NA | NA |
| BPL status | |||||
| Yes | 20(43.5) | 20(43.5) | 23(50) | 6(13.0) | 3(6.7) |
| No | 27(37.0) | 28(60.9) | 26(56.5) | 8(17.4) | 8(17.9) |
| P value* | 0.52 | 0.095 | 0.725 | 0.562 | 0.108 |
| Chi square value | 0.40 | 2.78 | 0.39 | 0.33 | 2.58 |
| Financial dependency status | |||||
| Independent | 21(43.8) | 25(52.1) | 32(66.7) | 9(18.8) | 8(17) |
| Partially dependent | 4(25) | 7(43.8) | 6(37.5) | 1(6.3) | 1(6.3) |
| Completely dependent | 12(42.9) | 16(57.1) | 11(39.3) | 4(14.3) | 2(7.4) |
| P value* | 0.39 | 0.693 | 0.027 | 0.477 | 0.346 |
| Chi square value | 1.87 | 0.73 | 7.2 | 1.4 | 2.12 |
*Note: Chi square test, # Fisher exact test
Table 2 shows that a statistically significant association was observed between education levels and awareness of IGNOAPS (p=0.045), Delhi Old Age Pension Scheme (p=0.005), and Rashtriya Vayoshri Yojana (p=0.037). Illiteracy was highest among IGNOAPS (26.2%) and Annapurna Scheme (47.6%) beneficiaries, whereas postgraduate beneficiaries were more frequent in Delhi Old Age Pension Scheme (100%) and PMVVY (50%). Socioeconomic status was significantly associated with Delhi Old Age Pension Scheme (p=0.028) and Rashtriya Vayoshri Yojana (p=0.049), with lower-income groups being the primary beneficiaries. Financial dependency was significantly associated with the Delhi Old Age Pension Scheme (p=0.027), where financially independent individuals had higher enrollment. Ownership of a house was significantly associated with IGNOAPS (p=0.023) and Rashtriya Vayoshri Yojana (p=0.005). Beneficiaries living in their own homes were more likely to be enrolled in these schemes. Homeless individuals were least represented, except in the Annapurna Scheme (36.4%). No statistically significant differences were found concerning marital status or BPL status across schemes. Type of family was significantly associated with the Annapurna Scheme (p=0.05), with a higher number of joint-family beneficiaries compared to nuclear families.
| Barriers | n (%) |
| Unawareness on how to avail scheme | 53(57.6) |
| Tedious administrative process | 13(14.1) |
| Inadequate Government facility | 12(13.0) |
| No problem faced | 6(6.5) |
| Bedridden/physical dependence | 4(4.3) |
| Corruption | 3(3.3) |
| Time constrains | 1(1.1) |
Table 3 shows that the main barriers for utilization was Lack of awareness (57.6%), Administrative difficulties (14.1%) and inadequate government facilities (13.0%). Physical dependence, corruption, and time constraints were also reported.
| Social Security measures | Males N(%) | Females N(%) | Total N (%) | X2, d, p value |
| Railway ticket concession | 41(61) | 11(44) | 52(56.5) | 2.19, 0.139 |
| Higher interest rate in bank/post office | 23(34.3) | 4(16) | 27(29.3) | 2.95, 0.086 |
| Seats reservation in bus | 42(62.7) | 10(40) | 52(56.5) | 3.81,0.05 |
| Air travel concession | 10(15.2) | 4(16) | 14(15.2) | 0.01,0.92 |
| NPHCE | 14(20.9) | 3(12) | 17(18.5) | 0.96,0.33 |
| Income tax rebate | 54(80.6) | 22(88) | 76(82.6) | 0.69, 0.40 |
Table 4 shows that the awareness of social security measures was higher among elderly men than women for railway ticket concessions (61% vs 44%), higher interest rates in banks or post offices (34.3% vs 16%), and seat reservation in buses (62.7% vs 40%). A statistically significant association with gender was observed only for awareness of seat reservation in buses (χ² = 3.81, p = 0.05). Awareness of air travel concessions was comparable among men and women (15.2% vs 16%; p = 0.92). Awareness of the National Programme for Health Care of the Elderly (NPHCE) (20.9% vs 12%; p = 0.33) and income tax rebates (80.6% vs 88%; p = 0.40) did not show a statistically significant gender-wise difference.
Among study subjects, the additional benefits expected from the government was mainly financial 30 (32.6%), followed by medical benefits 24(26.1%), housing 21(22.8%), employment 12(13%), transportation 4 (4.3%) and increased role in local government/panchayat 1(1.1%).
Discussion
In the present study, it was found that 65.4% of participants were aware of at least one social welfare scheme, with awareness levels for specific schemes ranging from 12% to 53%. However, contrastingly, Maroof et al., [19] in Aligarh found only 28.9% awareness, whereas Murugan PB et al.,[20] and Goswami et al.,[16] observed higher rates, with 73.2% and 86.9% awareness of geriatric welfare schemes, which is notably higher than our findings. Nivedita B M et al.,[21] reported a 49.5% awareness rate among the elderly in rural Bengaluru. In an urban context, these disparities in the awareness of various social security Schemes could be attributed by the educational status, their cultural differences, urban-rural differences. The study also indicated that male participants demonstrated greater awareness, consistent with findings by Joseph N et al.,[22] although this contrasts with other studies that reported higher awareness among females which could be due to majority of males participants in our study.
The study found an awareness of 40.2% for IGNOAPS which is similar to the findings of study conducted by Joseph N et al.,[22] In contrast to the findings, many studies have found the awareness for IGNOAPS which is significantly higher than present study such as Goswami et al.,[17] also noted an 85.5% awareness, while Bartwal et al.,[23] recorded an even higher awareness at 97.3%. In rural Dehradun, Srivastava AK et al.,[24] found a 74.6% awareness among below Poverty Line (BPL) populations, indicating a disparity in awareness compared to our findings which could be attributed by differences in their socioeconomic status as BPL people are more aware about the IGNOAPS as compared to the APL people and the urban- rural geographical differences.
The study showed a 52.2% awareness of Annapurna Scheme. Kohli C et al.,[25] reported similar awareness levels at 50.2%, while Joseph N et al.,[22] documented significantly lower awareness at 18.4%. 53.3% were aware of Old Age Pension Scheme. This is comparable to Joseph N et al.,[22] findings of 47.6% awareness but it contrasts with Bartwal J et al.,[23], who reported only 19.7%.
A statistically significant association was observed between education levels and awareness of IGNOAPS (p=0.045), Delhi Old Age Pension Scheme (p=0.005), and Rashtriya Vayoshri Yojana (p=0.037) similar to Joseph N et al.,[22] which could be due to higher sample size and higher literacy rate. Socioeconomic status was significantly associated with Delhi Old Age Pension Scheme (p=0.028) and Rashtriya Vayoshri Yojana (p=0.049), with lower-income groups being the primary beneficiaries similar to Joseph N et al.,[22] Financial dependency was significantly associated with the Delhi Old Age Pension Scheme (p=0.027), where financially independent individuals had higher enrollment. Ownership of a house was significantly associated with IGNOAPS (p=0.023) and Rashtriya Vayoshri Yojana (p=0.005). Type of family was significantly associated with the Annapurna Scheme (p=0.05), with a higher number of joint-family beneficiaries compared to nuclear families.
The main barriers to utilizing these schemes in the study were a lack of knowledge on how to access them (57.6%), followed by tedious administrative processes (14.1%) and inadequate government facilities (13%). Umashankar et al.,[26] found that transportation (23.5 %) & inadequate government facility (20.5 %) as important challenges while Kohli C et al.,[25] reported tedious administrative procedures (38.1 %) as the concerning challenging for the elderly to avail the benefits from these government schemes.
The strength of the study includes better participation of study subjects due to attached field area of Department of community medicine and addition of new social security schemes which were not covered in previous studies. The limitation of study were recall bias and small sample size which may reduce the generalizability of the study.
Conclusion
This study highlights significant gaps in awareness of social welfare schemes among the elderly population. Although 65.2% of the participants were aware of at least one welfare scheme. u Education, socioeconomic status, financial independence, and housing status were significantly associated with awareness of schemes like IGNOAPS, Delhi Old Age Pension Scheme, and Rashtriya Vayoshri Yojana. The main barriers for utilisation were lack of knowledge on how to avail the benefits (57.6%) and cumbersome administrative processes.
This study includes the scope of studying the utilization of social security schemes and measures along with awareness of the social welfare schemes. Health education can be provided at individual, family and through mass media regarding social welfare schemes and social security measures including the National Health Programme for the elderly (NPHCE). Barriers related to utilization of schemes could be addressed through health education.
Declarations
Authors’ Contributions
Each contributor had participated sufficiently in concept, design, definition of intellectual content, literature search, data acquisition, data analysis, statistical analysis, manuscript preparation, manuscript editing and manuscript review. All authors have read and approved the final manuscript. Data is confidentially kept with the investigators.
Ethical approval
Ethical approval was taken from institutional ethics committee no 691(05/2024)/IEC/ABVIMS/RMLH/422 dated 20.06.2024. we have taken written informed consent from all the participants. We have not used any AI generated writing tool for manuscript preparation.
Funding Statement
Nil.
Conflicts of interest
There is no conflict of interest.