INTERNATIONAL JOURNAL OF LATEST TECHNOLOGY IN ENGINEERING,

MANAGEMENT & APPLIED SCIENCE (IJLTEMAS)

ISSN 2278-2540 | DOI: 10.51583/IJLTEMAS | Volume XV, Issue I, January 2026

Beyond Affordability: Trust, Sustainability, and the Lived

Experiences of Jan Aushadhi Kendra Owners

¹Dr. Nimitha Aboobaker^{* 2}Dr. Priya R.

¹Assistant Professor, School of Management Studies, Cochin University of Science and Technology,

Kerala

²Assistant Professor, Post Graduate Department of Commerce & Research Centre, Sanatana Dharma

College, Kerala

DOI : https://doi.org/10.51583/IJ L T EMAS.2026.150100042

Received: 16 January 2026; Accepted: 24 January 2026; Published: 29 January 2026

ABSTRACT

This study examines the lived experiences of Jan Aushadhi Kendra (JAK) owners to understand how the Pradhan

Mantri Bhartiya Jan Aushadhi Pariyojana (PMBJP) is enacted at the grassroots level and what factors shape its

long-term sustainability. Positioned at the intersection of entrepreneurship and public health delivery, JAK

owners play a critical role in translating policy intent into everyday access to affordable medicines. Using a

qualitative research design, in-depth semi-structured interviews were conducted with 74 JAK owners across

Kerala and Karnataka. Data collection continued until thematic saturation was achieved, and the interviews were

analysed using reflexive thematic analysis following Braun and Clarke's framework. The findings reveal four

interrelated themes. First, owners articulated a social mission and hybrid entrepreneurial identity, framing their

participation as public service-oriented rather than profit-driven. Second, the medical community emerged as

institutional gatekeepers of trust, with limited endorsement from doctors and allied health professionals

constraining consumer confidence in generic medicines. Third, business sustainability was found to be fragile,

shaped by low margins, expiry-related losses, supply chain disruptions, and stock-outs that undermined both

financial viability and customer trust. Finally, trust-building, consumer perceptions, and awareness gaps

highlighted how persistent quality–price misconceptions and weak institutional communication compelled

owners to act as informal educators, relying heavily on interpersonal relationships and word of mouth to sustain

demand. Overall, the study demonstrates that while PMBJP has been effective in improving affordability, its

sustainability depends on factors extending beyond price, including institutional trust, operational reliability, and

coordinated communication. Strengthening medical endorsement, improving supply chain stability, and

embedding systematic awareness initiatives are essential for positioning generic medicines as a trusted and

mainstream component of India's healthcare system.

Keywords: Jan Aushadhi Kendras; Generic Medicines; Qualitative Analysis; Healthcare Access; Public Health

Entrepreneurship

INTRODUCTION

Access to affordable medicines is a central concern for achieving equitable healthcare, particularly in low- and

middle-income contexts where out-of-pocket expenditures remain high. The Pradhan Mantri Bhartiya Jan

Aushadhi Pariyojana (PMBJP) was introduced to address this challenge by promoting the availability and use

of low-cost generic medicines through Jan Aushadhi Kendras (JAKs). While existing research and policy

discussions primarily focus on affordability and consumer uptake, relatively limited attention has been paid to

the experiences of JAK owners who operationalise the scheme at the ground level (Alfonso-Cristancho et al.,

2015; Pareek, 2019). JAK owners occupy a hybrid role as entrepreneurs and community health intermediaries.

Their everyday practices, constraints, and interactions with customers and healthcare professionals directly

influence trust in generic medicines and the scheme's sustainability (Alrasheedy et al., 2014; Assin et al., 2025;

Pareek and Prakash, 2019; Shweta and Kumar, 2023). Understanding their perspectives is therefore critical for

www.ijltemas.in

Page 474

INTERNATIONAL JOURNAL OF LATEST TECHNOLOGY IN ENGINEERING,

MANAGEMENT & APPLIED SCIENCE (IJLTEMAS)

ISSN 2278-2540 | DOI: 10.51583/IJLTEMAS | Volume XV, Issue I, January 2026

assessing how PMBJP functions beyond policy intent. This study addresses this gap by qualitatively examining

the experiences of JAK owners, focusing on motivations, operational realities, stakeholder relationships, and

perceptions of sustainability.

METHODOLOGY

Research Design and Analytical Approach

This study adopted a qualitative interpretive research design to explore the lived experiences of Jan Aushadhi

Kendra (JAK) owners and to understand how the policy-level intentions of the Pradhan Mantri Bhartiya Jan

Aushadhi Pariyojana (PMBJP) are enacted at the grassroots level. Given the exploratory nature of the research

and the focus on meanings, perceptions, and practices, a qualitative approach was considered most appropriate.

Data were analysed using reflexive thematic analysis, following the framework proposed by Braun and Clarke

(2006), which enables systematic identification, analysis, and interpretation of patterns of meaning across

qualitative datasets. This approach was selected because it allows both inductive theme development and

theoretically informed interpretation, while recognising the active role of the researcher in knowledge

construction. Rather than aiming for frequency counts or code reliability, reflexive thematic analysis prioritises

depth, coherence, and contextualised understanding of participants' narratives.

Sampling Strategy and Participants

The study involved in-depth interviews with 74 Jan Aushadhi Kendra owners, comprising 37 participants each

from Kerala and Karnataka. A stratified random sampling strategy was employed to ensure representation across

urban, semi-urban, and rural locations, as well as variation in prior occupation, educational background, years

of operation, and income levels. This approach was intended to capture heterogeneity in ownership experiences

while maintaining comparability across contexts. The initial sampling target was 40 owners per state; however,

thematic saturation was achieved by the 34th interview in each state, with no substantively new insights

emerging thereafter. To ensure robustness and confirm saturation, interviews were continued until 37

participants per state were reached. This decision strengthened analytical confidence while avoiding redundancy.

Data Collection

Data were collected through semi-structured, in-depth interviews, allowing participants to articulate their

experiences in their own terms while ensuring coverage of core domains, including motivation for entering the

scheme, operational challenges, interactions with doctors and customers, perceptions of generic medicines, and

views on sustainability. Interviews were conducted in local languages and English, depending on participants'

preferences, and were later translated where necessary to preserve meaning. All interviews were audio-recorded

with informed consent and transcribed verbatim. To ensure anonymity and confidentiality, a systematic coding

protocol was applied. Participants from Kerala were labelled OKL1–OKL37, and those from Karnataka were

labelled OKA1–OKA37, enabling traceability across transcripts, demographic profiles, and analytical

interpretations without revealing identities.

Data Analysis: Reflexive Thematic Analysis

Data analysis followed the six-phase reflexive thematic analysis approach outlined by Braun and Clarke and was

conducted iteratively rather than as a linear sequence. The researchers began by immersing themselves in the

data through repeated readings of the interview transcripts to achieve familiarity, noting initial impressions,

emotional tones, and recurring concerns expressed by JAK owners. This process enabled sensitivity to the social,

moral, and operational dimensions embedded within the narratives. Initial coding was then undertaken

inductively, remaining close to participants' language and meanings. Codes captured both semantic elements

(such as low margins, doctor resistance, and stock-outs) and latent dimensions (including moral duty, trust work,

and identity as a public health actor), with flexible coding practices allowing multiple codes to be applied to the

same data segments.

www.ijltemas.in

Page 475

INTERNATIONAL JOURNAL OF LATEST TECHNOLOGY IN ENGINEERING,

MANAGEMENT & APPLIED SCIENCE (IJLTEMAS)

ISSN 2278-2540 | DOI: 10.51583/IJLTEMAS | Volume XV, Issue I, January 2026

Subsequently, codes were examined for conceptual linkages and clustered into candidate themes, with analytical

attention directed toward patterns that cut across individual experiences rather than state-specific distinctions,

consistent with the study's integrated analytical focus. Provisional thematic maps were developed to explore

relationships among social mission, business viability, trust, and institutional support. These candidate themes

were then reviewed and refined against the whole dataset to ensure internal coherence and a clear distinction

between themes; some were merged, while others were elaborated into sub-themes to capture analytical

complexity, such as differentiating between profitability constraints and supply chain failures. In the next phase,

themes were clearly defined and named, with their scope, focus, and relevance to the research objectives

carefully articulated, ensuring conceptual precision and theoretical interpretability. Finally, the themes were

woven into a coherent analytical narrative that linked empirical findings to broader discussions on healthcare

access, generic medicine adoption, and social entrepreneurship, with carefully selected participant excerpts used

to substantiate interpretations while foregrounding participants' voices.

Findings: Integrated Thematic Analysis of JAK Owner Experiences

Social Mission and Hybrid Entrepreneurial Identity

Across contexts, Jan Aushadhi Kendra owners framed their engagement with PMBJP as a socially embedded

form of entrepreneurship rather than a profit-oriented retail activity. Owners consistently positioned their

Kendras as community health resources serving economically vulnerable groups, elderly patients, and

individuals with chronic illnesses. Emotional fulfilment, moral responsibility, and community recognition

emerged as central motivations that often outweighed financial returns. This hybrid identity combining

livelihood with public service shaped owners' willingness to tolerate operational burdens and economic

uncertainty, reinforcing the perception of JAKs as socially anchored healthcare institutions rather than

conventional pharmacies (OKL23; OKL36; OKL34).

"It's not just a shop, it's a place where people come when they're desperate for affordable medicines."

(OKL23);

"I run a shop, yes. But this feels more like a seva." (OKL36);

"People thank us with tears sometimes. That makes all the effort worth it." (OKL34)

Medical Gatekeeping and Institutional Trust Deficit

The medical community emerged as an influential gatekeeper, shaping public trust in generic medicines. Owners

reported that limited endorsement, indifference, or informal discouragement by doctors, nurses, and allied health

staff significantly constrained customer confidence, even when medicines were clinically effective. This lack of

professional validation created a structural disconnect between policy approval of generics and routine

prescribing practices. Owners frequently described being excluded from prescription flows, including those

operating near public hospitals, forcing them to counter medical scepticism at the point of sale independently.

Such institutional trust deficits placed additional emotional and communicative labour on owners and

undermined scheme legitimacy (OKL22; OKL24; OKL27).

"Doctors don't even mention us, so why would patients come here then?" (OKL22);

"A nurse once told a patient not to take our medicines because they're 'government issue'." (OKL24);

"Even though we're next to a hospital, the prescriptions always list branded medicines." (OKL27)

Fragile Business Sustainability and Operational Constraints

Despite the social value of affordable medicines, owners faced persistent structural challenges that threatened

the sustainability of their businesses. Low profit margins, dependence on high sales volumes, expiry-related

losses, and the absence of stock return mechanisms constrained financial viability. These pressures were

www.ijltemas.in

Page 476

INTERNATIONAL JOURNAL OF LATEST TECHNOLOGY IN ENGINEERING,

MANAGEMENT & APPLIED SCIENCE (IJLTEMAS)

ISSN 2278-2540 | DOI: 10.51583/IJLTEMAS | Volume XV, Issue I, January 2026

exacerbated by supply chain disruptions and frequent stock-outs, which not only reduced sales but also weakened

customer trust and continuity of care. While some owners sustained operations through strong local credibility

and consistent footfall, sustainability was widely perceived as fragile and contingent on systemic reforms rather

than individual effort or efficiency alone (OKL11; OKL32; OKL33).

"Compared to traditional shops, we need three times the sales to make the same profit." (OKL11);

"One expired box can wipe out our profits for the week." (OKL32);

"When we don't have BP medicines, customers go elsewhere." (OKL33)

Trust-Building, Consumer Perceptions, and Awareness Gaps

Customer engagement was shaped by a combination of interpersonal trust-building and persistent perceptual

barriers surrounding generic medicines. Many customers associated lower prices with inferior quality, relying

on visual cues such as plain packaging and unfamiliar manufacturers to judge efficacy. In the absence of

structured public communication, owners served as informal educators, explaining therapeutic equivalence and

reassuring customers through repeated interactions. Trust typically develops over time, particularly among

elderly and chronically ill patients, through observed treatment outcomes and personalised service. However,

low public awareness and weak institutional marketing limited broader acceptance, leaving owners reliant on

word of mouth and local outreach to generate demand (OKL12; OKL32; OKL21; OKL20).

"People think cheaper means weaker. They judge by how the box looks." (OKL12);

"Some ask, 'Is this government medicine safe?' It takes time to build their trust." (OKL32);

"Radio and TV ads would go a long way. Now it's all word of mouth." (OKL20)

DISCUSSION

This study advances understanding of the Pradhan Mantri Bhartiya Jan Aushadhi Pariyojana (PMBJP) by

foregrounding the perspectives of Jan Aushadhi Kendra (JAK) owners, who function as the scheme's frontline

implementers. The findings show that PMBJP operates not merely as a price-based intervention but as a socially

embedded system dependent on trust, institutional alignment, and operational reliability (Brems et al., 2011;

Pareek and Prakash, 2019). Owners consistently articulated a hybrid entrepreneurial identity, blending livelihood

with public service. This aligns with social entrepreneurship literature, which emphasises mission-driven

enterprise under resource constraints, and suggests that the success of affordability initiatives depends on

sustaining the motivation of these intermediaries.

A central contribution of the study is to highlight the role of the medical community as institutional gatekeepers

of trust. Despite regulatory approval of generic medicines, weak endorsement from doctors and allied staff

undermines consumer confidence and disrupts the translation of policy intent into clinical practice. This finding

underscores that access alone is insufficient; legitimacy within professional networks is critical for normalising

generics (Aboobaker and Priya, 2025). The burden of compensating for this trust deficit is shifted onto owners,

who must repeatedly justify quality and efficacy at the point of sale. The findings further reveal that business

sustainability under PMBJP remains fragile. Low margins, expiry losses, and supply chain disruptions create

persistent vulnerability, particularly for owners with low and inconsistent footfall (Carter et al., 2023;

Chaniotakis and Lymperopoulos, 2009). These structural constraints suggest a misalignment between the

scheme's social objectives and its operational design. While owners demonstrate resilience and commitment,

reliance on individual goodwill raises concerns about long-term scalability. Finally, the study shows that trust-

building and awareness generation are essentially interpersonal and owner-driven. Consumer perceptions of

generics continue to be shaped by price–quality heuristics, visual cues, and peer narratives (Charan et al., 2021;

Rana and Roy, 2015). In the absence of systematic public communication, owners act as informal educators,

gradually building acceptance through repeated use and observed outcomes. This highlights that demand for

generics is socially constructed and requires coordinated institutional support rather than fragmented local effort.

www.ijltemas.in

Page 477

INTERNATIONAL JOURNAL OF LATEST TECHNOLOGY IN ENGINEERING,

MANAGEMENT & APPLIED SCIENCE (IJLTEMAS)

ISSN 2278-2540 | DOI: 10.51583/IJLTEMAS | Volume XV, Issue I, January 2026

IMPLICATIONS

The findings suggest that PMBJP must move beyond affordability-centric metrics to address trust, legitimacy,

and sustainability. Stronger integration of generic prescribing norms within the medical system is essential,

including consistent sensitisation of doctors and allied health professionals. Without professional endorsement,

generics risk remaining peripheral despite regulatory approval. Policymakers should also revisit margin

structures, introduce mechanisms for returning expired stock, and strengthen supply chain predictability to

reduce financial risk for owners (Mishra, 2019; Rathi and Biyani, 2021). For programme implementation, JAK

owners should be formally recognised as community health partners rather than treated solely as retailers.

Training in patient communication, clear explanations, and digital engagement could support their role in

building trust. Standardised packaging and clearer government branding may help counter quality-price

misconceptions and reduce reliance on owner-level persuasion (Rituparna, 2015). From a broader public health

perspective, the study demonstrates that the adoption of generic medicines is contingent on social trust and

experiential validation. Sustained use rather than mere availability is key to achieving health equity and cost

containment (Seshadhri et al., 2023). Strengthening institutional communication and aligning supply systems

can help normalise the use of generics across socioeconomic groups, contributing to more inclusive and

sustainable healthcare delivery.

CONCLUSION

This study provides an integrated qualitative account of how Jan Aushadhi Kendras function at the grassroots

level, based on the lived experiences of their owners. The findings reveal that while PMBJP has successfully

expanded access to affordable medicines, its long-term effectiveness depends on factors extending beyond price,

namely institutional trust, operational reliability, and social legitimacy. JAK owners emerge as critical yet under-

supported actors who sustain the scheme through moral commitment, relational labour, and adaptive practices.

The study concludes that affordability initiatives in healthcare must be designed as trust-centred systems rather

than solely cost-based interventions. Strengthening medical endorsement, improving supply chain stability, and

institutionalising awareness efforts are essential to reducing the disproportionate burden currently placed on

owners. By aligning policy design with the realities of implementation, PMBJP can transition from a welfare-

oriented scheme to a sustainable, mainstream healthcare model that integrates generic medicines into routine

consumption practices.

Acknowledgement: This project was supported by the Indian Council for Social Science Research

Conflict of Interest: There is no potential conflict of interest

Ethical Approval: This study involved human participants and was conducted in accordance with established

ethical standards for social science research. Ethical approval for the study was obtained from the Institutional

Ethics Committee of the researchers' affiliated university prior to data collection. All participants were informed

about the purpose of the study, assured of confidentiality and anonymity, and provided voluntary informed

consent before participating. Participants were also informed of their right to withdraw from the study at any

stage without any consequences.

Data Availability Statement: The data are not publicly available due to ethical and confidentiality

considerations. Anonymised excerpts are included in the article, and additional information may be provided by

the corresponding author upon reasonable request.

REFERENCES

1. Aboobaker, N., & Priya, R. (2025, November). From affordability to sustainability: A mixed-method

study on customer perceptions of generic medicines and universal health. In Proceedings of the 10th

International Conference on Economic Growth and Sustainable Development: Emerging Trends (ISBN

978-93-83302-82-6). SDMIMD.

https://www.sdmimd.ac.in/conferenceproceedings/iec2025papers/IEC25168.pdf

www.ijltemas.in

Page 478

INTERNATIONAL JOURNAL OF LATEST TECHNOLOGY IN ENGINEERING,

MANAGEMENT & APPLIED SCIENCE (IJLTEMAS)

ISSN 2278-2540 | DOI: 10.51583/IJLTEMAS | Volume XV, Issue I, January 2026

2. Alfonso-Cristancho, R., Andia, T., Barbosa, T., & Watanabe, J. H. (2015). Definition and classification

of generic drugs across the world. Applied health economics and health policy, 13, 5-11.

3. Alrasheedy, A. A., Hassali, M. A., Stewart, K., Kong, D. C., Aljadhey, H., Ibrahim, M. I. M., & Al-

Tamimi, S. K. (2014). Patient knowledge, perceptions, and acceptance of generic medicines: a

comprehensive review of the current literature. Patient Intelligence, 1-29

4. Assin TJ, V., A. George, N., Aboobaker, N., & P, S. (2025). Emerging market dynamics: risk perceptions,

perceived usefulness and E-pharmacy adoption. International Journal of Pharmaceutical and Healthcare

Marketing, 19(1), 139-159.

5. Deshpande, P., et al. (2018). Functioning and productivity of Jan Aushadhi stores in India: The owners'

perspective.

6. M. Pareek, D. M. (2019). Providing Generic Medicines to the Poor in India: An Overall Assessment of

Government-Run Generic Medicine Scheme Pradhan Mantri Bhartiya Janaushadhi Pariyojana (PMBJP)

With Reference to the Experience of Store Owners in the City of Jaipur. Indian Journal Of Pharmaceutical

Research.

7. Pareek, M., & Prakash, D. M. (2019). Providing generic medicines to the poor in India: An overall

assessment of government-run generic medicine scheme Pradhan Mantri Bhartiya Janaushadhi

Pariyojana (PMBJP) with reference to the experience of store owners in the city of Jaipur. Available at

SSRN 3382656.

8. Braun, V., & Clarke, V. (2006). Using thematic analysis in psychology. Qualitative research in

psychology, 3(2),

9. Brems, Y., Seville, J., & Baeyens, J. (2011). The expanding world market of generic pharmaceuticals.

Journal of Generic Medicines, 8(4), 227-239.

10. Carter, S. R., Ahmed, A. M., & Schneider, C. R. (2023). The role of perceived service quality and price

competitiveness on consumer patronage of and intentions towards community pharmacies. Research in

Social and Administrative Pharmacy, 19(5), 717-727

11. Chaniotakis, I. E., & Lymperopoulos, C. (2009). Service quality effect on satisfaction and word of mouth

in the health care industry. Managing Service Quality: An International Journal, 19(2), 229-242.

12. Charan, J., Saxena, D., Chaudhri, M., Dutta, S., Kaur, R. J., & Bhardwaj, P. (2021). Opinion of primary

care physicians regarding prescription of generic drugs: A Cross-sectional study. Journal of Family

Medicine and Primary Care, 10(3), 1390-1398.

13. Rana, P., & Roy, V. (2015). Generic medicines: issues and relevance for global health. Fundamental &

clinical pharmacology, 29(6), 529-542

14. R. Mishra, B. S. (2019). Generic Drug Distribution in India-Issues and Challenges. Journal of

Pharmaceutical Care & Health Systems

15. Rathi, H., & Biyani, M. (2021). Knowledge, Attitude, and Perception of Indian population about generic

versus branded medicines: A web-based study. Asian J Pharm Clin Res, 14(2), 95-98.

16. Rituparna Maiti, V. B. (2015). Essential Medicines: An Indian Perspective. Indian Journal of Community

Medicine/Vol 40/Issue 4, 223-235.

17. Seshadhri, S., Poncheran, P., & Venkateswaramurthy, N. (2023). A cross-sectional survey on the average

public's knowledge towards allopathic generic drugs and their side effects. Journal of Population

Therapeutics and Clinical Pharmacology, 30(17). https://doi.org/10.53555/jptcp.v30i17.2540

18. Shweta, & Kumar, D. (2023). Qualitative exploration of the issues of Indian generic medicine supply

chain using ISM-MICMAC. International Journal of Logistics Systems and Management, 45(3), 291-

316.

19. Singh, D. K., & Khan, S. (2023). Exploring the Consumer Perception of Generic Medicine in Eastern

Maharashtra during the Covid-19 Pandemic: An Empirical Analysis. International Journal, 11(2).

20. Singh, S. A. N. D. E. E. P., Tewari, A. N. U. R. A. G., Aggarwal, P. R. A. N. A. V., Ranjan, R. A. J. I. V.,

& Bansal, A. J. I. T. (2020). A study of patient awareness regarding the purchase of generic and ethical

branded medicines. International Journal of Pharmaceutical Research, 12(2).

21. Yenet, A., Nibret, G., & Tegegne, B. A. (2023). Challenges to the availability and affordability of essential

medicines in African countries: a scoping review. ClinicoEconomics and Outcomes Research, 443-458.

www.ijltemas.in

Page 479