Exploring the Impact of the JEEViKA Swasthya Mitra Helpdesk Intervention on Improving Healthcare Access in Tertiary Healthcare Facilities in Bihar: A Qualitative Descriptive Evaluation.

Abstract Background: Rural populations in Bihar, India, face significant healthcare access challenges due to geographical, infrastructural, and financial barriers. The Swasthya Mitra program, initiated by the Bihar Rural Livelihood Promotion Society in collaboration with local and international partners, aims to mitigate these challenges by employing trained community members to navigate patients through the healthcare system. Methods: This qualitative study employed semistructured int erviews and thematic analysis to evaluate the Swasthya Mitra program in the Bhagalpur and Jamui districts in Bihar, India. The participants included Swasthya Mitras, healthcare professionals, and beneficiaries. This study focused on understanding the program's impact on healthcare access, out-of-pocket expenditures, and the role of Swasthya Mitras in facilitating healthcare services. Findings: The program significantly improved healthcare access for rural populations, with beneficiaries reporting reduced navigational confusion, decreased out-of-pocket expenditures, and enhanced patient care. Swasthya Mitras effectively bridged the gap between the community and healthcare facilities, ensuring timely and efficient medical attention. The program also empowered women, both Swasthya Mitras and beneficiaries, by improving their access to healthcare and increasing their involvement in health-related decision-making. Interpretation: The Swasthya Mitra program offers a viable model for improving healthcare access in rural settings, demonstrating the importance of community involvement in healthcare delivery. The findings suggest that such programs can be instrumental in overcoming barriers to healthcare access and reducing financial burdens on vulnerable populations.