Enhancing rural healthcare delivery in India: eSanjeevani and the community health officer perspective.

Background We explored the perceptions of community health officers (CHOs) regarding the effectiveness of eSanjeevani, a telemedicine platform used in rural healthcare delivery across India. The increasing use of eSanjeevani highlights its potential to address healthcare accessibility limitations, particularly in remote areas. Methods We included 120 CHOs who completed training between March and August 2020 and had a 2-year experience at the time of this study (September 2022). A structured questionnaire was distributed via Google Forms to assess the CHOs' perceptions of eSanjeevani. Interviews were also conducted to gather qualitative data on perceived modifications for improvement. Descriptive statistics were analysed for quantitative data. Results A response rate of 88.3% (n=106) was achieved. Over half (53.77%) the CHOs used eSanjeevani daily. CHOs perceived eSanjeevani to be effective in managing non-communicable diseases, with 39.6% reporting it was useful for diabetes and 38.7% for hypertension, skin conditions (50.9%), followed by paediatric (45.3%) and maternal health issues (42.5%). However, limited specialist availability (58.49%), network connectivity issues (22.64%), and extended waiting times (15.1% with wait times exceeding 90 minutes) were identified as the limitations of the platform. Thematic analysis of the open-ended responses revealed recommendations for improvement, with a focus on increasing specialist availability (41.5%) and reducing waiting times (37.7%). Conclusion From the perspective of CHOs, the eSanjeevani platform facilitates improved access to specialists and early diagnosis but challenges related to infrastructure and resource limitations persist. The findings support continued investment in eSanjeevani alongside efforts to address identified limitations to optimize role of telemedicine in enhancing rural healthcare delivery.