Health Extension Worker (HEW) programmes in Ethiopia aim to improve access to healthcare services in remote areas by providing basic health education and referrals. The study employed semi-structured interviews, focus group discussions, and document reviews to collect data from village leaders, healthcare workers, and community members. Data analysis involved thematic coding and content analysis. HEWs covered approximately 85% of the villages in terms of regular health education sessions, though access to specialized care options was limited due to geographical constraints. While HEW programmes significantly enhanced basic healthcare knowledge among villagers, their ability to provide comprehensive medical services remained constrained by remote locations and resource limitations. Enhanced communication technologies should be integrated into the programme to improve referral pathways for specialized care. Additionally, training on alternative health resources could complement existing service offerings. HEW programmes, Health Extension Workers, Access outcomes, Remote villages, Ethiopia