Pregnant women’s perceptions of an ICT-based reminder and monitoring system for antenatal care services in rural coastal Tanzania: A cross- sectional study
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Objective
This study assessed the level of early antenatal care attendance, identified barriers to attendance, and assessed pregnant women’s perceptions of an ICT-based reminder and monitoring system in rural coastal Tanzania.
Design
A Cross-sectional study was conducted using structured interviewer administered questionnaires with data collected through kobotoolbox.
Setting
This study was conducted at antenatal care clinics of Bagamoyo and Mkuranga District Hospitals, Coastal Region, Tanzania, from April to May 2026.
Participants
308 pregnant women who attended antenatal care clinics were systematically sampled from ANC registers.
Results
31.2% of pregnant women initiated antenatal care within the first 12 week of gestation. Prolonged waiting time at antenatal care clinics was the most prominent barrier, followed by distance from health facility and feeling healthy. Four constructs of the Health Belief Model were associated with positive perception toward the ICT- based reminder and monitoring system; High perceived susceptibility (aPR = 3.517; 95%CI: 1.846–6.701), high perceived benefit (aPR = 2.697; 95%CI: 1.472–4.945), high self-efficacy (aPR = 1.498; 95%CI: 1.285–1.872), high cue to action (aPR = 1.941; 95%CI: 1.121–3.359).
Conclusion
Early antenatal care attendance in rural settings still falls below recommended WHO level, attributed to individual, accessibility, and health system barriers. The ICT-based reminder and monitoring system was perceived favorably by pregnant women and has the potential to improve timely antenatal care attendance and service delivery.
Key point
Questions
What is the level of early antenatal care attendance among pregnant women in rural coastal Tanzania?
What are the barriers faced by pregnant women who attended antenatal care clinics?
What are pregnant women’s perceptions of an ICT-based reminder and monitoring system to support their attendance at antenatal care services?
Finding
Only 31.2% of 308 pregnant women initiated antenatal care within 12 weeks of gestation. The predominant barriers to antenatal care attendance were prolonged waiting time, distance to facility, and feeling healthy. High perceived susceptibility, perceived benefit, self-efficacy, and cue to action were positively associated with positive perception of the ICT-based reminder and monitoring system.
Meaning
Pregnant women in rural coastal Tanzania had positive perceptions toward an ICT-based reminder and monitoring system and viewed it as a potentially useful approach for improving antenatal care uptake when combined with health education and the reduction of health facility structural barriers.
