Pregnant women's perceptions of an ICT-based reminder and monitoring system for antenatal care services in rural coastal Tanzania.

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 favourably by pregnant women and has the potential to improve timely antenatal care attendance and service delivery. Keywords: Antenatal Care, Pregnant women, Digital health technology, Tanzania