Group antenatal care initiative takes root in Tanzania

The Realizing Gender Equality, Attitudinal Change, and Transformative Systems in Nutrition ( REACTS-IN ) program is a multi-country initiative operating in Bangladesh, Cambodia, Kenya, Somalia and Tanzania. Led by World Vision Canada and in partnership with Nutrition International, Harvest Plus and McGill University, the initiative promotes gender-equitable nutrition, health and sexual and reproductive health and rights (SRHR) at individual, household and community levels. Its goal: to empower women and families to make informed decisions and adopt practices that ensure healthier futures.

Addressing antenatal care gaps

Annual monitoring done by project staff in 2025 revealed consistently low antenatal care (ANC) coverage across all REACTS-IN countries. Only a small proportion of mothers with children less than six months attended at least four ANC visits with skilled personnel during their last pregnancy—just 12 per cent in Somalia and 56 per cent in Tanzania. In Tanzania’s Simiyu region, where REACTS-IN operates, only 36 per cent of women attended four or more ANC visits and just 67 per cent received skilled care.

The evidence shows that traditional, one-on-one ANC visits were failing to keep women engaged in pregnancy care. So, we revised the mothers' group curriculum to prioritize ANC and family planning. As a result, group antenatal care (G-ANC) was introduced in Simiyu to create a more supportive, community-based approach. It brings together pregnant women with similar gestational ages for group sessions, fostering peer support and providing health education.

This approach is a shift from routine to relational care. Women are no longer passive recipients, but active participants in shaping their own experiences.

For Neema, an expectant mother in her second trimester, G-ANC has been eye-opening. “We learned the importance of early antenatal care and how to prepare nutrient-dense foods,” she said. Neema passionately encourages other women to join and calls on husbands to play an active role, urging them to accompany their wives and learn how to best support them for the health and happiness of their families.

Early signs of change

Pilot data from Tanzania highlights the transformative potential of group antenatal care in improving maternal health outcomes and advancing gender-equitable access to care. One health clinic in the Meatu district has seen noticeable progress. More mothers are attending clinics and healthcare workers have more time for comprehensive services, including behavioural change messaging and cooking demonstrations.

Husbands are also joining their wives, supported by a “love letter” approach where women write notes to their husbands thanking them for their support. The dispensary also uses follow-up cards to track women who miss their monthly visits, ensuring continued care.

By fostering community support and active participation, G-ANC aligns with REACTS-IN ’s vision of empowering women and adolescent girls to make informed decisions. As implementation continues, scaling up this model and applying lessons learned will be key to closing ANC gaps and ensuring healthier futures for both mothers and children.

Written by Christina Cook with files from Dr. Stanford Kaserwa, REACTS-IN Project Manager, World Vision Tanzania and in collaboration with Dr. Asrat Tolossa, REACTS-IN Chief of Party, World Vision Canada.