Vaccination programmes are essential for preventing infectious diseases in pregnant women, yet uptake can be low, particularly among first-time mothers in rural areas where access to healthcare is limited. A qualitative analysis was conducted, involving semi-structured interviews with 50 first-time pregnant women and focus group discussions with community leaders. Data were analysed using thematic content analysis. First-time pregnant women in rural Tanzania cited concerns about side effects (68%), lack of perceived risk (42%), and cost-related issues (35%) as significant barriers to vaccination adoption. The contextual factors identified include socio-cultural norms, healthcare access, and economic constraints. These findings suggest that interventions should focus on addressing these specific barriers through culturally sensitive communication strategies and affordable options. Interventions should prioritise engaging community leaders in education campaigns about the benefits of vaccination for both mothers and infants. Additionally, offering subsidized vaccines could enhance uptake among economically disadvantaged groups. Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.