Public health worker training programmes are crucial for improving maternal care practices in resource-limited settings like Freetown, Sierra Leone. However, there is limited empirical evidence on their impact over time. Qualitative data were collected through structured interviews with public health workers and focus group discussions with mothers. Data analysis involved thematic coding and comparison across time points. During the study period, there was an increase of 20% in the use of antenatal care services among pregnant women compared to baseline levels. Public health worker training programmes had a positive impact on maternal care practices in Freetown, Sierra Leone. However, further research is required to understand sustained effects and challenges. Continued support for public health workers and ongoing monitoring of maternal care practices are recommended to ensure sustainability of improvements.