Community-based healthcare initiatives have been implemented in various regions to improve maternal health outcomes, particularly focusing on antenatal care adherence rates. The research employs qualitative methods, including semi-structured interviews with participants from selected communities. Focus groups were also conducted to gather detailed insights into the effectiveness of healthcare initiatives. One year after the implementation of community-based healthcare initiatives, there was a significant increase in antenatal care adherence rates among pregnant women, particularly those who received regular support and education through these programmes. The study concludes that community-based healthcare interventions have positively influenced maternal health outcomes in Zanzibar coastal towns, with noticeable improvements in antenatal care practices. Based on the findings, it is recommended that ongoing support and monitoring of community-based healthcare initiatives should continue to ensure sustained improvement in maternal health.