This study examines the effectiveness of network strengthening efforts among Health Extension Workers (HEWs) in maternal care networks within rural villages of Gambia. A participatory action research approach was employed, involving qualitative interviews and observations conducted by the HEWs themselves. Data were collected through semi-structured interviews and focus group discussions (FGDs) to understand their experiences and perspectives. HEWs reported significant challenges in maintaining consistent communication and coordination across different villages, with over 60% of respondents indicating difficulties in scheduling appointments due to varying village schedules. The analysis highlights the importance of developing standardised communication protocols and enhancing HEW training on effective network management strategies to improve service delivery outcomes. Recommendations include establishing a central database for appointment scheduling, organising regular training sessions focusing on networking skills, and promoting community health committees as intermediaries in village coordination.