The study examines community-based maternal health check-ups in Sierra Leone's rural villages over several decades. An ethnographic approach was employed to gather qualitative data from interviews and observations conducted within participating communities. Focus groups were used for in-depth discussions about health practices and challenges. Survival rates of mothers and infants have shown significant improvement over the past five decades, with a notable increase in maternal vaccinations from 20% to 85% among those who received regular check-ups. Community-based maternal health programmes have contributed substantially to improved survival outcomes. Cultural adaptations were crucial for programme sustainability. Further research should explore the long-term effects of these programmes on community health infrastructure and identify best practices for replication.