Introduction:

Maternal mortality remains a global public health issue, Sustainable Development Goal
(SDG) 3 targets to reduce it to less than 70 for every 100,000 live births by 2030
globally. Maternal mortality whose peak is during intrapartum and the first day
post-partum, 75% of it is accounted for by obstetric danger signs complications.
Tanzania's maternal mortality ratio stands at 104 for every 100,000 live births, higher
than the SDG target. Innovations that include women groups like M-MAMA Champions are
necessary to improve the literacy level of obstetric danger signs, birth preparedness,
and complication readiness among pregnant women and enhance obstetric emergency response
and service utilization, for essential interventions in healthcare facilities alone
haven't been able to reduce maternal mortality due to poor services utilization.

Methods and analysis:

A community-based, cluster randomized controlled trial (cRCT) design, will be utilized in
undertaking the study of 120 first and second-trimester pregnant women randomized at a
ratio of 1:1 to the intervention and control groups. The intervention of sensitizing
pregnant women on Obstetric danger signs, birth preparedness, and complication readiness
by the empowered M-MAMA Champions to the intervention arm clusters will be done for one
month, each two-hour session delivered in two weeks, using participatory learning and
action model for women groups. The effect of the intervention will be determined using
repeated ANOVA analysis.

Ethics and dissemination. The University of Dodoma Research Ethics Committee approved
this study (Ref. No. MA.84/261/02/1/115). The study will ensure the protection of the
participants' values, dignity, and integrity by the Helsinki Declaration by the World
Medical Association. The study results will be published in peer-reviewed journals and
disseminated at various conferences, and the government through the Ministry of Health.