INTRODUCTION:
Maternal and newborn health outcomes in rural South Africa are constrained by inequities in access to quality care, health information, and continuity across the antenatal–postnatal continuum. In Xhariep District, long travel distances, limited resources, late antenatal bookings, low health literacy, and poor retention of mother–baby pairs contribute to preventable maternal and neonatal complications. Rural care delivery is often fragmented and task-focused, limiting emphasis on education, psychosocial support, early risk identification, and postnatal linkage.

METHODS:
A facility-based quality improvement initiative guided by the Plan–Do–Study–Act (PDSA) framework was implemented to strengthen equity and continuity in perinatal care. Two primary healthcare facilities with high pregnancy rates and significant social challenges were purposively selected. Thirty-six pregnant women were enrolled in the multidisciplinary antenatal sessions. Three low-cost interventions were implemented:(1)structured multidisciplinary antenatal sessions focusing on health education, nutrition, danger sign recognition, and birth preparedness; (2)a Mommy Reminder Card to reinforce key perinatal messages, promote appointment adherence, and address literacy barriers; and (3)a mother–baby pair booking system to ensure continuity of care from pregnancy through postnatal period. The initiative involved nurses, dieticians, environmental health practitioners, health promoters, community healthcare workers, registered counsellors, and social workers. Process and outcome measures included attendance at scheduled visits, retention of mother–baby pairs, multidisciplinary participation, and participant satisfaction

RESULTS:
Post-implementation, findings demonstrated improved antenatal and postnatal visit attendance, strengthened retention of mother–baby pairs, and enhanced multidisciplinary collaboration addressing medical and social determinants of perinatal health. Participants reported improved knowledge of danger signs, nutrition, and birth preparedness. Evaluation findings revealed 100% Multidisciplinary team engagement and 97% participant satisfaction, with sessions confirmed informative and objective-aligned.

CONCLUSIONS:
Simple, context-appropriate, low-cost interventions can strengthen perinatal care continuity, empower mothers, and integrate services in resource-limited rural areas. The Xhariep model provides a scalable, sustainable approach to reduce inequities and improving maternal and newborn health outcomes.