A Dissertation Submitted inPartial fulfilment of Requirement fortheAward of Degree of Masters in Health Monitoring and Evaluation of Mzumbe UniversityGlobally, Maternal mortality ratio (MMR) reported to be declined, although is still high in sub-Saharan Africa. Antenatal care services (ANC) acknowledged to prevent detrimental outcomes for pregnant women and their babies through early identification of disorders like hypertensive, anaemia and malaria thus reducing mortality and morbidity. Maternal morbidity and mortality in Tanzania exist at unacceptably high levels. Maternal deaths, out of health facility and unskilled assisted deliveries existin the study areadespite of long term FANC model guideline implementation, which is also geared to influence facility based deliveries, completion four ANC visits hence reducing maternal related complications and mortalities.The level of health workers knowledge,adherence and practice regarding FANC model guideline was not fully knownin the study area. The objectives study was to determine FANC model guideline knowledge; identify challenges; examine/explore the adherence level and determine healthcare workers’ perception. Study design was a cross sectional descriptive study adopted both qualitative and quantitative methods.Forty eight RCH department health care workers selected randomly, whereby10 were interviewed, recorded and transcription imported into Atlas.ti for coding, content analysis and themes were established. Thirty eight workers were observed by using a checklist. An Exploratory Data Analysis (EDA) for quantitative data provided insights based on proportions regarding FANC model guideline parameters and participant’s demographic characteristics. Secondary data were analyzed by using Microsoft Excel. Findings indicate that the knowledge level in regards to FANC model guideline is high and majority of health care workers perceived it positively. Variation in adherence levels based on five FANC model guideline categories exist among health care workers observed of which majority (60%) were nurses(EN,RN).It is recommended that regular and intensive Reproductive and Child health focused supportive supervision at health facility levels is conducted to facilitate health care workers compliance of FANC model guideline.