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Inadequate health literacy has been shown to have a detrimental ef fect on health status1). Women’s health literacy directly influences their protective and preventive health behaviors and promotion of physical and mental health2). Antenatal care(ANC)is one opportunity for pregnant women to obtain maternal health literacy, especially in settings with few information sources. However, factors that may negatively af fect the motivation to seek ANC include extreme poverty and prior bad experiences with inadequate ANC and/or other healthcare services3). Therefore, culturally sensitive needs‒oriented approaches, if implemented appropriately, may be effective and affordable ways to improve women’s health literacy, especially in traditional societies with limited healthcare resources4). In addition, the capability of healthcare personnel and community‒based netFactors associated with maternal health knowledge among pregnant women in a remote region of Paraguay