Knowledge, Perceived Benefits and Willingness to Adopt Telehealth Among Women of Reproductive Age Attending Selected Rural Primary Health Care Centres in Ibadan, Oyo State, Nigeria: A Facility-Based Cross-Sectional Study

<title>Abstract</title> <p>Background Nigeria contributes nearly one-third of global maternal deaths, and rural women bear a disproportionate burden due to understaffed primary health centres (PHCs), geographic barriers, and limited access to skilled care. Telehealth has been identified as a scalable strategy for improving access to maternal and reproductive health services. However, evidence on demand-side readiness, specifically the knowledge and perceived benefits that drive willingness to adopt telehealth, remains limited among rural women of reproductive age in Nigeria. Methods A facility-based descriptive cross-sectional study was conducted among 336 women of reproductive age (15–49 years) attending nine rural PHCs across three Local Government Areas (Ido, Oluyole, and Ona Ara) in Ibadan zone, Oyo State, using multistage probability sampling. Data were collected using the validated bilingual Rural Telehealth Adoption Assessment Questionnaire (R-TAAQ), grounded in the Technology Acceptance Model (TAM), Health Belief Model (HBM), and UTAUT. Descriptive statistics, chi-square tests, Pearson correlation, and binary logistic regression were employed. Results The response rate was 93.6%. The majority demonstrated high knowledge of telehealth (62.8%; mean = 5.80 ± 2.34/8) and positive perceived benefits (82.4%; mean = 25.6 ± 7.52/30). Willingness to adopt was high (83.9%; mean = 11.1 ± 3.24/15). Perceived benefits were the only variable significantly associated with willingness to adopt (χ² = 46.774, p &lt; 0.001). Knowledge (p = 0.428), facilitating conditions (r = 0.037, p = 0.493), and all socio-demographic variables (p &gt; 0.05) were not significant. Binary logistic regression confirmed perceived benefits as the sole significant predictor (AOR = 11.274, 95% CI: 5.427–23.422, p &lt; 0.001; Nagelkerke R² = 0.254; classification accuracy = 84.5%). Women with 3–4 children were significantly less likely to be willing to adopt (AOR = 0.073, p = 0.027). Conclusions Rural women demonstrated high knowledge and strong willingness to adopt telehealth for maternal care. Perceived benefits, not knowledge, infrastructure, or demographics, is the primary determinant of adoption intention. Telehealth promotion in rural PHC settings should prioritise benefit-focused communication. Structural barriers, particularly electricity instability and data unaffordability, must be addressed to close the intention-behaviour gap.</p>