ObjectiveThe objective of this study was to determine the effectiveness of a set of multifaceted interventions designed to increase the access of rural women to antenatal, intrapartum, postpartum and childhood immunisation services offered in primary healthcare facilities.DesignThe study was a separate sample pretest–post-test quasi-experimental research.SettingThe research was conducted in 20 communities and primary health centres in Esan South East and Etsako East Local Government Areas in Edo State in southern NigeriaParticipantsRandomly selected sample of ever married women aged 15–45 years.InterventionsSeven community-led interventions implemented over 27 months, consisting of a community health fund, engagement of transport owners on emergency transport of pregnant women to primary health centres with the use of rapid short message service (SMS), drug revolving fund, community education, advocacy, retraining of health workers and provision of basic equipment.Primary and secondary outcome measuresThe outcome measures included the number of women who used the primary health centres for skilled pregnancy care and immunisation of children aged 0–23 months.ResultsAfter adjusting for clustering and confounding variables, the odds of using the project primary healthcare centres for the four outcomes were significantly higher at endline compared with baseline: antenatal care (OR 3.87, CI 2.84 to 5.26 pConclusionWe conclude that community-led interventions that address the specific concerns of women related to the bottlenecks they experience in accessing care in primary health centres are effective in increasing demand for skilled pregnancy and childcare in rural Nigeria.