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Background and objective: maternal and neonatal mortality rates in Mozambique are high, due to insufficient numbers of qualified health workers, lack of equipment and materials, referral system deficiency, difficulties to access health services and gender issues. This study assesses the barriers to health care access, regular attendance at ante natal consultations, institutional delivery and postnatal and neonatal follow-up. This is part of the baseline study for an implementation research project to reduce maternal and neonatal mortality in Natikiri, Nampula, Mozambique. Conclusion: local community members and health professionals were asked to state what they thought would be the best way to intervene. These ideas were then discussed further at a conference with health professionals and government representatives. Six intervention strategies to address identified problems were decided on and will be the basis for the ongoing implementation research project. They were: 1. Expanding family planning especially with adolescents. 2. Community based transport system for pregnant women. 3. Strengthening maternal and child health services by training maternity personnel in obstetrical emergency care and neonatal resuscitation. 4. Providing four quality prenatal visits. 5. Providing quality cesarean deliveries. 6. Supporting the Mozambican Government's campaign against bribery.