As part of the development of a national reproductive health plan, Zambia's Ministry of Health carried out a safe motherhood needs assessment in 1996. The specific objectives of the assessment were to describe the availability, use and quality of maternal and newborn care, and to identify gaps in the provision of maternal care. Ninety-six health centres, eleven hospitals and nine district health management teams were surveyed. Clients and staff were interviewed at each of these sites using WHO's safe motherhood needs assessment methodology. While the 1992 Demographic Health Survey indicated that 96 per cent of pregnant women had at least one antenatal check-up and that only half delivered in a health facility, the assessment found substantial gaps in the availability and quality of care. The results provide information for development of the national safe motherhood policies and guidelines within a comprehensive reproductive health programme.