Despite all the legislative efforts regarding child protection and campaigns to prevent and combat early marriage and maternity, Mozambique was ranked 9th globally in terms of the prevalence of early marriage, with 48% of girls aged 20-24 marrying before the age of 18 years. The aim of this study was to develop a strategic alignment framework for the prevention and combat of early marriage and maternity in Zambézia Province, Mozambique. This study used a two-stage equal-status concurrent sequential mixed-method design. Data were collected through a cross-sectional survey, administered to 383 early married, maternity and pregnant girls; life story interviews with early married, maternity and pregnant girls (25) aged 10-19 years; semi-structured interviews with professionals from the education and health sectors, local authorities, families of the early married, maternity and pregnant girls (37), and group discussions with members of a child committee (16). The results indicated that the majority of early married, maternity and pregnant girls only completed primary education (55.9%), followed by secondary education (39.9%), and higher education (2.9%). About 65% of adolescent girls became pregnant at the age of 15-17. Among adolescent girls, 18.8% had their first baby before the age of 15 years and 99.2% had their first baby before they were 18 years old. Among the early maternity girls (362), 24.3% responded “yes” to the questions about health complications during their first baby’s birth and 75.7% of the respondents said “no”. Socio-cultural meanings, such as socialisation into roles, legitimising having children, the value and benefits of the bridewealth, the role of initiation, the social meaning of the first menstruation, geographical and transport issues were the main drivers for school dropout, forcing adolescent girls to marry. Engaging in sexual practices was found to provide the girls a sense of meaning and purpose, or as a result of poverty. Physical aspects, interpersonal relations, education, work, and emotional distress were some of the negative consequences of early marriage and maternity. There were some relevant interventions and efforts to prevent and combat early marriage and maternity in Maganja da Costa and Morrumbala districts in Zambézia Province, Mozambique. However, the alignment of the activities implemented by different NGOs and CBOs to MNSPCM (2016-2019) was still a challenge. Only World Vision was implementing programmes aligned to the National Strategy. Based on the results, I developed a strategic alignment framework for the prevention and combat of early marriage and maternity in Zambézia Province, Mozambique. / Health Studies / D. Litt. et Phil. (Health Studies)