Millennium Development Goal 4 (MDG 4) requires a reduction of under- five mortality rates by 2/3 between 1990 and 2015; and MDG 5 of maternal mortality rates by 3/4. Under-five mortality decline in Ghana has been very slow from 155 deaths/1,000 live births in 1988 to 80 in the 2008, with stagnated neonatal mortality rates (GDHS 2008). Estimates of community based maternal mortality and institutional mortality rates remain very high. Development of new and or improved interventions to accelerate mortality decline are urgently needed. This project seeks to develop and evaluate the impact of integrated and interdependent multi- disciplinary interventions on maternal and neonatal survival in Ghana. The priority theme is organization and delivery of essential and quality health services. However because of the interrelated nature of issues in health systems, to address effectively the core theme, the project also addresses linked themes in health system governance and decision making including human resource management. This Accelerate project seeks to promote reduction in maternal and infant mortality by developing and evaluating approaches for accelerated attainment of MDG 4 and 5. The work will be carried out in the Northern and Greater Accra regions of Ghana and is expected to provide lessons for Ghana as well as other sub-Saharan African countries. The interventions aim at strengthening the basic health system functions of organization and the delivery of essential and quality health services, human resource management, and governance and clinical decision making related to maternal and neonatal health. The interventions will be executed in three closely interrelated research sub-projects. PhD researchers in the disciplines of epidemiology, medical anthropology, and health policy and health systems management will be trained within the projects as part of capacity building for sustainable development. Their participation in the project will be rooted in their institutional context to strengthen health service delivery and academic institutions in Ghana. Between 1990 and 2015, MDG 4 calls for a reduction by 2/3 of the under five mortality rate; and MDG 5 for a reduction by 3/4 of the maternal mortality ratio. Progress towards achievement of MDG 4 & 5 has been low in Ghana and other countries of sub-Saharan Africa. Without innovative approaches to accelerate progress, it is unlikely that these goals will be achieved. When mortality is disaggregated it is seen that neonatal mortality rates have remained more or less unchanged and are a major contributor to the slow decline. When trends in under five mortality over the last 15 – 20 years are disaggregated by age bands it is clear that mortality has steadily declined in the child age group (1 – 4 years) and the gaps between a deprived region like the northern region and a better endowed region like the Greater Accra region are closing. However after declines early in the period, rates of neonatal deaths (1st month of life) have been or less stagnant. The stagnation of mortality decline in the neonatal age group accounts for much of the failure for mortality decline in the 1st year of life to match the declines in the age group 1 – 4 years and Ghana’s difficulties in attaining the MDG. The problem appears to be one that is of equal concern in the more economically deprived northern as well as less deprived Greater Accra region. The Accelerate project is innovative in its integration of parallel interventions at different levels of the health care system from local to district through regional to national level to address the problem of unacceptably high levels of preventable maternal and neonatal deaths. The interventions in this project are also targeted in a coordinated manner from a variety of disciplines that were rarely joined in the same research programme. The programme aims at different aspects of health system functions that affect maternal and neonatal health ranging from delivery of improved quality clinical care services to human resource management and policy. In the process, the project pulls together and strengthens capacity in the applied disciplines of the clinical, public health and social sciences that are interdependent and yet traditionally tend to work apart to find joint solutions to health system problems. The project is also innovative in the learning it will provide about the effective application of integrative and inter-disciplinary approaches and in the multidisciplinary training that is foreseen for all six PhD fellows.