BACKGROUND: Malaria presents a disproportionate threat to pregnant women, making access to malaria prevention tools crucial for controlling the disease in this vulnerable population. METHODS: This prospective descriptive study targeted women of reproductive age (13-49 years old) living in the Mopeia district, a high malaria endemic area in Zambezia province, Mozambique. As part of the BOHEMIA cluster randomized trial, the study included a simplified and full census to collect data on socio-demographic, socio-economic and household factors, health status, and malaria prevention tools from the target population. RESULTS: Data from 7,099 women of reproductive age living in the BOHEMIA clinical trial study area was collected, including 497 (7.0%) self-referred as pregnant. Access to malaria vector control tools was high, with 89.9% of women self-referred as pregnant, 87.9% of women self-referred as not- pregnant living in a household with at least one long-lasting insecticidal net and 69.6% of women self-referred as pregnant and 73.4% of women self-referred as not-pregnant living in household that received indoor residual spraying in the past 12 months. Intermittent preventive treatment coverage was moderate-low, with 53.1% of women self-reported as pregnant having taken at least one dose. CONCLUSIONS: This study found that women of reproductive age in the highly-endemic Mopeia district have good access to malaria vector control tools. However, intermittent preventive treatment coverage remains below World Health Organization-recommended levels. Focused efforts are needed to improve this coverage, and continuous monitoring along with tailored interventions are essential for achieving optimal prevention outcomes among vulnerable populations.