The background of the study refers to the limited access to health care services in rural indigenous communities in Southern Mexico. Health facilities serving the rural population experience problems of loss and diversion of essential drug supply. Access to existing health services faces cultural barriers. Functional barriers play also an important role in restricting health service utilization as well. Despite trained health staff is available at health facilities, the lack of equipment and essential drugs hinders the provision of high quality services. Socioeconomic barriers are the most important deterrent for using health services in rural areas of Chiapas. The current government assistance programmes consist of pure financial supply without a follow up or any other knowledge building, like sustainable programmes require. The aim of the research was to identify health care seeking practices to get to know the perceived problems of access to basic drugs and to know perceived health needs, including possible solutions, solving them in a community participatory manner. The methods used for the study focused on combination of quantitative and qualitative research methods: a) a cross-sectional survey including 480 households; b) 190 pharmacy-user surveys; c) 15 semi-structured interviews with local health staff; d) 9 focus group discussions; e) 3 participatory evaluation workshops. Results show that the study population live in poor socio-economic living conditions. The health care- and drug seeking practices are concentrated in governmental health services. As limitations were perceived: Lack of basic drugs, precarious financial situation of patient and family, insufficient transport and communication facilities and the lack of adaptation of services on local needs (local language, cultural traditions). Perceived health needs were expressed like 24hour service in consideration to local needs, local access and improvement of living conditions. Solutions may be a better supply of drugs for the existing health services and health related activities within the community in a participatory manner. Concluding, results show an urgent need to plan, implement, carry out, and evaluate a pilot project on community activities in health related issues, focused on a participatory manner, approaching every community individually. The participatory focus showed that the population is aware about its health related situation, needs and possible solutions. They are interested in cooperate in solutions and feel themselves capable to cooperate actively in an improvement of its health related situation. [Author p. 1]