How to cut child mortality in half again: making primary healthcare work.

The gap between what primary healthcare (PHC) could achieve and what it currently delivers remains wide. Preventable child deaths remain a reality, particularly in underserved communities, and hard-won gains risk being reversed by diminishing attention. Making PHC work for children and adolescents requires clear, evidence-based standards, supportive health systems, and community-driven engagement. The WHO Pocket Book of Primary Health Care for Children and Adolescents and its mobile application bridge these pillars into one actionable strategy. Over the past decades, global child mortality has fallen by nearly 60%, largely due to services delivered through PHC. Yet millions of preventable deaths persist, reflecting weaknesses in governance, financing, workforce, and quality of care. Selective interventions contributed to earlier progress but narrowed the Alma Ata vision, limiting PHC to a small set of conditions. The Pocket Book and its app provide an integrated, evidence-based framework spanning birth to 18 years that operationalises comprehensive PHC. Country adaptation processes act as catalysts for systems change by identifying and correcting health systems' dysfunctions and engaging parents and caregivers as partners in care. This approach offers a practical pathway to halving child mortality again.