The 2008 report examines the state of child survival and primary health care for children, with a strong emphasis on trends in child mortality. It appraises the lessons learned in child survival over the past century. The centrepiece of the report looks at several of the most promising approaches to community partnerships, the continuum of care framework and health to system strengthening for out to comes to to reach those mothers, new borns and children who are currently excluded from essential interventions. By highlighting examples from countries and districts where these have been successful, as well as exploring the main challenges to their expansion, this report offers practical ways to jump to start the progress.