On September 21st, stakeholders will come together at the United Nations General Assembly to discuss the importance of aligning investments on primary health care as a key pathway for achieving universal health coverage (UHC) (1). This event fulfills the agreement to convene a high-level meeting in 2023 included as part of the Political Declaration of the High-Level Plenary Meeting on Universal Health Coverage resolution adopted by the General Assembly in 2019 (A/RES/74/2) (2).Latest reports from UHC 2030 show that the positive trajectory from 2019 to 2021 in country commitments to universal health stagnated starting in 2022, and there was systematic underinvestment in reducing financial barriers to health services across many countries (3). UHC 2030 also found continued country reliance on disease-specific programming and wide variations in progress across countries in increasing the service coverage index (Sustainable Development Target 3.8, indicator 3.8.1) *(3). A critical question is how much these findings reflect the situation for women, children, and adolescents, the population groups at the center of the UHC agenda.According to the latest United Nations global maternal mortality estimates, progress in reducing maternal mortality stagnated from 2016 to 2020, and the world is off track for achieving Sustainable Development Goal target 3.1 ** (4)(5). Those same estimates, which reflect pre-pandemic levels, translate into approximately 800 maternal deaths every day. These global figures mask large inequalities in maternal mortality across regions and countries, with a growing concentration of maternal deaths in sub-Saharan Africa’s poorest countries and in conflict-affected contexts (4). The most recent stillbirth, neonatal and child mortality estimates show similar patterns. In 2021, there were an estimated 1.9 million stillborn babies, approximately one every 16 seconds (6). Progress in reducing stillbirth rates has been slow, and the highest stillbirth rates were in sub-Saharan Africa (6). Around 2.3 million children died during the first month of life in 2021 – about 6,400 deaths per day (7). Children at greatest risk of dying during the neonatal period were, again, in sub-Saharan Africa (7).The message is clear about the growing concentration of mortality in sub-Saharan Africa and fragile contexts, and the urgent need to prioritize these settings for action. But these statistics do not tell the whole story. Country efforts to strengthen health service delivery platforms and reduce health inequalities have yielded important results for women and children that should be acknowledged. For example, a recent analysis examining trends in 101 low- and middle-income countries over the past three decades on coverage of the composite coverage index (CCI) – composed of eight essential interventions along the reproductive, maternal, newborn, child, and adolescent health (RMNCAH) continuum of care – found both positive changes in coverage levels as well as significant reductions in inequalities within and between countries (8). The CCI increased approximately 22 percentage points, from an average of 49% coverage across these countries in 1993 to 71% in 2021. Similarly, absolute inequalities in CCI coverage levels between the richest and poorest women and children living in these countries declined, with the coverage gap narrowing from 33 percentage points to 14 percentage points. The study also found that low-income countries experienced the greatest increases in coverage during the last 30 years. However, West and Central Africa performed the poorest, with the lowest coverage levels of the CCI and highest levels of inequalities (8). Although these study findings paint an optimistic picture of what is possible, they are consistent with the latest assessment of 16 key RMNCAH interventions in the Global Strategy for Women’s, Children’s, and Adolescents’ Health presented at the World Health Assembly in May***. This assessment showed that despite laudable progress, the world is far from achieving universal coverage for essential RMNCAH services, and the poorest and most vulnerable women and children remain much less likely to receive these services than their wealthier counterparts (9). Similarly, new projections suggest that only 18 of 70 low- and middle-income countries for which data was available will achieve 80% or higher coverage of the CCI by 2030 (10). What can we do to re-build momentum as the world recovers from the COVID19 pandemic and accelerate access to high quality essential health services for all women and children? The September 21st High Level Meeting on Universal Health Coverage is a pivotal moment for country governments and stakeholders to recommit to the primary health care approach as the bedrock to the achievement of UHC.The Declaration of Astana resulting from the Global Conference on Primary Health Care in 2018 describes the three pillars of the primary health care approach, which are foundational to ensuring all women, children, and adolescents receive the care they need to survive and thrive (11). These pillars emphasize the importance of resilient health care systems able to provide high quality health services throughout the life course, the need for coordinated multi-sectoral actions and a whole-of-government approach to best address underlying determinants of health, and community engagement – including meaningful adolescent and youth participation – to ensure health care services are responsive to the needs of people and to hold governments to account for delivering on their UHC commitments.There have been important strides in each of these three pillars in recent years that should be continued. Growing recognition of the interconnectedness of maternal and newborn health, for example, has resulted in strategic alignment between the Every Newborn Action Plan (ENAP) and Ending Preventable Maternal Mortality (EPMM) initiatives, with unified messages on service integration as key to saving maternal and newborn lives, and on the importance of partners and countries working together to build health care systems that provide comprehensive, high quality RMNCAH services from the community level to health posts and all the way up to intensive care facilities (12). The establishment of the Child Survival Action initiative launched in April 2023 (13) and its linkage to ENAP and EPMM is another example of the global community’s efforts to operationalize the life-course paradigm and ensure continuity of care throughout the pre-pregnancy, pregnancy, postpartum, and childhood periods.The launch of the Catalytic Fund for the Community Health Road Map in 2020 was also a major step forward for bringing together Ministries of Health, partners, and donors to identify priorities and invest in community health systems (14). Women and children are primary beneficiaries of community health care programs that reach them where they live, and their scale up is an important strategy for bringing services to zero dose communities. New country commitments to adolescent health and well-being that will be made in the context of the SDG Summit and at the upcoming Global Forum for Adolescents (15) is an important milestone for increasing visibility and funding to this population group who will become future leaders and parents of the next generation. Regarding human resources for health, the COVID19 pandemic further reinforced awareness of health care workers as the backbone of health care systems, and the need for governments and partners to adequately invest in their training and in creating enabling environments for them so they can provide respectful care according to standards. Ensuring sufficient numbers of well-trained health care workers who are equitably distributed throughout countries is fundamental to achieving universal coverage of the services all women and children deserve.Together, by re-committing to the UHC agenda, reaffirming the principles of the primary health care approach, investing in innovations (16), and strengthening social participation mechanisms, we can make greater strides towar