Egypt is the first country in the Region to have reached Millennium Development Goal (MDG) 4 on reduction of under-5 mortality, with a 74% reduction between 1990 and 2008 versus the proposed MDG reduction of 66%, according to estimates published in the World Health Statistics 2010. Over 91% of primary health care facilities in the country have been covered by the Integrated Management of Child Health (IMCI) strategy, this representing an outstanding achievement. Given the good access to primary health care services, this may suggest a high coverage of the under-5 population to key primary child health care services. On the other hand, child survival inequalities (e.g. by place of residence, wealth quintiles) remain and represent one of the current challenges to be addressed. As Egypt may start looking beyond child survival, challenges also include low coverage of interventions in the community which can lay the foundations of the future health of children, such as exclusive breastfeeding.