This paper addresses these challenges by approaching child health policy re- form from a system-transformation argue that (1) the vision and operating logic of the child health system must be responsive to the new under- standing of child health development and to the changing epidemiology of child health; (2) a transformative approach is necessary to improve performance, to achieve current and emerging child health goals, and to address constraints that impede real reform; (3) transformation of the child health systemshould be guided by a new operating logic, organizational approach, and set of financing strategies; and (4) the strategies for policy reform should focus on a long-term transforma- tive.