Professor Zulfiqar A. Bhutta addresses an area where opportunities remain for improving maternal and child health: the preconception and periconception periods. Maternal morbidity, neonatal morbidity and risk of stillbirths are highest in some of the poorest regions of the world. To improve the health of new-borns, the health of the mothers must be addressed. The targets are clear, and recommendations and programs addressing these areas exist. However there are major challenges to implementing the recommendations, including a lack of dedicated infrastructure which would allow help to reach those most in need.Professor Bhutta restates that up to 40% of all first-time pregnancies in the least developed countries are to adolescent mothers. This he says is “evidence of a gap in the continuum of care”, especially around the periconceptive period (2 years before conception and up to 5 years after birth). Those most in need of periconceptive care and advice include adolescents, women and newly-weds. Importantly, a key target group are also men, whose health and behaviour can pose a risk to maternal and child health.Study data presented by Professor Bhutta suggest that providing health education, preventing adolescent pregnancy, optimising nutrition and managing obesity and diabetes risk factors can be effective and should be implemented, especially in a community setting.