Child health issues are of high importance in the occupied Palestinian territories, where half of the population are children. The Royal College of Paediatrics and Child Health have developed a comprehensive paediatric training programme for primary healthcare providers with the aim of improving child health in the area. The course has taken 8 years to develop with the pilot running in 20052007 and is now being extended to other centres in the region. In this article, we describe the process through which this course has developed, some of the difficulties faced and the final teaching programme as it has evolved. A number of lessons have been learnt, over the years, which are of potential value to others designing similar teaching programmes. Its greatest strength lies in the partnership developed with local paediatricians, which encourages us to believe that sustainability has been achieved. Evaluation confirms that the course is meeting the needs of local doctors and nurses and improving their paediatric skills. Although developed specifically for the occupied Palestinian territory, our experience offers a process and design for a teaching programme that could be adapted for use in other countries around the world.