Sindh province is moving forward to incorporate IMCI into pre-service education. A national practical orientation and planning workshop was held in 2008, supported by the Child and Adolescent Health Programme of the WHO Regional Office for the Eastern Mediterranean, which involved representatives of 18 teaching institutions, including medical colleges and paramedical and nursing teaching institutions. Following the national event, Sindh province took the lead, conducting IMCI pre-service education orientations for medical colleges in 2009, followed by the development of plans by each institution in 2010. These plans have the objective to integrate IMCI into undergraduate and post-graduate teaching programmes of departments of paediatrics and community medicine of eight medical colleges. One-block IMCI courses for post-graduate students in the Diploma in Child Health, MD (Paediatric medicine) and Fellowship of the College of Physicians and Surgeons (FCPS) of these medical colleges have also started. Focal points in each institution have been designated and training courses in IMCI to build capacity in teaching are being held. Five public health schools have also been oriented on IMCI and are expected to develop plans soon to include IMCI in their lady health visitor teaching programme. With strong WHO technical support, these efforts are the result of active leadership in the province with partnership between the teaching institutions, the Maternal, Neonatal and Child Health Programme (MNCH) of the Ministry of Health and the Health Department of Sindh province, WHO (country and Sindh provincial offices) and projects such as the United States Agency for International Development (USAID)-funded Pakistan Initiative for Mothers and Newborns (PAIMAN) and the Norway–Pakistan Partnership Initiative (NPPI) which support maternal and child health activities. IMCI pre-service education is seen as one of the key approaches to ensure IMCI sustainability in the long term and prepare graduates to deliver quality child care services also in settings with limited resources.