- This paper describes changes that are occurring in paediatric practice in a variety of settings. The ‘new morbidity’ demands focused training of paediatricians of the twenty-first century. Areas that include advocacy, public health, adolescence, chronic illness, health promotion, behavioural issues, parenting and family dynamics, social influences, health and social inequalities, managerial decision making and technological advances should be a part of paediatric training. These factors assume different importance in developing nations where priorities may be more focused on public health, nutrition and health promotion. Partnership with others who have children's interests at heart, for example mental health services, public health, social sciences, education and social services is imperative in planning service development informed by good information systems incorporating measures of mortality and morbidity. Copyright © 2000 John Wiley & Sons, Ltd.