The earliest years of life are pivotal in forming the foundations for healthy development and providing children and their societies the opportunity to reach their full potential. However, many children in developing countries are not able to develop to their full potential because of serious deficits in health, nutrition and proper cognitive and non-cognitive stimulation. The effects of the delayed development in the early years can be deleterious and long lasting, reinforcing the intergenerational transmission of poverty. Early Childhood Development (ECD) programs are seen as a promising way to prevent such delays and foster early development. While there is a growing evidence base on the effects of ECD programs in the United States, Latin America and elsewhere, there is little evidence of the effectiveness and cost-effectiveness of such programs in the African context.