Awareness of the importance of early childhood care and education (ECCE) for children below the age of 8 has increased in recent years. It is seen as the foundation of primary education and as a crucial step towards attaining the five MDGs which concern the health, nutrition and education of young children. A key challenge now is how to make high-quality ECCE universal so that it reaches the children who need it most. Young Lives research tracking individual children in India, Ethiopia and Peru offers important evidence about the changing nature of ECCE provision and patterns of inequality in young children's access to care and education. This Policy Brief presents findings from Andhra Pradesh in India and concludes that more efficient resourcing and effective regulation are needed to strengthen existing services, both public and private, if long-term outcomes for children are to be improved. But equally important is the need for a holistic and comprehensive vision policy for ECCE and the early years of every young child.