<p>There is a growing call to reduce environmental risk factors for children in LMICs and to provide children and parents in these places with the services they need to promote healthy development. In aid of this, we create an index of multidimensional service delivery for children in a developing country context. This approach is motivated by the consensus in the literature that early childhood development (ECD) is multidimensional in nature, and that children need multiple inputs <i>at the same time</i> for healthy development. The index is created using South African data, and shows that the full complement of the services is not adequately provided in any municipality in South Africa. Following on from this, a first validation is provided by assessing whether the constructed ECD services index is associated with individual child outcomes. The analysis reveals that the index is statistically significantly associated with child cognitive outcomes, and specifically, that public infrastructure service delivery is positively related to cognitive outcomes in children who attend an ELP in South Africa. This is consistent with the hypothesis that interventions which supplement child nutrition and the home environment have a larger positive impact than those which focus only on one element of development such as cognitive stimulation. This initial validation suggests that this index is useful to measure the compliment of services that children need to develop healthily.</p>