There is a growing call to reduce environmental risk factors for children in developing countries and to provide children and parents in these places with the services they need to promote healthy development. To address this issue, 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 at the same time for healthy development. The index is created using South African data, and shows that there is no municipality in South Africa where all children receive the full complement of the services they need to thrive. Following on from this, a first validation is provided by assessing whether the constructed ECD services index correlates with individual child outcomes. The analysis reveals that public infrastructure service delivery is positively related to cognitive outcomes in children who attend an ELP in South Africa. Since the sample of children who attend ELPs in South Africa is representative of the more advantaged children in the country, these results imply that improved municipal environments are complementary inputs to early childhood care and education. 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 cognitive stimulation.