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Part of the "Studies in Early Transitions" series, this Working Paper draws on interviews and observations carried out as part of "Young Lives", a 15-year longitudinal study of childhood poverty in Ethiopia, India, Peru and Vietnam based at the University of Oxford's Department of International Development. This paper focuses on the challenges of translating into practice the potential of quality early childhood care and education to transform young lives. These include building a positive equity agenda, setting clear policy objectives, raising quality standards, building the skills and motivation of teachers, and recognising where equity goals can be incompatible with a market-led private system. The paper asks which children do and do not have access to an early childhood programme, and explores children's and parents' views about the quality of what is on offer. A brief summary of data collection methods is appended. (Contains 2 boxes, 21 figures and 9 footnotes.)