Prepared as a contribution to the World Summit for Children organized by the United Nations in New York in September 1990, this report highlights and promotes commitment at the highest political level for goals and strategies that ensure the survival, protection, and development of children. As part of the process of looking beyond survival and of working toward a "fair start" for children, this document offers the following: (1) a straightforward presentation of what is meant by child development, distinguishing it from child survival and growth and linking it to the concept of child care; (2) a rationale for investing in programs of early childhood care and development; (3) a brief description of the evolution of child care and development programs and a sketch of the current configuration of institutionalized programs, with special attention given to changes occurring since 1979 when the International Year of the Child (IYC) was celebrated; (4) a programming framework in three dimensions, combining stages of child development with five complementary program approaches and with a set of program guidelines; (5) brief descriptions of several programs from various countries that illustrate different ways to support and enhance early childhood development; and (6) some conclusions about what needs to be done to increase investment and to move child care and development programs from rhetoric to reality. References are included with each section except the introduction. (TJQ)