This review compiles the wealth of available information in regards to developmental difficulties in resource poor settings and summarises them in a systematic framework to be used by health care providers, policy and program staff. It features information from the WHO Developmental Difficulties in Early Childhood Survey, which provides information on various national health system responses to the prevention, detection, assessment and early management of developmental difficulties. Note this review does not provide in depth, impairment specific guidance, and early childhood is defined as 0-3 years.