An Early Childhood Care and Education (ECCE) program in rural India was evaluated in terms of care and learning outcomes of children. The study was undertaken to observe and describe the ECCE system for children who were economically and educationally disadvantaged and enrolled in three Government Primary Schools (GPS) in India. In particular, the study tries to answer the question, ‘What factors affect the learning of Mathematics and English in the primary schools of rural Tamil Nadu?’ This Observational study was undertaken over a six-month period. The study included 183 children from LKG to Class 3 in normative stages of development as per their age and stage requirements. The parameters that were observed included learning outcomes in Math, English, Science and Social studies. An innovative daily baseline assessment was undertaken over a three-month period to understand children’s learning milestones. Results indicate that the learning outcomes were deplorably poor by Indian and international standards of education. Many challenges still remain in helping children gain a healthy start to life. There is a lack of an integrated framework that combines both health & well-being and learning. In the COVID-19 pandemic era, it is critical to move away from the traditional physical center models to a more hybrid scientific and technology driven systems for scale that are financially viable. These require a planned approach for introduction considering the scale in which it has to be implemented in India. Such plans need to be both top-down and bottom-up approach which entail large up-front investment in communicating and educating all the stakeholders. Personalized attention is not possible in traditional systems catering to such a large population. Additionally, and more importantly, there are no early warning mechanisms in place to help identify issues when it matters the most. Our analysis supports our research question and proves our hypotheses.