In recent years, there has been an increase in the demand for and supply of early childhood education (ECE) in low- and middle-income countries. There is also growing awareness that unless ECE is of high quality, children may attend school but not learn. There is a large literature on the conceptualization and measurement of ECE quality in the United States that focuses on the nature of teacher-child interactions. Efforts to expand access to high quality ECE in low- and middle-income countries will require similar measurement efforts that are theoretically-grounded and culturally-adapted. This paper assesses the factor structure and concurrent validity of an observational classroom quality tool to assess teacher-child interactions—the Teacher Instructional Practices and Processes System© (TIPPS; Author, 2013b; 2017)—in Ghanaian pre-primary classrooms. We find evidence of three conceptually distinct, but empirically correlated, domains of quality: Facilitating Deeper Learning (FDL), Supporting Student Expression (SSE), and Emotional Support and Behavior Management (ESBM). Teachers’ schooling level, training in early childhood development, and professional well-being positively predict the three quality domains in different ways. SSE and ESBM predict classroom end-of-the-school-year academic outcomes, and SSE predicts classroom end-of-the-school-year social-emotional outcomes. Implications for the field of international education and global ECE policy and research are discussed.