Background: Very little is known about the landscape of clinical trials recruiting children in Africa. To combat this dearth of information, The World Health Organization (WHO) is co-ordinating a multi-regional initiative to increase clinical trial activity and registration involving children worldwide. The Pan African Clinical Trials Registry (www.pactr. org), based at the South African Cochrane Centre, provides a platform to prospectively register all clinical trials conducted in Africa. In 2009, in partnership with the WHO, www.pactr.org developed a Child Strategy to encourage prospective registration of African child-focused trials. Objectives: To increase the rate of registration of clinical trials that recruit children in Africa. Methods: The Child Strategy aims to: 1. To develop an awareness of the global and continental need to register clinical trials and the dearth of information on pediatric trial research; 2. To encourage trial work utilising children as participants in the region; 3. To increase the number of registered trials conducted on the African continent; The Child Strategy aims to increase awareness of pediatric clinical trial issues to encourage debate and policy development through hosting collaborative meetings that will bring together clinicians, researchers, policy makers and funders. The Strategy will call together regional journal editors with the hope that they can develop a statement supporting clinical trial registration and ethical oversight. Additionally active dissemination of the importance of trial registration and oversight will be undertaken to develop a network of informed stakeholders in the region with the ultimate goal of developing regional policy for clinical trial research. Conclusions: Through www.pactr.org registration initiatives the Child Strategy aims to build a prospective database of child focused trials on the continent to fill gaps in knowledge. The Strategy aims to increase awareness, assist in the development of policy and create a supportive environment for clinical research using child participants.