In many countries, maternal and child health (MCH) handbooks help ensure the quality and continuity of health care for mothers and children. In Bangladesh the main health communication tools currently in use, such as treatment cards, immunization cards, and antenatal and postnatal cards, support only one-way communication. There is no evidence that mothers in Bangladesh are convinced of the cards' merits. A pilot MCH handbook project was carried out in Bangladesh in 2002 by the author, as a PhD student in the International Collaboration Division of Japan's Osaka University. The study showed that the MCH handbook had strong positive impacts on mothers' MCH knowledge, practices, record keeping, and service utilization and on the quality of MCH services. Since 2006 the Government of Bangladesh has approved project-based utilization of MCH handbooks, and some NGOs are now implementing projects using MCH handbooks. Building on the findings of the earlier pilot study, and with 2007-2009 support from the Japan Society for Promotion of Sciences (JSPS), researchers have been conducting a community-based study of the use of the MCH handbook, in preparation in for potential nationwide expansion of MCH handbook use in Bangladesh.