Bangladesh, Family Health Card, service-delivery



  1. Gazi, Rukhsana MBBS, MPH
  2. Khatun, Jahanara MSc, MPH
  3. Ashraf, Ali MA, MPH


A client-retained Family Health Card (FHC) was distributed to all households of 2 districts of Bangladesh under the Health and Population Sector Programme. This study assessed the extent and factors relating to retention of FHC, its perceived usefulness, and the extent of use. Quantitative and qualitative data were collected from randomly selected subdistricts. Nearly half of clients retained FHC. The card retainers were married, females, and educated, and sought services for their children. Multivariate analysis confirmed that educational attainments, sex, clients' perceived usefulness of FHC, and enforcement by service providers for bringing FHC were significantly associated with retention of FHC. Both clients and service providers perceived FHC as a useful tool that supports the service-delivery system. The client provider observations identified some omissions made by the providers in filling up the sections contained screening checklists thus they missed the opportunity asking about the additional needs of the family. FHC was used for referring about one-fifth of clients. More orientation of service providers with particular emphasis on sections containing screening checklists in FHC is needed for better identification of additional family-health needs. Ample opportunities exist promoting FHC for tapping the missed opportunities to address unmet needs of a whole family.