Boshi Techo: Japan's Maternal and Child Health Handbook Explained

Learn what the small booklet issued at pregnancy registration records, how residents of any nationality receive it, and why families keep it for life.

Published October 19, 2026 at 10:26 AM JST | By Tokyo Paul

Quick answer: Boshi techo, officially the Maternal and Child Health Handbook, is a booklet that a local government issues once a pregnancy has been registered. It records prenatal care, birth details, checkups, vaccinations and growth from pregnancy through early childhood. It is available regardless of nationality, and families usually carry it to every medical appointment.

What the handbook is

Boshi techo (literally "mother and child notebook") is the booklet that nearly every family in Japan receives once a pregnancy has been registered with the local municipality. It works as a single, portable health record that follows both the mother and the child. Doctors, midwives, public health nurses and vaccination clinics all write in it, so one small book holds information that would otherwise sit in many separate files.

The full official name is Boshi kenko techo, the Maternal and Child Health Handbook. Some municipalities now use the name Oyako kenko techo, the Parent-Child Health Handbook, which reflects the growing role of fathers in childcare. Whatever the cover says, the purpose is the same: one place for the story of a child's health, kept by the people who know the child best.

How to get one

The process starts with a medical visit. After a clinic or hospital confirms the pregnancy, the mother receives a pregnancy notification form from the facility. She then submits it at the municipal office, often at a maternal and child health counter or health center. The office issues the handbook, and the local procedure is usually explained at the counter.

The handbook is issued regardless of nationality, so foreign residents who live in a Japanese municipality are able to receive it. Many municipalities hand over a booklet of checkup tickets at the same time, which helps cover the cost of prenatal and newborn checkups. One city's English guide describes this pairing clearly. Counter names, floors and required documents differ by city, so it is worth checking the local website or calling ahead.

Timing matters a little. Municipalities encourage registration early in pregnancy, partly because the checkup tickets are tied to the handbook. A foreign resident who has just moved should first complete the usual residence registration, since the municipal office works from local resident records.

What it records

The first part of the handbook follows a national format. It includes pregnancy and childbirth records, the baby's condition at birth, newborn checkups, growth measurements, immunization records and dental checkups through early childhood. Doctors and public health nurses fill in many of these pages, while parents add their own notes on feeding, sleep and milestones.

The second part is usually designed by each municipality. It often carries local information about classes, consultation services and subsidies, along with guidance pages on pregnancy health and infant care. Because of this split, a handbook from one city can look quite different from another's, even though the core record pages are laid out in much the same way.

Because so many professionals write in the same book, it also becomes a bridge between settings. A clinic that sees a child for the first time can learn the birth weight, feeding history and vaccination dates in a minute or two, which is especially helpful when a family moves between cities or countries.

A short history

The handbook dates back to 1948, shortly after the Second World War, when it was first issued under the name Boshi techo. In 1966 the name changed officially to Boshi kenko techo. Local governments have been responsible for making and issuing it throughout this time, which is why it carries regional touches.

The idea also traveled overseas. In the late 1980s a Japanese doctor working in Sumatra helped local doctors make a handmade prototype, and after Indonesian doctors visited Japan in the early 1990s, Indonesia began its own handbook project. Roughly fifty countries, mostly in Asia and Africa, are reported to have adopted versions of the system. Overseas editions are generally adapted to local health systems rather than simply translated, so each country's booklet reflects its own clinics and records.

A physician who has promoted the handbook abroad credits it, alongside the work of doctors and nurses, as a major reason for Japan's very low infant mortality rate. The booklet itself is a modest object, but its simple, low-cost design is part of why other countries have found it practical to adapt.

Language support for foreign residents

Many municipalities, especially those with large foreign communities, can provide versions in languages other than Japanese. These usually sit alongside the Japanese handbook and help parents follow the guidance pages. The Japanese record pages are still the ones that medical staff fill in, so the translated version is a companion rather than a replacement.

If the municipality does not offer a version in the needed language, there are practical options. Many city offices can arrange an interpreter or provide a leaflet in English, and some clinics have staff who speak other languages. Translation apps can help with the guidance text. Record pages for checkups and vaccinations follow a set format, so even a basic understanding of the headings goes a long way.

Parents who plan to use a translated edition can ask the municipal counter whether it is available at the time of registration. Asking early also gives time to request help for the first prenatal visits, when the handbook is first filled in.

Using the handbook day to day

The simplest habit is to bring the handbook to every appointment: prenatal checkups, newborn visits, vaccinations, dental checkups and the group health checkups that municipalities schedule at set ages. Staff will often ask to see it before anything else. Keeping it in a clear folder with the checkup tickets and insurance card makes this easy.

Parents also use the growth pages to track height and weight, and the blank notes sections to record first words, first steps and questions for the doctor. Many families keep the handbook into adulthood, since vaccination history and early health information can be useful later. Taking a photo of key pages and storing it on a phone gives a backup if the booklet is lost.

Tips and common mistakes

A frequent mistake is to wait too long to register the pregnancy, which can delay both the handbook and the checkup tickets. Another is to leave the booklet at home on the day of a vaccination, which can mean rescheduling. A third is to assume that a handbook from an earlier municipality still covers new local services after a move; people who move to a new city are usually asked to visit the local counter.

Related terms include ninshin todoke (pregnancy notification), kenshin (health checkup) and yobo sesshu (preventive vaccination). This guide shares general cultural information and published research, not professional advice; for a child's health, talk with a pediatrician or local clinic.

Frequently Asked Questions

Can foreign residents get a boshi techo?

Yes. The handbook is issued by the municipality where the pregnancy is registered, and it is available regardless of nationality. Bring the pregnancy notification form from the clinic and any identification the office asks for, and check the local website for the counter and the languages it supports.

Is the boshi techo only for pregnancy?

No. It starts with pregnancy and childbirth records, then continues with newborn checkups, growth, vaccinations and dental checkups through early childhood, up to around elementary school age. Many families keep it afterward because vaccination and early health information can be useful in adult life.

Does Japan have an English boshi techo?

Many municipalities provide versions in other languages, but availability varies by location. The Japanese pages are the ones staff fill in. Ask the local health center about translated editions, interpreters and English leaflets before the first appointment.

Want to go deeper? Tokyo Paul's book Japanese Parenting Secrets That Create Calm, Independent Children is available on Amazon.

Keep Exploring

More guides from Tokyo Paul: Infant Health Checkups in Japan: The Municipal Kenshin System, Childhood Vaccinations in Japan: Routine Schedule and Booking and Celebrating Babies in Japan.