The other day I visited the ward office in Shinagawa to learn more about the Japan’s Maternal & Child Health Handbook – Boshi Kenkou Techou, which is an excellent example of Japan’s high level of healthcare. The handbook is a personal health record that allows parents and healthcare providers to track the condition of a mother-to-be as well as the health and development of the child, including immunizations and the use of health services. In accordance with the Maternal and Child Health Act, local governments distribute the Maternal and Child Health Handbook to all women, regardless of nationality, when they register their pregnancies. You can also obtain copies of the handbook for children not born in Japan by registering at the local health office.The Maternal and Child Health Handbook is an official document, and should therefore be treated with great care. The handbook must be presented to the healthcare provider at all visits pertaining to the health of the pregnant mother or the child, including childbirth. For all intents and purposes, the notarized handbook is treated like a birth certificate and is required when applying for a Japanese passport for the child.Japan’s healthcare system offers various discounts for health checkups and vaccinations to registered residents. These discounts and services vary depending on the municipality. As an example, expectant mothers registered in Tokyo’s 23 wards receive 14 discount vouchers for maternity health checkups. The first health checkup is discounted ¥8430, while the remaining thirteen are discounted ¥5140 each. Some municipalities, including Shinagawa, also give expectant mothers a ¥5300 discount voucher for an obstetric ultrasound.When it comes to health checkups for the children, Tokyo’s 23 wards offers residents free health checkups at four, six and nine months, and Shinagawa adds a free dental checkup for three-year-old children residing there. Routine vaccinations—BCG, PCV, DPT-IPV, MR, Japanese encephalitis, Hib and HPV—are administered free of charge if you present the handbook. Additional voluntary vaccinations for seasonal influenza, chickenpox, mumps, hepatitis A, hepatitis B, rotavirus are available for a fee. Some municipalities offer discounts on selected optional vaccines. Shinagawa, for example, offer ¥3000 discounts on mumps, chickenpox and hepatitis B shots.The Maternal and Child Health Handbook is also published in English, and some local governments may offer it for free. The Mothers’ and Children’s Health and Welfare Association have also created bilingual versions of the handbook in English, Korean, Chinese, Thai, Tagalog, Portuguese, Indonesian and Spanish. The price for one of these bilingual handbooks is ¥820, and copies can be purchased through the Mothers’ and Children’s Health and Welfare Association webshop or ordered at the local bookstore. If you have both Japanese and bilingual handbooks, the handbook that is notarized is considered to be the official one.The ward office people were all very kind and helpful, but don’t expect a high level of English.