Abstract:The Road-to-Health (RTH) card has served as a tool for monitoring nutrition and vaccination status individual child for several decades. The card has the potential to serve as a community database for research if kept by the caretaker for a considerable period. This study aimed to assess whether the magnitude of possession and retention of RTH cards is adequate to serve as a community database for monitoring and evaluating health interventions targeting under fives. This cross-sectional study was conducted among under fives in Korogwe town and its suburbs in Tanzania. Six wards and four villages were randomly selected and all under fives found were included. Using a structured questionnaire, demographic information was obtained from the parent/guardian of the child. Information was collected on the presence of RTH card from which the date of birth was recorded. A total of 4899 households were involved and information obtained for 6364 under fives. The overall card possession rate was 74.3%. Possession of RTH cards was found to be highest among the last born under fives (78.3%) than the third-from-last born under fives (45.1%). Caretakers who were married and educated had higher card possession rate. In conclusion the possession of RTH cards was adequate to serve as a community database for monitoring health status and evaluating health interventions targeting the under fives. However, the low retention rate poses a limitation for the cards to serve as a permanent community database. This paper discusses some of the strategies to increase retention of the cards by caretakers. _______________________________________________________________________________________