The implementation of checklist-based box system intervention was found effective in improving the utilization of three postnatal care visits. Mothers who received CBBSI were more likely to receive three postnatal visits compared to their counterparts.The implementation of this trial can be boosted by minimizing practical level challenges: improving documentation at the health post level, uninterrupted supply of necessary materials, improving the knowledge and skill of health extension workers and strengthening the linkage between primary health care units.