The paper addresses the critical issue of in or exclusion of the urban poor in the NGO provided healthcare service delivery system in Bangladesh. It indicates how a project has excluded the urban poor by developing an analytical framework. Both external and internal factors related with the project seem to influence the utilization rate of the services of the UPHCP centre. It concludes that the urban poor seem to be excluded from the benefits of the project for leakage (that means inclusion error) in Rajshahi City. Additionally, the author is trying to provide relevant, feasible recommendations to ensure future inclusion of the urban poor and enhance accountability as well as institutional and financial sustainability of health care provisioning.