Siddiqi, Khan, Chandir); IRD Pakistan ( Ali, Munir, Shah, Chandir); Harvard Medical School ( Khan, Chandir) "There is...a programmatic and research gap regarding strategies to improve immunization coverage and timeliness in low-literacy communities through cost-effective, sustainable solutions that...focus on transforming caregivers from passive to active recipients of immunization services." Evidence indicates that suboptimal immunisation coverage and timeliness is attributable not only to supply-side deficiencies, but also to demand-side problems such as caregiver complacency, forgetfulness, and unawareness of required number and timing of doses. Globally, a widely used method to communicate the vaccination schedule to caregivers is the paper-based immunisation card. Like immunisation cards, which require literacy, reminder-recall (R/R) interventions requiring mobile phone ownership fail to penetrate the lowest socioeconomic strata, thus widening the global immunisation equity gap. In Pakistan, one of the strategies deployed in response to caregivers' failure to visit immunisation centres on time is the implementation of door-to-door vaccination and awareness campaigns, but these are resource intensive. Thus, this study evaluated the effect of an alternative - silicone bracelets - in improving immunisation coverage in children under 2 years of age in a low-literacy, peri-urban community in Pakistan. The secondary outcome focused on caregiver feedback regarding the bracelet, including its value, ease of use, and visibility.