Home-based records (HBRs) are an important tool for achieving, monitoring and sustaining vaccination coverage; however they have often been under-utilized in immunization programs. Historically many countries have used a traditional format that may not be easy for health workers to complete accurately or for caregivers to understand the data that is recorded. Also, various users may not understand the value of these documents. Redesign approaches in some countries have been successful in meeting the needs of health workers, caregivers, and the health system while also increasing the availability and use of these important records (with an overall objective of increasing immunization coverage). Experiences from Madagascar and Ethiopia - where the traditional vaccination card was redesigned and incorporated into an integrated communication tool - are highlighted in this document. These case studies can inform countries who may be interested in undertaking their own redesigns to understand the stakeholders involved, steps in the process, and key points to consider.