This Zero-Dose Learning Hub toolkit provides practical guidance for using lot quality assurance sampling (LQAS) to monitor and manage vaccination programs at decentralized levels of the health system. Designed for program managers and monitoring, evaluation, and learning specialists, the toolkit supports users in planning LQAS surveys, defining supervision areas, selecting thresholds and decision rules, and using results to identify where vaccination coverage may be falling below target. By helping teams move beyond aggregate coverage estimates, LQAS can support more targeted action to reach zero-dose and under-immunized children.