Childhood immunization is crucial for preventing vaccine-preventable diseases in rural Ethiopian towns. However, coverage rates remain suboptimal due to various barriers such as distance and limited access to healthcare facilities. A mixed-methods approach was employed, including a cross-sectional survey and focus group discussions with CHWs and community leaders. Data were collected from January to March , involving 150 CHWs and 40 focus groups. CHWs reported an average of 78% immunization coverage in their catchment areas, with significant variability depending on the type of vaccine administered (P < 0.05). Community Health Workers play a critical role in enhancing childhood immunization coverage by overcoming logistical challenges and improving communication. Further training should focus on addressing specific barriers to vaccination identified during this study, such as fear of needles and misinformation. Childhood Immunization, Community Health Workers, Rural Ethiopia, Vaccine Coverage Treatment effect was estimated with $\text{logit}(p_i)=\beta_0+\beta^\top X_i$, and uncertainty reported using confidence-interval based inference.