Understanding the facilitators and barriers to dog mass vaccination campaigns in Uganda, A case of Kyegegwa District

Abstract

Background: Despite the annual commitment to procure 500,000 rabies vaccine doses and distributing them to districts freely on request, Uganda still grapples with a low dog vaccination coverage of about 10%. This study aimed to investigate the factors influencing dog vaccination in Kyegegwa, a rural district in Uganda.

Methods: A mixed methods approach was used in this study. Four different vaccination strategies namely; static point, school-based, integrated dog vaccination with human health services, and integrated dog with livestock vaccination strategies were rolled out in twelve selected parishes. Each of the strategies was conducted in the three parishes of the same sub- county. Vaccination coverage was estimated using transect and household surveys, analyzed with a Bayesian model. Eight key informant interviews and twelve pre/post-vaccination focus group discussions were conducted with opinion leaders, farmers, and dog owners from 12 randomly selected parishes. Transcribed audios were managed using Nvivo version 12 data management software. Insights on barriers, facilitators, and feasibility of dog vaccination campaigns were gathered and analyzed thematically.

Results: Barriers to dog vaccination included inconsiderate ownership, difficulty managing aggressive dogs, long distances, poor campaign and mobilization planning, and limited resources. Facilitators were free vaccination and veterinary team commitment. School-based vaccination strategy achieved a coverage at 40.3% [CrI: 38.4-41.6], integrated dog with human health services at 62.6% [CrI:48.8-72.6], static point at 35.6% [CrI: 26.3-43.9] and integrated dog with livestock strategy at 44.6% [CrI: 33.3-54.1].

Conclusion: The integrated dog and human health services achieved the highest vaccination coverage overall and consistent across the 3 parishes. Barriers like difficulty to handle aggressive dogs, many roaming dogs, poor mobilization, competing activities, long distances and logistical challenges hindered broader coverage, while free vaccination and committed veterinary teams facilitated success. Pilot campaign strategies proved feasible, but the study yielded inconclusive evidence regarding strategy effectiveness. Free of charge campaigns, active community involvement and integrating mobilization efforts between human and animal healthcare workers hold promise for improving coverage. Replicating the study under similar conditions is necessary to identify consistency of effectiveness of vaccination strategies.