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An implementation science framework to understand low coverage in mass dog rabies vaccination
Ricardo Castillo-Neyra1,2,3, Lizzie Ortiz-Cam3, Jorge L Cañari-Casaño3
1Department of Biostatistics, Epidemiology & Informatics, Perelman School of Medicine at University of Pennsylvania, Philadelphia, Pennsylvania, United States of America.
Plos Neglected Tropical Diseases
|July 23, 2025
Summary
Mass dog vaccination campaigns face community and implementer barriers, including poor communication and funding issues. Strategies to improve participation involve strengthening alliances and enhancing campaign accessibility.
Area of Science:
- Veterinary Public Health
- Implementation Science
- One Health Strategy
Background:
- Dog-mediated human rabies remains a significant threat in many African, Asian, and Latin American countries.
- Mass dog vaccination campaigns (MDVC) are crucial for rabies elimination but face challenges in achieving sustained coverage.
- The Consolidated Framework for Implementation Research (CFIR) can identify barriers to effective MDVC implementation.
Purpose of the Study:
- To apply the CFIR to understand barriers to mass dog vaccination campaigns in Arequipa, Peru.
- To identify challenges faced by community members and public health personnel involved in dog rabies control.
- To inform strategies for improving MDVC participation and effectiveness.
Main Methods:
- Conducted seven focus groups with 56 community participants to gather perspectives on rabies and vaccination.
- Held a workshop with 69 public health personnel (implementers and authorities) to explore post-COVID-19 MDVC challenges.
- Utilized the CFIR framework to analyze barriers across five domains: innovation, outer setting, inner setting, individuals, and implementation.
Main Results:
- Community barriers included poor communication, short vaccination periods, and fragmented collaboration.
- Individual-level barriers involved decreased rabies risk perception due to COVID-19, prioritization of human vaccination, and financial impacts on time for dog vaccination.
- Implementer barriers included insufficient materials, unclear responsibilities, lack of evaluation time, financial constraints, and fragmented institutional commitment.
Conclusions:
- Identified key barriers hindering MDVC participation and effectiveness.
- Co-designed strategies to enhance MDVC include strengthening municipal alliances and improving campaign publicity.
- Proposed solutions involve adequate training, fixed vaccination points, and expanded campaign hours to boost participation.
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