Community participation improves perceptions of dog vaccination in Tanzania
Rabies is responsible for an estimated 1,500 deaths per year in Tanzania. The most effective way of controlling rabies spread is through mass dog vaccinations. However, certain factors, including perceptions of effects on the vaccine on dogs, limited knowledge of dog behaviour, and poor handling techniques reduce participation of dog owners in vaccination campaigns. This study engaged communities to learn what societal underpinnings influence their participation in mass dog vaccination campaigns.
Rabies is a viral disease of the central nervous system, transmitted to humans 99% of the time by domestic dogs. In the absence of timely administration of post-exposure prophylaxis, rabies infection definitely results in death. Globally, the case-specific death rate for rabies is estimated at 59,000 annually, 40% of which is in children, with 3.9 billion people worldwide at risk of contracting the disease. Approximately 99% of all fatalities occur in Africa and Asia where dog vaccines and life-saving post-exposure prophylaxis are not accessible to affected populations due to social, geographical and economic factors. The disease is endemic in Tanzania and causes about 1,500 deaths annually.
The goal of this engagement with affected communities is to avert these losses, thus contributing to achieving Sustainable Development Goals 1, 2, 3, 15 and 17: to eliminate poverty, erase hunger, establish good health and well-being, advance life on land and build partnerships for these goals.
Community participation is crucial to mass dog vaccination
Scientific evidence shows that if 70% of the dog population is vaccinated, transmission of the disease among dogs and to humans is prevented. Current approaches to dog vaccination is through mass community-level vaccination campaigns, the success of which depends on dog owners bringing their dogs for vaccination. Vaccination coverage data from mass dog vaccination campaigns across Africa show that achieving 50% participation among owners during these campaigns is a herculean task. My PhD research, on “Process evaluation of community-based mass dog vaccination delivery strategies in the Mara Region of Tanzania” found that this poor participation has some societal underpinnings: many people believe that vaccinated dogs will not reproduce, hunt or bark and that they will develop skin rashes or die. Other people reported that they are afraid of their dogs because they are fierce, mostly as a result of a lack of understanding of dog behaviours and/or lack of knowledge of dog handling techniques.
The engagement processes
We started with the identification of two wards and held separate community entry meetings with their respective leaderships. In these sessions, perceptions of rabies and the objectives and activities of the study were discussed. Community leaders identified sub-villages and scheduled visits for each with the research team, taking into account when most of the villagers are back from their farms and when no one is likely to encounter elephants. Fourteen village meetings were conducted in which the following issues were discussed: i) dog behaviour (identification and interpretation); ii) safe ways to catch a dog at home and the correct ways to hold a dog to be vaccinated; iii) safe ways to interact with strange dogs, and iv) what to do when attacked or bitten by a dog. Images and video illustrations were used, and some villagers demonstrated how they communicate with their dogs.
Next, the research team met with district veterinary officials and ward leaders together to describe in detail the nature of a mass dog vaccination campaign and to outline the role of each stakeholder. Community leaders agreed to promote the campaign, provide meals for vaccinators, provide waste bins, tables and chairs, elect people to assist vaccinators, conduct a census of dogs and assess the effectiveness of the campaigns.
In response to dog aggression during vaccination, we organised three brainstorming sessions for nine vaccinators to design simple devices from local materials to easily restrain fierce dogs. Various prototypes resulted from this process.
Fear of one’s own personal dog and of dog vaccines were found to be common, as were weak bonding between owners and their dogs, limited knowledge of dog behaviour and handling techniques. These factors may have limited willingness to send dogs to vaccination centres.
Human resources can take up to 40% of cost of vaccination campaigns. Therefore, community participation in the delivery at village levels have the potential to significantly reduce operational costs. In this regard, we found that the community structure of Tanzania provides a supportive institutional framework for delivering such village-level interventions. However, voluntary participation has to be encouraged.
The brainstorming sessions to design local means of restraining fierce dogs demonstrated impressive abilities of community-level vaccinators to trouble-shoot problems with campaigns, reinforcing the value of community participation in the planning and execution of community-level programmes.
Following the engagement, we received inquiries from villagers wishing to train and/or understand certain behaviours of their dogs. Hence, if local livestock officers are trained and provided with resources, they can be useful sources of information to dog owners and enhance their interest in the welfare of their dogs.
About Christian Tetteh Duamor
Christian Tetteh Duamor is a Ghanaian Implementation Scientist and an Afrique One-ASPIRE PhD Fellow in the Department of Global Health at the Nelson Mandela African Institute of Science and Technology, Arusha, Tanzania. He specialises in intervention research and is a grantee of the Community and Public Engagement (CPE) programme supported by the Developing Excellence, Leadership and Training in Science in Africa (DELTAS Africa) programme of the African Academy of Sciences.