Barriers to rabies control through mass dog vaccination in rural Uganda: Insights from community perspectives and key informant interviews.

Abstract

BACKGROUND: Globally, rabies claims about 59,000 human lives annually, and 99% of human transmission is by dogs. The disease is entirely preventable through mass dog vaccination. Despite this, only an estimated 10% of dogs in Uganda are vaccinated, and the reasons for this low uptake are not fully understood. This study investigated barriers to mass dog vaccination for rabies control in Kyegegwa, a rural Ugandan district. METHODOLOGY: This qualitative study was conducted with eight key informants (KIs) and twelve focus groups (FGs) with participants from twelve randomly selected parishes. Audio recordings were transcribed in English and transcripts were managed using Atlas ti version 6.0 data management software. Thematic analysis was conducted to produce the results. RESULTS: This study identified three major themes affecting mass dog vaccination in Kyegegwa District: (1) community dynamics, including misconceptions about vaccines, limited awareness, and difficulties in handling aggressive dogs; (2) Resource and service constraints such as vaccine shortages, limited veterinary personnel, and high costs; and (3) Systemic and operational challenges, including delayed campaign announcements, poor communication, and lack of vaccination certificates. These barriers collectively explain the persistently low coverage of mass dog vaccination in rural Uganda. CONCLUSION: Limited awareness, logistical challenges, and inadequate veterinary resources were reported to be barriers to rabies control in Kyegegwa District. Addressing these issues may require timely communication, workforce strengthening, animal mobile clinics, and cost mitigation. Accurate dog population assessments and tailored community strategies may improve vaccination coverage, offering a foundation for effective rabies prevention in Kyegegwa District and similar resource-limited settings.