Healthcare accessibility to rabies post-exposure prophylaxis in rural Kenya: implications for vaccine placement and travel time

Our findings demonstrate that increased geographic distance and longer travel times to health facilities substantially reduce accessibility to rabies PEP, particularly in rural settings where reliance on non-motorized travel is common. To our knowledge, this is the first study to provide quantitative, county-specific estimates of travel time impacts on PEP access in rural Kenya, filling a critical evidence gap for planning PEP distribution under Kenya's Stepwise Approach to Rabies Elimination (SARE). Optimizing the placement of PEP within existing healthcare networks can increase the proportion of the population able to reach services within recommended time thresholds. Expanding vaccine availability at strategically located facilities would therefore improve timely PEP to bite victims and support efforts to prevent human rabies deaths. These results highlight the importance of incorporating geographic accessibility analyses into planning for rabies elimination programs.