Factors that influenced the delivery of a community-based continuous mass dog rabies vaccination approach in the Mara region of Tanzania

Introduction Mass dog vaccination is the most effective approach for interrupting canine rabies transmission. However, current vaccination strategies are typically centralized and conducted annually, leaving some communities excluded and with few opportunities to vaccinate their dogs. A community-based continuous mass dog vaccination strategy was piloted in the Mara region of Tanzania. We investigate factors that influenced the delivery of this approach and how the processes were sustained over two years. Methods We employed mixed methods to explore what influenced vaccination delivery. We conducted in-depth interviews ( n = 24) and focus group discussions ( n = 12) with implementers and community members, and non-participant observation of vaccinations ( n = 172 h). We documented time spent by dog owners attending campaigns ( n = 610) and how dogs were handled ( n = 696), and audited how components of the community-based continuous approach were delivered (n= 47). Qualitative data was analyzed thematically, and regression and descriptive statistics used to assess factors affecting delivery. Main findings Factors that facilitated participation in the campaigns included delivering vaccination free of charge, more frequent availability of vaccinations, and co-implementation with communities. Limiting factors were distance to vaccination points, difficulties in handling dogs and vaccination schedules conflicting with local socioeconomic activities. Sub-village level campaigns were more accessible and required less time from dog owners. Interpretation Involving community-based persons facilitated planning and advertising of campaigns. Mass dog vaccination campaigns can achieve and maintain herd immunity if organized at least twice a year and at subvillage levels. Educating vaccinators and communities on dog behavior and handling could improve participation in campaigns.