With increased global attention to neglected diseases, there has been a resurgence of interest in eliminating rabies from developing countries through mass dog vaccination. Tanzania recently embarked on an ambitious programme to repeatedly vaccinate dogs in 28 districts. To understand community perceptions and responses to this programme, we conducted an anthropological study exploring the relationships between dogs, society, geography and project implementation in the districts of Kilombero and Ulanga, Southern Tanzania.
Over three months in 2012, we combined the use of focus groups, semi-structured interviews, a household questionnaire and a population-based survey. Willingness to participate in vaccination was mediated by fear of rabies, high medical treatment costs and the threat of dog culling, as well as broader notions of social responsibility. However, differences between town, rural and (agro-) pastoralist populations in livelihood patterns and dog ownership impacted coverage in ways that were not well incorporated into project planning. Coverage in six selected villages was estimated at 25%, well below official estimates. A variety of problems with campaign mobilisation, timing, the location of central points, equipment and staff, and project organisation created barriers to community compliance. Resource-limitations and institutional norms limited the ability for district staff to adapt implementation strategies.
Conclusions and Significance
In the shadows of resource and institutional limitations in the veterinary sector in Africa, top-down interventions for neglected zoonotic diseases likes rabies need to more explicitly engage with project organisation, capacity and community participation. Greater attention to navigating local realities in planning and implementation is essential to ensuring that rabies, and other neglected diseases, are controlled sustainably.
Mass vaccination of dogs is the most effective strategy to eliminate dog-mediated human rabies from developing countries. In 2009, a large-scale elimination demonstration project was funded and coordinated by the Bill and Melinda Gates Foundation (BMGF) and the World Health Organisation (WHO) in three southern countries, including the United Republic of Tanzania. This paper explores community perceptions and responses to this programme in the districts of Kilombero and Ulanga, Southern Tanzania. The study was based on focus groups and interviews in 16 villages as well as a household questionnaire (n = 113), a population-based survey (n = 6,157 households) and key informant interviews (n = 24). The study showed that fear of rabies, the threat of dog culling and broader ideas of community responsibility drove compliance. However differences in local livelihoods shaped dog ownership patterns and the distribution of dogs in ways that were not explicitly addressed by project strategies. A survey in six villages found that only 25% of dogs had been vaccinated in 2011. We discuss the operational constraints and problems that lowered coverage as viewed by different actors at the district and village-level. A more explicit engagement with project organisation, capacity and community involvement are needed to address this low coverage.