Tanzania's efforts to eliminate dog-mediated rabies by 2030 face significant challenges that hinder the success of vaccination campaigns. A recent study published on the Scientific Reports highlights how geographical factors affect campaign completeness and coverage, underscoring the need for targeted solutions to achieve the national target.

The study was conducted across 25 districts in five regions of southeastern Tanzania – Lindi, Mtwara, Pwani, Dar es Salaam, and Morogoro – covering five rounds of Mass Dog Vaccination (MDV) campaigns between January 2010 and January 2017.

Led by Maganga Sambo, a scientist at the Ifakara Health Institute, in collaboration with researchers from the University of Glasgow and the University of Manchester in the UK, the study provides insights into logistical challenges and geographical barriers, offering recommendations to improve vaccine delivery. 

Geographical barriers impacting campaign completeness
The study reveals stark differences in campaign success between urban and rural areas. Urban districts were found to be eight times more likely to achieve campaign completeness than rural districts. 

This is in part due to the smaller, densely populated nature of urban settings that simplifies access and transportation for vaccination to efficiently reach all selected points. In contrast, rural districts, characterized by widely scattered villages, present significant logistical challenges that require additional financial resources to ensure full coverage. 

The study also found that cropland areas achieved higher campaign completeness compared to forested and remote regions, largely due to better transportation infrastructure. These findings underline the need for tailored logistical solutions to address regional challenges.

Challenges in achieving vaccination coverage
Despite higher campaign completeness in urban areas, the study shows vaccination coverage remained lower compared to rural districts. This discrepancy is reportedly due to the prioritization of rural areas by livestock officers given the higher dog populations in the regions.

In light of these findings, the scientists underscore the importance of conducting in-depth assessments in urban areas to identify specific barriers to vaccination coverage. The researchers noted, “Our findings mark an important addition that although it is easier to achieve campaign completeness in urban areas it does not necessarily results in achieving higher coverage.”

Addressing contextual barriers to vaccination
The study also highlights several contextual factors affecting vaccination campaign completeness and coverage, including low awareness of ongoing campaigns, residents' busy schedules, and concerns about community trust and acceptability of dog vaccination.

To overcome these barriers, the study recommends strategies such as increasing public awareness, extending vaccination hours, and introducing weekend vaccination drives to improve participation rates.

Recommendations for improved vaccination campaigns 
To address the geographical challenges hindering vaccination efforts, the study proposes several actionable strategies. These include expanding vaccination sites in large and remote villages to improve accessibility, implementing community-based approaches with local volunteers for house-to-house vaccinations, particularly in hard-to-reach areas, and optimizing budget allocation to better reflect the logistical needs of larger districts.

Additionally, utilizing mobile applications for real-time data collection and monitoring can streamline efforts, while fostering multisectoral collaboration, such as partnering with wildlife and transport authorities, which will help address access issues and enhance vaccine storage infrastructure.

The need for micro-planning in vaccination campaigns 
Concluding their study, Maganga Sambo and his colleagues emphasize the importance of meticulous micro-planning to overcome MDV delivery constraints, including investigating the influence of geographical, operational and demographic factors on campaign completeness and dog vaccination coverage.

“By incorporating these geographical factors into micro planning, rabies national program managers in low- and middle-income countries can design dog vaccination interventions that bridge coverage gaps, leading to a rabies-free and healthier community,” the scientists noted.

They also underscore the critical need to address geographical disparities in vaccination efforts to meet Tanzania's 2030 target for eliminating dog-mediated rabies.

Read the publication here.