As countries work toward eliminating dog-mediated rabies, new evidence from northern Tanzania suggests that decentralizing mass dog vaccination to the community level could strengthen rabies control — especially in rural settings.

The study published in Frontiers in Tropical Diseases compared two delivery strategies for mass dog vaccination (MDV) in Tanzania’s Mara Region between 2020 and 2023. The research was led by Joel Changalucha of Ifakara Health Institute, in collaboration with partners from the University of Glasgow, Washington State University, and Global Health Tanzania.

Why this study matters

Rabies is estimated to cause around 60,000 human deaths globally each year, mostly in low- and middle-income countries. Despite the proven effectiveness of vaccinating dogs, many countries struggle to sustain large-scale campaigns due to financial and logistical challenges.

Mass dog vaccination remains the cornerstone of rabies elimination. This study provides practical evidence to guide policymakers on how to strengthen national rabies control programmes and accelerate progress toward global elimination targets.

Comparing two vaccination approaches

The researchers compared:

1. Team-led vaccination — the traditional approach where district veterinary teams conduct annual central-point vaccination campaigns in villages.
2. Community-led vaccination — a decentralised, hybrid model where locally based animal health workers coordinate vaccination activities throughout the year, using flexible delivery methods such as village clinics, sub-village outreach, and door-to-door visits.

Nearly twice as many dogs vaccinated

Over the three-year study period, 187,778 dogs were vaccinated across the study area.

• 129,051 dogs (68.7%) were vaccinated under the community-led approach.
• 58,727 dogs (31.3%) were vaccinated under the team-led model.

At ward level, the community-led strategy vaccinated nearly twice as many dogs annually compared to the team-led approach.

Although the community-led model had higher total programme costs at ward level, the average cost per dog vaccinated was similar between the two strategies. Median costs per dog were significantly lower under the community-led approach, indicating more consistent cost performance.

Rural areas benefit most

The study found that cost-effectiveness varied by location.

• In rural areas, the community-led approach was more cost-effective.
• In urban settings, the traditional team-led campaigns were cheaper per dog vaccinated.

Both approaches showed economies of scale, meaning the cost per dog decreased as more dogs were vaccinated.

“The economies of scale achieved through community-led delivery can enable governments to expand vaccination coverage within existing budgets while freeing resources to strengthen fragmented veterinary systems,” the authors noted.

Reducing the burden on households

Another important finding was the difference in who bears the cost burden. While provider costs were comparable per vaccinated dog, households incurred significantly higher time and travel costs under the team-led approach, as dog owners had to bring animals to central vaccination points.

In contrast, the community-led model reduced household burden through more accessible and flexible vaccination delivery options.

Implications for rabies elimination

The study concludes that both delivery models are viable but should be strategically applied depending on the setting.

Community-led vaccination appears particularly suitable for rural and hard-to-reach areas, while team-led campaigns may remain efficient in densely populated urban environments.

“This approach [community-led] is particularly relevant where limited public funding constrains widespread dog vaccination coverage, making the superior cost-effectiveness of community-based strategies essential for achieving elimination targets aligned with global frameworks such as Zero by 30,” the study concludes.

Read the publication, here.