Duamor, C. T. et al. (2023) Integrating a community-based continuous mass dog vaccination delivery strategy into the veterinary system of Tanzania: a process evaluation using normalization process theory. One Health, 17, 100575. (doi: 10.1016/j.onehlt.2023.100575) (PMID:37332884) (PMCID:PMC10272491)
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Abstract
Sustained vaccination coverage of domestic dog populations can interrupt rabies transmission. However, challenges remain including low dog owner participation, high operational costs associated with current (centralized and annually delivered (pulse)) approaches and high dog population turnover. To address these challenges an alternative (community-based continuous mass dog vaccination (CBC-MDV)) approach was designed. We investigated the potential for successful normalization of CBC-MDV into routine practice within the context of local communities and the veterinary system of Tanzania Methods: In a process evaluation of a pilot implementation of CBC-MDV, we conducted in-depth interviews with implementers and community leaders (n = 24), focus group discussion with implementers and community members (n = 12), and non-participant observation (n = 157 h) of delivery of the intervention components. We analyzed these data thematically drawing on the normalization process theory, to assess factors affecting implementation and integration. Main findings: Implementers and community members clearly understood the values and benefits of the CBC-MDV, regarding it as an improvement over the pulse strategy. They had a clear understanding of what was required to enact CBC-MDV and considered their own involvement to be legitimate. The approach fitted well into routine schedules of implementers and the context (infrastructure, skill sets and policy). Implementers and community members positively appraised CBC-MDV in terms of its perceived impact on rabies and recommended its use across the country. Implementers and community members further believed that vaccinating dogs free of charge was critical and made community mobilization easier. However, providing feedback to communities and involving them in evaluating outcomes of vaccination campaigns were reported to have not been done. Local politics was cited as a barrier to collaboration between implementers and community leaders. Conclusion: This work suggests that CBC-MDV has the potential to be integrated and sustained in the context of Tanzania. Involving communities in design, delivery and monitoring of CBC-MDV activities could contribute to improving and sustaining its outcomes.
Item Type: | Articles |
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Additional Information: | Funding for the postgraduate study of (CTD) and supervision by (EM & KK) was received from the DELTAS Africa Initiative [Afrique One-ASPIRE/DEL-15-008]. Afrique One-ASPIRE is funded by a consortium of donors, including the African Academy of Sciences (AAS), Alliance for Accelerating Excellence in Science in Africa (AESA), the New Partnership for Africa's Development Planning and Coordinating (NEPAD) Agency, the Wellcome Trust [107753/A/15/Z] and the UK government. The mass dog vaccination and research activities were funded by the Department of Health and Human Services of the National Institutes of Health [R01AI141712]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. The Wellcome Trust funded KH and CTD [207569/Z/17/Z]. |
Status: | Published |
Refereed: | Yes |
Glasgow Author(s) Enlighten ID: | Wyke, Professor Sally and Czupryna, Dr Anna and Mpolya, Dr Emmanuel and Lankester, Dr Felix and changalucha, Mr joel and Kreppel, Dr Katharina and Cleaveland, Professor Sarah and Lugelo, Dr Ahmed and Lushasi, Mr Kennedy and Duamor, Mr Christian and Hampson, Professor Katie |
Authors: | Duamor, C. T., Hampson, K., Lankester, F., Lugelo, A., Changalucha, J., Lushasi, K. S., Czupryna, A., Mpolya, E., Kreppel, K., Cleaveland, S., and Wyke, S. |
College/School: | College of Medical Veterinary and Life Sciences > School of Biodiversity, One Health & Veterinary Medicine College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care |
Journal Name: | One Health |
Publisher: | Elsevier |
ISSN: | 2352-7714 |
ISSN (Online): | 2352-7714 |
Published Online: | 03 June 2023 |
Copyright Holders: | Copyright © 2023 The Authors |
First Published: | First published in One Health 17:100575 |
Publisher Policy: | Reproduced under a Creative Commons License |
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