Multilevel barriers to dog rabies vaccination uptake in Kilosa District, Tanzania

Abstract Barriers to dog vaccination in Tanzania in general, and in Kilosa District in particular, are not well understood. Therefore, this study sought to address the following research question: What are the multilevel barriers to the vaccination of dogs against rabies in Kilosa District? Guided by a socioecological model, the study explored the barriers to dog vaccination at multiple levels within the Kilosa District context. A case study design employing a qualitative research approach was used. Data were collected through focus group discussions (FGDs) and in-depth interviews to investigate contextual barriers to dog vaccination. The collected data were analyzed using a thematic analysis approach. The results are organized according to the levels of the socioecological model. At the individual level, barriers include limited literacy about rabies and dog rabies vaccination; low perceived risk of rabies transmission; low prioritization of dog vaccination in household financial decisions; and uncertainty regarding the cost of dog vaccination. At the organizational/health system level, barriers include fragmented provision of rabies-related health education, reactive rather than proactive sensitization efforts, and limited communication channels, primarily relying on loudspeaker announcements. At the community level, barriers include misconceptions about protection against rabies and mistrust in political leadership. In conclusion, Rabies vaccination uptake in Kilosa District is constrained by multilevel barriers. Individually, limited knowledge, low risk perception, and financial uncertainty reduce prioritization of dog vaccination. Organizational barriers include fragmented health education, weak cross-sector coordination, and reactive communication. At the community level, logistical challenges, absence of By-Laws, persistent misconceptions, and political mistrust further limit vaccination coverage.