Barriers to attendance of canine rabies vaccination campaigns in Haiti, 2017.

Abstract

We conducted a cross‐sectional survey to better understand the barriers to attendance at canine rabies vaccination campaigns in Haiti. A structured community‐based questionnaire was conducted over a 15‐day period during May–June 2017, focused on socio‐economic status correlated with participation at canine rabies vaccination campaigns. Questions phrased as a bidding game were asked to determine individuals’ willingness to pay (WTP) for dog rabies vaccination and willingness to walk (WTW) to fixed‐point vaccination campaigns. The Kaplan–Meier estimator was applied to determine relationships between survey variables. Logistic regression was used to examine factors associated with participants’ WTP and WTW. A total of 748 households from eight communities were surveyed. Respondents were predominantly female (54.4%) and had a median age of 45 years. The total number of owned dogs reported from households was 926, yielding a human‐to‐dog ratio in dog‐owning households of 5.2:1. The majority of dogs (87.2%) were acquired for security, and 49% were allowed to roam freely; 42.0% of dog owners reported that they were unable to manage (or restrain) their dogs using a leash. Seventy per cent of dog owners were willing to pay up to 15.9 gourdes (0.25 USD) and/or walk up to 75 m to vaccinate their dogs. Households that owned free‐roaming dogs, owned dogs for the purpose of companionship and owned dogs that they were unable to walk on a leash were associated with a higher WTP for vaccination. Living in Artibonite Department, having a middle or higher household income, and owning a dog for security purpose were associated with a higher WTW for vaccination. Low leash use and propensity for dogs to roam freely are barriers to successful fixed‐point vaccination methods in Haiti, and alternative methods such as door to door (DD), capture–vaccinate–release (CVR) or oral vaccination should be explored. There may be some prospect for fee‐for‐service vaccination in Haiti; however, this programme should be introduced as a supplement, rather than a replacement for free rabies vaccination programmes so that mass dog vaccination is not discouraged.