Willingness to pay for rabies vaccination services and associated factors among communities in Geita District, Tanzania

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Despite all the effort put into rabies vaccination campaigns, there are still new cases all the time, and vaccination coverage is still low. Therefore, this study aimed to explore the willingness to pay for rabies vaccination services and associated factors among communities in Geita district, Tanzania. Methods: A cross-sectional study was conducted among 312 respondents in Geita district from August to September 2023. The study deployed a willingness-to-pay (WTP) technique using a bidding game to elicit the maximum values respondents were willing to pay for rabies dog vaccination and human post-exposure prophylaxis. An interviewer-administered questionnaire was used to collect all the necessary data. Linear regression models were used to evaluate the WTP and associated factors. Results: The results suggest that people are willing to pay slightly more for dog vaccination services ($0.3 above the prevailing price) compared to human post-exposure prophylaxis (PEP), in which the average WTP is the same as the prevailing price. 62% of the respondents were willing to pay above the prevailing price ($1.2) for dog vaccines compared to 32% for PEP ($20). In dog vaccination and human PEP services, men are more willing to pay than women. Conclusion: This study highlights the significance of economic consideration in rabies vaccination decisions. In addition to awareness, availability, and access to vaccines, it is crucial to consider socioeconomic factors and financial values individuals place on the welfare of animals. Trial registration: Not Applicable Rabies Willingness-to-pay dog vaccination human post-exposure prophylaxis Tanzania Figures Figure 1 Figure 2 Figure 3 Figure 4 Figure 5 Figure 6 Background Rabies is a viral disease that affects the central nervous system of mammals, ultimately affecting the brain cells and causing death [ 1 ]. The virus is commonly transmitted to humans through bites by rabid animals, especially dogs [ 2 ]. Rabies is a significant public health threat and the most underreported neglected tropical disease in low-income countries [ 3 , 4 ]. Rabies is estimated to cause 59,000 human deaths annually in over 150 countries, with 95% of cases occurring in Africa and Asia [ 5 ]. Rabies has a significant impact on communities. The disease is associated with an increased economic burden, with control and management costs estimated to reach up to $ 20 million in Africa [ 4 ]. In Tanzania, where rabies is endemic, it is estimated to cause over 1,400 annual deaths [ 6 ]. The direct medical cost associated with a complete regime of post-exposure prophylaxis (PEP) is estimated at an average of $ 100 per person in the country [ 4 ]. These expenses impose a substantial burden, particularly on impoverished and rural communities where access to preventive measures such as vaccination may be limited. Geita is among the districts in Tanzania that experience a notable burden of rabies cases among human and animal populations, where in 2023, there were about 11 rabies cases in the region. Dog vaccination is considered one of the most cost-effective methods for preventing and controlling dog-mediated human rabies and associated deaths [ 7 ]. Evidence shows that an increase in domestic dog vaccination coverage is strongly associated with a decrease in the incidences of rabies [ 8 , 9 ]. This is because 99% of human exposures occur through rabid dogs [ 10 , 11 ]. Also, prompt administration of PEP prevents human rabies in victims of dog bites [ 12 ]. Unfortunately, the cost of PEP can be a significant barrier for bite victims and governments in LMICs [ 13 , 12 ]. Although dog vaccination against rabies is mandatory for every owner in Tanzania, the vaccine is considered a private good. Therefore, owners are usually charged a fee to vaccinate each dog. However, the higher the cost, the lower the compliance is likely to be [ 14 ]. Therefore, before setting the prices, it is essential to understand whether communities see the value of rabies vaccination and are willing to pay for the associated benefits. The willingness to pay enables involved parties to determine the price that will promote the uptake of rabies vaccination services among vulnerable communities. Willingness to pay (WTP) is one of the important economic values. It is a fundamental economic concept that provides insights into consumers’ preferences, elasticity of demand, and perceived benefits of the good or service [ 15 ]. The WTP analysis has been used in a different field for economic valuation to estimate the economic value of non-market goods and services such as environmental services [ 16 ], forest management [ 17 ], and health interventions [ 18 – 20 ]. Willingness to pay for healthcare services has been reported to correlate with age, education, income, household size, perception/perceived risk, healthcare quality, locality, and ability to pay [ 21 – 23 ]. WTP has been used in Rabies studies to estimate the monetary value individuals place on services such as dog vaccine costs and vaccination cards [ 14 , 24 , 25 ]. However, no studies have been conducted individually on WTP for human rabies vaccine. Understanding WTP for rabies interventions is key to improving policies and programmatic strategies to enhance access to rabies vaccination services and reduce the burden of rabies, particularly in resource-limited settings. Therefore, his paper aims to provide insights into the economic preferences and priorities of residents regarding rabies prevention and control strategies by evaluating community willingness to pay for rabies vaccination services (Dog vaccines and human vaccines) in Geita District, Tanzania. The conceptual framework guiding this study is rooted in health economics and behavioural economics theories, which recognise the interplay between individual perceptions, socio-economic factors, and healthcare decision-making processes. Methods Description of the study area Geita district is among the districts located in the Geita region in northwestern Tanzania. The district is made up of 35 wards and 145 villages. According to the 2022 National Population and Housing Census, the district had a total population of 1,035,214 people, of which 507,788 (49%) were male and 527,426 (51%) were female [ 26 ]. Geita district was selected for this study because of the following reasons: (i) Between 2018 and 2021, eleven (11) cases of Rabies in dogs were reported in the animal health surveillance system, putting 3085 dogs at risk (Ministry of Livestock and Fisheries, personal communication). (ii) The presence of Burigi-Chato National Park in the region is also considered a risk factor for fueling rabies transmission via wildlife-human interaction. Two sites (rural village and urban sites) were selected to get diverse contexts on the systems-level factors attributed to rabies prevention and control in the district. Figure 1 . Map of Tanzania showing study site Study design This analytical cross-sectional study was conducted among community members in the Geita district from August to September 2023. Study population The study population comprised all households in the selected areas in Geita district council. The study targeted dog owners and non-owners in Geita because we hypothesised that individuals have diverse understandings and willingness to pay for vaccination-related services for rabies. Dog owners and non-owners over 18 years old residing in the selected areas were eligible to gather diverse perspectives regarding the subject. Sample size estimation The researchers did not have enough information on the population size (total number of households) for each village. Therefore, the sample size estimation formula for unknown populations was used as described by Charan and Biswas (2013) [ 27 ]. It is used for calculating the sample size of a qualitative variable in prevalence or cross-sectional studies: Sample size (n) =(Z 1−∝/2 ) 2 *p (1-p)/d 2 Where : n = Sample size Z 1−∝/2 = Standard normal variate at p < 0.05 is 1.96 p = estimated proportion of the study variable, at 50% (for maximum variability) d = Margin of error, 5% The margin of error accommodated non-responses and refusals; hence, the sample is sufficient for estimating the parameters. As a result, a sample of 384 respondents was obtained Sampling procedures Household was the sampling unit, and multi-stage sampling procedures were followed as indicated in Fig. 2 : Figure 2 . Multistage Sampling procedure A total of six villages were selected depending on the following strata: location (rural or urban category), dog population (high and low population) and recent incidents of bites and rabies in the area (high and low prevalence) to compare multiple variables across them. A proportional technique was used to determine the number of respondents, where 5% of the total households in the village were recruited for the study. During the selection, gender split was considered, and it was ensured that at least 30% of the selected households were female-headed. A random number generator ( https://www.randomizer.org/ ) randomly selected eligible households. Data collection Data were collected using an interviewer-administered electronic questionnaire built on the Open Data Kit (ODK) mobile application [ 28 ]. The instrument covered the socio-demographic characteristics of the respondents, such sex, education, age, occupation, as dog ownership, risk perception, awareness about rabies, rabies vaccination services, and willingness to pay for rabies vaccination services. The questionnaire was administered to a household head except in a few cases where the potential respondent chose an adult representative within the household who is more informed. The willingness to Pay (WTP) method was presented as a bidding game to assess the respondent’s perceived costs and benefits of vaccinating their dogs and post-exposure prophylaxis (human vaccine) as reported in [ 24 ]. To assess WTP for dog vaccination fee, the respondent was first offered an initial price for a dog rabies vaccine of 3,000 TZS (approximately $ 1.20). This is the standard price that the district veterinary officials have set to charge for vaccination services. If the respondent accepted or answered “Yes” to this initial price, he/she was directed to the next question. He/she was continuously offered higher and higher prices step by step until the s/he rejected or said No. Alternatively, if the respondent rejects (“No”) the initial price (first question), then the respondent was directed to a lower price option, and the prices repeatedly decreased step by step until the respondent accepted a given price or reached zero. The same methodology was used to assess Willingness to Pay for Post-exposure prophylaxis. Data processing and analysis Data from the questionnaire was downloaded from the ODK server, cleaned using Microsoft™ Excel and converted into a CSV (Comma-Separated Values) file for easy transfer and analysis in other software. The analysis was done using Microsoft™ Excel statistical analysis package and Python programming language (version 3.9). Descriptive statistics summarised participants’ demographics and responses to the selected variables, including mean, median, mode, range, and variance. Multinomial logistic regression analysis was used to assess the influence of independent variables on the categorical outcome variables. Multiple linear regression analysis predicted the values between independent and continuous outcome variables. The chi-square test was used to evaluate whether there is a significant association between two categorical variables. A P value of less than 0.05 was considered statistically significant. Results Summary statistics ​ In this study, a total of 384 households were selected. However, only 312 (81%) participated in the study (Table 1 ). There were no non-responses, rather, some (72) selected participants were not available for interviews on the allocated dates. Table 1 Villages selected for the study in Geita District Village Location Dog population* Incidences of dog bite/rabies* Sample Bugogo Urban High High 53 Nyakagomba Rural High Low 40 Nyamigota Urban Low Low 51 Lwamgasa Urban Low Low 45 Bukondo Rural High High 73 Butundwe Rural High High 49 TOTAL 312 *This was unpublished report of the dog population reported by the district veterinarian Socioeconomic Demographic characteristics of the respondents Table 2 details the socio-economic-demographic characteristics of 312 respondents who participated in the survey. Of these, 92 (29.5%) were female. The median age of the respondents was 47 years old, ranging from 18 to 83 years old. More than half (52.3%) had completed primary education, and 18.6% had no formal education. The primary income source for most households (91%) was selling/trading agricultural produce and products, and 53.5% reported an annual income of less than 500,000TZS ( $ 200). Fifty-two percent of the respondents lived in rural areas. Table 2 Socio-Economic Demographic information of participants Variable Frequency Percentage Gender Male 220 70.5 Female 92 29.5 Household headship Male-headed 255 81.7 Female-headed 57 18.3 Rural/Urban Rural 163 52.2 Urban 149 47.8 Marita status Married/living together 247 79.2 Divorced/separated 15 4.8 Widowed 40 12.8 Single/never married 10 3.2 Respondent’s education No formal education 58 18.6 Primary education 209 67.0 Secondary education 41 13.1 Tertiary education 4 1.3 Annual household income (TZS) 5,000,000 8 2.5 Dog Ownership A third (34%) of the households owned dogs. Only 23.4% of female-headed households owned dogs. On average, each household kept two dogs (range: 1–12). Over half of the owners (53.4%) were from rural localities, and more than 80% claimed that they keep dogs as security animals to protect against thieves and wild animals. This was particularly important for those involved in livestock keeping and agricultural activities. However, more than 65% of the respondents were not keeping dogs in their households. Reasons for not owning dogs included: cost incurred when it bites someone, not seeing the need since they did not keep livestock, not seeing the value of keeping dogs. Incidence and distribution of animal bites and rabies cases The survey also revealed that there has been a surge of rabies cases among dogs in Geita, as approximately 42% recalled seeing a suspected rabid dog between 2020 and 2023 (Fig. 3 ). Among 312 respondents, 45 (14.4%) had ever been bitten by a dog, while 32 (10.3%) reported their dogs being bitten by other animals. When asked about their response to a suspected rabid animal, 52% of the respondents said they would kill the animal, while 19% said they would not act. Figure 3 : The last time the respondent saw a rabid dog Awareness about rabies Most of the respondents (96%, n = 312) had heard of rabies, and they highly associated the risks with dogs compared to other animal species, as 78% of them have ever seen a rabid dog. They were also aware that rabies can be transmitted between animals and humans and can be transmitted through dog bites (98%, n = 301) or when scratched by a rabid dog (57.8%). The level of awareness was normally distributed across the respondents. The median awareness level was 60% (range: 18%-91%, Fig. 4 ). Respondents were more aware of risks associated with dog bites regardless of who the owner is (51%, n = 312), hence they were ready to take the anti-rabies vaccine. They were also more aware of symptoms of rabid dogs (24%) than humans (8%). Generally, there was very little knowledge of the source of the rabies virus, as only 17% of the respondents got it right. Figure 4 : Awareness of rabies among respondents Vaccination against Rabies Ninety-five per cent of respondents (n = 107) who own dogs have ever vaccinated their dogs (females = 24/25, males = 78/82). Most respondents (70%) vaccinated their dogs between 2021 and 2023 (Fig. 5 ). However, respondents reported that most of the time, vaccination is sporadic as there is no clear schedule, and they cannot vaccinate on their own because vaccines are not readily available in the area. In 2023, many respondents vaccinated their dogs, but there had been no vaccination for the past three years. The district veterinary officer also confirmed that resentment that mass vaccination was budgeted for the first time in three years in 2023, where community members were to contribute a maximum of 3000 TZS ( $ 1.2). Figure 5 : Dog vaccination against Rabies in years Willingness to pay for dog vaccination services Respondents were asked how much they would pay for dog vaccination services. The median maximum WTP for individuals was $ 1.5 (3,750 TZS), with bids ranging from $ 0–12. Four percent of the respondents were unwilling to pay anything for the dog vaccination, claiming it should be free because rabies is a public health issue. Twenty-six percent (26%) were willing to pay less, while 62% were willing to pay more than the prevailing price for one dose ( $ 1.2). Some felt that the cost of dog vaccines should not be higher than the price of food animals like cattle as dogs are not used for food as one of them resented, “W hy should the cost of vaccinating a dog be raised when you can’t eat it ?” Factors associated with willingness to pay for dog vaccination services. There were slight differences in willingness to pay for dog vaccination services depending on demographic characteristics, dog ownership, and risk perception towards rabies. Men were willing to pay more ( $ 1.9) than women ( $ 1.65). Respondents who were single or never married were ready to pay $ 1.6 more than the indicative price, while widowed or separated respondents were willing to pay an additional $ 0.3. On the other hand, there was little difference in WTP between dog owners and non-owners, as their bids were $ 1.81 and $ 1.84, respectively. Higher education levels were associated with a greater willingness to pay for dog vaccines (Fig. 6 ). Respondents with Tertiary education were willing to pay more ( $ 2.76) than respondents with primary and secondary education ( $ 1.86) and respondents with no formal education ( $ 1.6). Linear regression analysis indicates that age and level of perceived risk are significantly associated with willingness to pay (p = 0.024 and p = 0.025, respectively). Younger age groups show a greater willingness to pay compared to older groups. Figure 6 : Association of Respondents’ level of education and Willingness to pay for dog vaccine There was an association between individual risk perception towards rabies and the willingness to pay for dog vaccination services (Table 3 ). A person who a dog has never bitten is willing to pay $ 1.86 ( $ 0.66 above the prevailing price), while the one who was bitten was willing to pay $ 1.6. On the other hand, a person who has ever seen a rabid dog is willing to pay $ 1.9 ( $ 0.7 above the prevailing price), while someone who has never seen a rabid dog is willing to pay $ 1.56 ( $ 0.36 above the prevailing price). A person who has ever seen a person with rabies was willing to pay the highest for rabies vaccination services compared to others. Table 3 Association between risk perception and WTP (numbers in brackets are the additional amount from prevailing price, $ 1.2) Risk perception Respondents WTP (In US Dollars) Ever Bitten by a dog Yes 1.6 (+ 0.4 $ ) No 1.86 (+ 0.66 $ ) Heard about rabies Yes 1.84 (+ 0.64 $ ) No 1.25 (+ 0.05 $ ) Ever seen a rabid dog Yes 1.9 (+ 0.7 $ ) No 1.56 (+ 0.36 $ ) Ever seen a person with rabies Yes 2.1 (+ 0.9 $ ) No 1.75 (+ 0.55 $ ) Willingness to pay for anti-rabies vaccine (Human PEP) The range for the WTP for anti-rabies was estimated to be between 0–80 USD, respectively, while the median WTP was $ 20. Respondents expressed willingness to pay the stated amount and added that human life is priceless. The willingness to pay differed across genders, with the average amount for men being $ 19.2 while for women being $ 14. The willingness to pay was associated with the respondent’s level of risk perception based on their experience. Respondents who had heard about rabies were willing to pay more ( $ 18.1) than those who hadn’t ( $ 4.9). Similarly, respondents who had ever seen a rabid dog were willing to pay 32% more ( $ 18.9) than those who hadn’t seen one ( $ 12.8). Moreover, those who had seen a rabies victim were willing to pay the highest amount of $ 21. One of the respondents even mentioned, “Human life cannot be traded for any other thing, so I will pay whatever amount just to stay alive ”. Discussion Rabies remains a significant public health and economic problem in Tanzania, where canine rabies is endemic. Our study explored community willingness to pay for dog vaccines and human anti-rabies in Geita district, Tanzania, and the associated determinants. The results suggest that people are willing to pay slightly more for dog vaccination services ( $ 0.3 above the prevailing price) compared to human post-exposure prophylaxis (PEP), in which the average WTP is the same as the prevailing price. Furthermore, the study revealed that 62% of the respondents were willing to pay above the prevailing price ( $ 1.2) compared to 32% for PEP ( $ 20). In dog vaccination and human PEP services, men are more willing to pay than women. The results also showed a strong association between age and WTP where young groups were willing to pay more than older groups. The study indicated that risk perception and experience with rabies-related incidents play a role in individual WTP. Particularly, a person who has ever seen a rabid dog or rabies victim was willing to pay the highest for dog vaccination ( $ 0.9 above the prevailing price) and human PEP ( $ 1 more) compared to others. This can partly be attributed to high awareness of rabies, including its transmission and symptoms in the dog. This suggests that individual experience and perception are critical factors when advocating for collective actions towards rabies control. Previous studies also support this, which shows that people are willing to pay for vaccines only when the perceived risk is high [ 29 ]. Respondents generally share that they attach the highest value to human life; therefore, they would do whatever it takes to protect it through PEP in case a stray dog bites someone. This sentiment also reflects a sentiment shared by many individuals when faced with the threat of a deadly disease like rabies. Compared to specific rabies-endemic countries, the WTP value exceeded the estimated per-dog vaccination cost in Thailand (0.52 USD) while being lower than in the Philippines (1.67 USD) for dog vaccination [ 24 ]. Several factors are associated with WTP for vaccination services. This study explored the association between dog ownership, number of dogs, age, income, gender, education, and risk perception with WTP to vaccination services for dogs and human PEP. However, it was found that only age and perceived risk were strongly associated with WTP. This contradicts previous studies on WTP for vaccines that explored the same factors [ 30 , 31 ]. This may be explained by the homogenous nature of the visited villages in terms of economic activities, education level, and the number of dogs they keep. Gender differences were observed in WTP, with men expressing a higher average amount than women in dog vaccination and human PEP. This difference could be influenced by various socio-cultural factors and men's economic power in the household. The previous studies [ 32 , 33 ] also show that men are more willing to vaccinate than women, contrary to the common narrative that women are risk averse than men. One potential explanation could be that willingness to pay involves financial decisions, which men often make. One noteworthy aspect is the comparison made by some participants between the cost of dog vaccines and that of vaccines for food animals like cattle. There is a sentiment that the price of dog vaccines should not exceed that of vaccines for animals raised for food production. This perspective reflects a utilitarian view of animals, whose value is primarily assessed based on their utility to humans, such as providing food. This sentiment is captured in the participant's statement, questioning why the cost of vaccinating a dog should be raised when it is not consumed as food. Conclusion This study highlights the significance of economic consideration in rabies vaccination decisions. In addition to awareness, availability, and access to vaccines, it is crucial to consider socioeconomic factors and financial values individuals place on the welfare of animals. Greater awareness of the risks associated with the disease is necessary to persuade more people to pursue vaccination services. When developing vaccination programs to promote collective actions towards rabies elimination, it is also important to consider intersectional factors such as age and gender. Declarations Ethics approval and consent to participate The ethical clearance for this study was sought from the Research Ethics Committee of the Sokoine University of Agriculture (SUA). Research clearance was granted with reference number SUA/DPRTC/R/186/65. Permission to conduct the study at study sites was obtained from the President’s Office- Regional Administration and Local Government Authorities (PO-RALG). Before the interviews and questionnaire administration, participants signed a consent form after the consent declaration as per the Declaration of Helsinki (2013). Consent for publication The authors have no conflict of interest to declare. Competing interests The authors have no conflict of interest to declare Funding The study was part of the TAPROD Research Small Grants Award (Ref #: TA/Tanzania/002) funded by the US Agency for International Development (USAID) through Transition Award 7200AA22CA00014 to Africa One Health University Network (AFROHUN). The funder had no role in the design of the study, data collection, analysis, interpretation, or preparation of this manuscript. Author Contribution JG, MM, LK and GS: Conceptualize the study with critical input from JK, HM, DK and MC. JG, MM, LK and GS: Data collection. JG and MM: Data analysis, interpretation and preparation of the first draft of the manuscript. JG, MM, GS, LK, JK, HM, DK and MC: Substantively revised the first draft and subsequent modifications. All authors contributed to the article and approved the submitted version. Acknowledgement This study was made possible by the generous support of the American people through the US Agency for International Development (USAID) Transition Award 7200AA22CA00014 to AFROHUN. The contents and associated materials are the responsibility of the authors and do not necessarily reflect the views of USAID or the US Government. We would also like to thank the Geita Regional secretariat, specifically Mr Shani Gervas (Regional Livestock Field Officer) and Dr. Israel Tarimo, district veterinarian from the Geita district council, for their immense support during the fieldwork. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4926351","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":343601044,"identity":"c5d56975-78d6-4006-9405-772496f57b83","order_by":0,"name":"Janeth George","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA4ElEQVRIiWNgGAWjYBACxgYGNhDNw8beAKQMLIjRwgzWIsPPcwCkRYIYeyBabCRnJIBoIrQwz+4/9vDrnloeg5vPr274USDBwN/enYDfYXMOsxvLPDvOY3A7p+xmD9BhEmfObsCvZUYym7TEgWMgLWk3eIBaDCRyidVy80zazT/EapH8cKCGR3IG+7HbxNpiJs1w4AAPP08O220ZAwkegn4xnJH4TPLHgTp7Nvbjz26++WMjx9/eS0BLAzCgeRgOA5k8BiABHrzKQUAe5LgfDHVAiv0BQdWjYBSMglEwMgEApbtHbLnR1XkAAAAASUVORK5CYII=","orcid":"","institution":"Sokoine University of Agriculture","correspondingAuthor":true,"submittingAuthor":false,"prefix":"","firstName":"Janeth","middleName":"","lastName":"George","suffix":""},{"id":343601045,"identity":"b75798eb-b874-4c9a-ae6c-fd69bffa5218","order_by":1,"name":"Mourice Mbunde","email":"","orcid":"","institution":"Muhimbili University of Health and Allied Sciences","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Mourice","middleName":"","lastName":"Mbunde","suffix":""},{"id":343601046,"identity":"932c806d-d30c-46ac-a331-77f1c191ccbb","order_by":2,"name":"Loveness Kimaro","email":"","orcid":"","institution":"Muhimbili University of Health and Allied Sciences","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Loveness","middleName":"","lastName":"Kimaro","suffix":""},{"id":343601047,"identity":"2159134f-dfdc-464b-bbeb-6524c80aed9a","order_by":3,"name":"Given Sam","email":"","orcid":"","institution":"Muhimbili University of Health and Allied Sciences","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Given","middleName":"","lastName":"Sam","suffix":""},{"id":343601048,"identity":"4b6f197e-7b2b-4c4c-8687-5418e1df20ee","order_by":4,"name":"Mkunde Chachage","email":"","orcid":"","institution":"University of Dar es Salaam, Mbeya College of Health and Allied Sciences","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Mkunde","middleName":"","lastName":"Chachage","suffix":""},{"id":343601049,"identity":"8fdd4169-034c-4731-bbf9-f4d5667497a3","order_by":5,"name":"Hussein Mohamed","email":"","orcid":"","institution":"Muhimbili University of Health and Allied Sciences","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Hussein","middleName":"","lastName":"Mohamed","suffix":""},{"id":343601050,"identity":"62870b26-5b3a-471f-929d-1b304bf9b938","order_by":6,"name":"Deodatus Kakoko","email":"","orcid":"","institution":"Muhimbili University of Health and Allied Sciences","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Deodatus","middleName":"","lastName":"Kakoko","suffix":""},{"id":343601051,"identity":"1a5fff12-1fe9-4b6c-aa1a-9c7de9d014cf","order_by":7,"name":"Japhet Killewo","email":"","orcid":"","institution":"Muhimbili University of Health and Allied Sciences","correspondingAuthor":false,"submittingAuthor":false,"prefix":"","firstName":"Japhet","middleName":"","lastName":"Killewo","suffix":""}],"badges":[],"createdAt":"2024-08-16 16:53:51","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4926351/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4926351/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":66668310,"identity":"e90889b2-71db-4f81-9091-20628e56f4ab","added_by":"auto","created_at":"2024-10-15 09:57:02","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":234601,"visible":true,"origin":"","legend":"\u003cp\u003eMap of Tanzania showing the study site\u003c/p\u003e\n\u003cp\u003eThe red colour in the left-hand map indicates Geita region, while right-hand map is Geita District)\u003c/p\u003e","description":"","filename":"Figure1.MapofTanzaniashowingstudysite.jpg","url":"https://assets-eu.researchsquare.com/files/rs-4926351/v1/80de137538c3d59b9612c64e.jpg"},{"id":66668309,"identity":"36eec881-6dbf-43f5-8a0e-4d6115bd9b25","added_by":"auto","created_at":"2024-10-15 09:57:02","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":54400,"visible":true,"origin":"","legend":"\u003cp\u003eMultistage Sampling procedure\u003c/p\u003e","description":"","filename":"Figure2.Multistagesamplingprocedures.png","url":"https://assets-eu.researchsquare.com/files/rs-4926351/v1/60de552c111bfa35fa9820b3.png"},{"id":66667384,"identity":"2e3caa0e-872e-4672-862d-e4f2a454e139","added_by":"auto","created_at":"2024-10-15 09:49:02","extension":"png","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":34039,"visible":true,"origin":"","legend":"\u003cp\u003eThe last time the respondent saw a rabid dog\u003c/p\u003e","description":"","filename":"Figure3.Thelasttimerespondentsawarabiddog.png","url":"https://assets-eu.researchsquare.com/files/rs-4926351/v1/f29e1b31ca7df55519d0ba45.png"},{"id":66667385,"identity":"28e9b6d8-7cc0-4ee8-93ee-65a597b0d252","added_by":"auto","created_at":"2024-10-15 09:49:02","extension":"png","order_by":4,"title":"Figure 4","display":"","copyAsset":false,"role":"figure","size":17689,"visible":true,"origin":"","legend":"\u003cp\u003eAwareness of rabies among respondents\u003c/p\u003e","description":"","filename":"Figure4.Awarenessofrabiesamongrespondents.png","url":"https://assets-eu.researchsquare.com/files/rs-4926351/v1/932764f9c6e43764eecfa2a9.png"},{"id":66667386,"identity":"6b30a184-fb60-441d-83ff-276fbd75f414","added_by":"auto","created_at":"2024-10-15 09:49:02","extension":"png","order_by":5,"title":"Figure 5","display":"","copyAsset":false,"role":"figure","size":49807,"visible":true,"origin":"","legend":"\u003cp\u003eDog Vaccination against Rabies in years\u003c/p\u003e","description":"","filename":"Figure5.Vaccinationagainstrabiesinyears.png","url":"https://assets-eu.researchsquare.com/files/rs-4926351/v1/163cf3499646caf00f5a35ec.png"},{"id":66667387,"identity":"7c4e5d2d-ca6f-46eb-a847-badcb17c7288","added_by":"auto","created_at":"2024-10-15 09:49:02","extension":"png","order_by":6,"title":"Figure 6","display":"","copyAsset":false,"role":"figure","size":14594,"visible":true,"origin":"","legend":"\u003cp\u003eAssociation of Respondents’ level of education and Willingness to pay for dog vaccine\u003c/p\u003e","description":"","filename":"Figure6.Associationofrespondentseducationlevelandwillignesstopayfordogvaccine.png","url":"https://assets-eu.researchsquare.com/files/rs-4926351/v1/0c497cd5489818ca9e4fd3b0.png"},{"id":86921484,"identity":"29b7ce4d-1479-41a5-aabb-7a4d7a6494fb","added_by":"auto","created_at":"2025-07-17 07:39:10","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1477466,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4926351/v1/32cd1eeb-e7d3-4913-a64e-391c5da010f4.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Willingness to pay for rabies vaccination services and associated factors among communities in Geita District, Tanzania","fulltext":[{"header":"Background","content":"\u003cp\u003eRabies is a viral disease that affects the central nervous system of mammals, ultimately affecting the brain cells and causing death [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. The virus is commonly transmitted to humans through bites by rabid animals, especially dogs [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. Rabies is a significant public health threat and the most underreported neglected tropical disease in low-income countries [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. Rabies is estimated to cause 59,000 human deaths annually in over 150 countries, with 95% of cases occurring in Africa and Asia [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eRabies has a significant impact on communities. The disease is associated with an increased economic burden, with control and management costs estimated to reach up to \u003cspan\u003e$\u003c/span\u003e20\u0026nbsp;million in Africa [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. In Tanzania, where rabies is endemic, it is estimated to cause over 1,400 annual deaths [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. The direct medical cost associated with a complete regime of post-exposure prophylaxis (PEP) is estimated at an average of \u003cspan\u003e$\u003c/span\u003e100 per person in the country [\u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. These expenses impose a substantial burden, particularly on impoverished and rural communities where access to preventive measures such as vaccination may be limited. Geita is among the districts in Tanzania that experience a notable burden of rabies cases among human and animal populations, where in 2023, there were about 11 rabies cases in the region.\u003c/p\u003e \u003cp\u003eDog vaccination is considered one of the most cost-effective methods for preventing and controlling dog-mediated human rabies and associated deaths [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Evidence shows that an increase in domestic dog vaccination coverage is strongly associated with a decrease in the incidences of rabies [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. This is because 99% of human exposures occur through rabid dogs [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. Also, prompt administration of PEP prevents human rabies in victims of dog bites [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Unfortunately, the cost of PEP can be a significant barrier for bite victims and governments in LMICs [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e]. Although dog vaccination against rabies is mandatory for every owner in Tanzania, the vaccine is considered a private good. Therefore, owners are usually charged a fee to vaccinate each dog. However, the higher the cost, the lower the compliance is likely to be [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. Therefore, before setting the prices, it is essential to understand whether communities see the value of rabies vaccination and are willing to pay for the associated benefits. The willingness to pay enables involved parties to determine the price that will promote the uptake of rabies vaccination services among vulnerable communities.\u003c/p\u003e \u003cp\u003eWillingness to pay (WTP) is one of the important economic values. It is a fundamental economic concept that provides insights into consumers\u0026rsquo; preferences, elasticity of demand, and perceived benefits of the good or service [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. The WTP analysis has been used in a different field for economic valuation to estimate the economic value of non-market goods and services such as environmental services [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e], forest management [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e], and health interventions [\u003cspan additionalcitationids=\"CR19\" citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e]. Willingness to pay for healthcare services has been reported to correlate with age, education, income, household size, perception/perceived risk, healthcare quality, locality, and ability to pay [\u003cspan additionalcitationids=\"CR22\" citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. WTP has been used in Rabies studies to estimate the monetary value individuals place on services such as dog vaccine costs and vaccination cards [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e, \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e, \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. However, no studies have been conducted individually on WTP for human rabies vaccine. Understanding WTP for rabies interventions is key to improving policies and programmatic strategies to enhance access to rabies vaccination services and reduce the burden of rabies, particularly in resource-limited settings. Therefore, his paper aims to provide insights into the economic preferences and priorities of residents regarding rabies prevention and control strategies by evaluating community willingness to pay for rabies vaccination services (Dog vaccines and human vaccines) in Geita District, Tanzania. The conceptual framework guiding this study is rooted in health economics and behavioural economics theories, which recognise the interplay between individual perceptions, socio-economic factors, and healthcare decision-making processes.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eDescription of the study area\u003c/h2\u003e \u003cp\u003eGeita district is among the districts located in the Geita region in northwestern Tanzania. The district is made up of 35 wards and 145 villages. According to the 2022 National Population and Housing Census, the district had a total population of 1,035,214 people, of which 507,788 (49%) were male and 527,426 (51%) were female [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. Geita district was selected for this study because of the following reasons: (i) Between 2018 and 2021, eleven (11) cases of Rabies in dogs were reported in the animal health surveillance system, putting 3085 dogs at risk (Ministry of Livestock and Fisheries, personal communication). (ii) The presence of Burigi-Chato National Park in the region is also considered a risk factor for fueling rabies transmission via wildlife-human interaction. Two sites (rural village and urban sites) were selected to get diverse contexts on the systems-level factors attributed to rabies prevention and control in the district.\u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e. \u003cb\u003eMap of Tanzania showing study site\u003c/b\u003e\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003eStudy design\u003c/h2\u003e \u003cp\u003eThis analytical cross-sectional study was conducted among community members in the Geita district from August to September 2023.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eStudy population\u003c/h2\u003e \u003cp\u003eThe study population comprised all households in the selected areas in Geita district council. The study targeted dog owners and non-owners in Geita because we hypothesised that individuals have diverse understandings and willingness to pay for vaccination-related services for rabies. Dog owners and non-owners over 18 years old residing in the selected areas were eligible to gather diverse perspectives regarding the subject.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eSample size estimation\u003c/h2\u003e \u003cp\u003eThe researchers did not have enough information on the population size (total number of households) for each village. Therefore, the sample size estimation formula for unknown populations was used as described by Charan and Biswas (2013) [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. It is used for calculating the sample size of a qualitative variable in prevalence or cross-sectional studies:\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eSample size (n) =(Z \u003csub\u003e1\u0026minus;\u0026prop;/2\u003c/sub\u003e)\u003csup\u003e2\u003c/sup\u003e *p (1-p)/d\u003csup\u003e2\u003c/sup\u003e\u003c/h2\u003e \u003cp\u003e \u003cem\u003eWhere\u003c/em\u003e:\u003c/p\u003e \u003cp\u003en\u0026thinsp;=\u0026thinsp;Sample size\u003c/p\u003e \u003cp\u003eZ \u003csub\u003e1\u0026minus;\u0026prop;/2\u003c/sub\u003e= Standard normal variate at p\u0026thinsp;\u0026lt;\u0026thinsp;0.05 is 1.96\u003c/p\u003e \u003cp\u003ep\u0026thinsp;=\u0026thinsp;estimated proportion of the study variable, at 50% (for maximum variability)\u003c/p\u003e \u003cp\u003ed\u0026thinsp;=\u0026thinsp;Margin of error, 5%\u003c/p\u003e \u003cp\u003eThe margin of error accommodated non-responses and refusals; hence, the sample is sufficient for estimating the parameters. As a result, a sample of 384 respondents was obtained\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec8\" class=\"Section2\"\u003e \u003ch2\u003eSampling procedures\u003c/h2\u003e \u003cp\u003eHousehold was the sampling unit, and multi-stage sampling procedures were followed as indicated in Fig.\u0026nbsp;\u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e:\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e. \u003cb\u003eMultistage Sampling procedure\u003c/b\u003e\u003c/p\u003e \u003cp\u003eA total of six villages were selected depending on the following strata: location (rural or urban category), dog population (high and low population) and recent incidents of bites and rabies in the area (high and low prevalence) to compare multiple variables across them. A proportional technique was used to determine the number of respondents, where 5% of the total households in the village were recruited for the study. During the selection, gender split was considered, and it was ensured that at least 30% of the selected households were female-headed. A random number generator (\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.randomizer.org/\u003c/span\u003e\u003cspan address=\"https://www.randomizer.org/\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e)\u003c/span\u003e randomly selected eligible households.\u003c/p\u003e \u003cdiv id=\"Sec9\" class=\"Section3\"\u003e \u003ch2\u003eData collection\u003c/h2\u003e \u003cp\u003eData were collected using an interviewer-administered electronic questionnaire built on the Open Data Kit (ODK) mobile application [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. The instrument covered the socio-demographic characteristics of the respondents, such sex, education, age, occupation, as dog ownership, risk perception, awareness about rabies, rabies vaccination services, and willingness to pay for rabies vaccination services. The questionnaire was administered to a household head except in a few cases where the potential respondent chose an adult representative within the household who is more informed.\u003c/p\u003e \u003cp\u003eThe willingness to Pay (WTP) method was presented as a bidding game to assess the respondent\u0026rsquo;s perceived costs and benefits of vaccinating their dogs and post-exposure prophylaxis (human vaccine) as reported in [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. To assess WTP for dog vaccination fee, the respondent was first offered an initial price for a dog rabies vaccine of 3,000 TZS (approximately \u003cspan\u003e$\u003c/span\u003e1.20). This is the standard price that the district veterinary officials have set to charge for vaccination services. If the respondent accepted or answered \u0026ldquo;Yes\u0026rdquo; to this initial price, he/she was directed to the next question. He/she was continuously offered higher and higher prices step by step until the s/he rejected or said No. Alternatively, if the respondent rejects (\u0026ldquo;No\u0026rdquo;) the initial price (first question), then the respondent was directed to a lower price option, and the prices repeatedly decreased step by step until the respondent accepted a given price or reached zero. The same methodology was used to assess Willingness to Pay for Post-exposure prophylaxis.\u003c/p\u003e \u003c/div\u003e \u003c/div\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003eData processing and analysis\u003c/h2\u003e \u003cp\u003eData from the questionnaire was downloaded from the ODK server, cleaned using Microsoft\u0026trade; Excel and converted into a CSV (Comma-Separated Values) file for easy transfer and analysis in other software. The analysis was done using Microsoft\u0026trade; Excel statistical analysis package and Python programming language (version 3.9). Descriptive statistics summarised participants\u0026rsquo; demographics and responses to the selected variables, including mean, median, mode, range, and variance. Multinomial logistic regression analysis was used to assess the influence of independent variables on the categorical outcome variables. Multiple linear regression analysis predicted the values between independent and continuous outcome variables. The chi-square test was used to evaluate whether there is a significant association between two categorical variables. A P value of less than 0.05 was considered statistically significant.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cdiv id=\"Sec12\" class=\"Section2\"\u003e \u003ch2\u003eSummary statistics\u003c/h2\u003e \u003cp\u003e \u003cem\u003e​\u003c/em\u003e In this study, a total of 384 households were selected. However, only 312 (81%) participated in the study (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e). There were no non-responses, rather, some (72) selected participants were not available for interviews on the allocated dates.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eVillages selected for the study in Geita District\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVillage\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eLocation\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eDog population*\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eIncidences of dog bite/rabies*\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eSample\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBugogo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHigh\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eHigh\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e53\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNyakagomba\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHigh\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eLow\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNyamigota\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eLow\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eLow\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e51\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLwamgasa\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eLow\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eLow\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e45\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eBukondo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHigh\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eHigh\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e73\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eButundwe\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHigh\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eHigh\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e49\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"4\" nameend=\"c4\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eTOTAL\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cb\u003e312\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"5\"\u003e*This was unpublished report of the dog population reported by the district veterinarian\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec13\" class=\"Section2\"\u003e \u003ch2\u003eSocioeconomic Demographic characteristics of the respondents\u003c/h2\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e details the socio-economic-demographic characteristics of 312 respondents who participated in the survey. Of these, 92 (29.5%) were female. The median age of the respondents was 47 years old, ranging from 18 to 83 years old. More than half (52.3%) had completed primary education, and 18.6% had no formal education. The primary income source for most households (91%) was selling/trading agricultural produce and products, and 53.5% reported an annual income of less than 500,000TZS (\u003cspan\u003e$\u003c/span\u003e200). Fifty-two percent of the respondents lived in rural areas.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eSocio-Economic Demographic information of participants\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVariable\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFrequency\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003ePercentage\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003ctr\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e220\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e70.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eHousehold headship\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMale-headed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e255\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e81.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFemale-headed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e57\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRural/Urban\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRural\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e163\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e52.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eUrban\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e149\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e47.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eMarita status\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarried/living together\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e247\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e79.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDivorced/separated\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWidowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e12.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSingle/never married\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eRespondent\u0026rsquo;s education\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo formal education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e18.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePrimary education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e209\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e67.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSecondary education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e41\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eTertiary education\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colspan=\"3\" nameend=\"c3\" namest=\"c1\"\u003e \u003cp\u003e\u003cb\u003eAnnual household income (TZS)\u003c/b\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026lt;\u0026thinsp;500,000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e167\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e53.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e500,000\u0026ndash;1,000,000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e67\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e21.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e1,000,000\u0026ndash;5,000,000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e70\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u0026gt;\u0026thinsp;5,000,000\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec14\" class=\"Section2\"\u003e \u003ch2\u003eDog Ownership\u003c/h2\u003e \u003cp\u003eA third (34%) of the households owned dogs. Only 23.4% of female-headed households owned dogs. On average, each household kept two dogs (range: 1\u0026ndash;12). Over half of the owners (53.4%) were from rural localities, and more than 80% claimed that they keep dogs as security animals to protect against thieves and wild animals. This was particularly important for those involved in livestock keeping and agricultural activities. However, more than 65% of the respondents were not keeping dogs in their households. Reasons for not owning dogs included: cost incurred when it bites someone, not seeing the need since they did not keep livestock, not seeing the value of keeping dogs.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec15\" class=\"Section2\"\u003e \u003ch2\u003eIncidence and distribution of animal bites and rabies cases\u003c/h2\u003e \u003cp\u003eThe survey also revealed that there has been a surge of rabies cases among dogs in Geita, as approximately 42% recalled seeing a suspected rabid dog between 2020 and 2023 (Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). Among 312 respondents, 45 (14.4%) had ever been bitten by a dog, while 32 (10.3%) reported their dogs being bitten by other animals. When asked about their response to a suspected rabid animal, 52% of the respondents said they would kill the animal, while 19% said they would not act.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e: \u003cb\u003eThe last time the respondent saw a rabid dog\u003c/b\u003e\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec16\" class=\"Section2\"\u003e \u003ch2\u003eAwareness about rabies\u003c/h2\u003e \u003cp\u003eMost of the respondents (96%, n\u0026thinsp;=\u0026thinsp;312) had heard of rabies, and they highly associated the risks with dogs compared to other animal species, as 78% of them have ever seen a rabid dog. They were also aware that rabies can be transmitted between animals and humans and can be transmitted through dog bites (98%, n\u0026thinsp;=\u0026thinsp;301) or when scratched by a rabid dog (57.8%). The level of awareness was normally distributed across the respondents. The median awareness level was 60% (range: 18%-91%, Fig.\u0026nbsp;\u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003e). Respondents were more aware of risks associated with dog bites regardless of who the owner is (51%, n\u0026thinsp;=\u0026thinsp;312), hence they were ready to take the anti-rabies vaccine. They were also more aware of symptoms of rabid dogs (24%) than humans (8%). Generally, there was very little knowledge of the source of the rabies virus, as only 17% of the respondents got it right.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig4\" class=\"InternalRef\"\u003e4\u003c/span\u003e: \u003cb\u003eAwareness of rabies among respondents\u003c/b\u003e\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec17\" class=\"Section2\"\u003e \u003ch2\u003eVaccination against Rabies\u003c/h2\u003e \u003cp\u003eNinety-five per cent of respondents (n\u0026thinsp;=\u0026thinsp;107) who own dogs have ever vaccinated their dogs (females\u0026thinsp;=\u0026thinsp;24/25, males\u0026thinsp;=\u0026thinsp;78/82). Most respondents (70%) vaccinated their dogs between 2021 and 2023 (Fig.\u0026nbsp;\u003cspan refid=\"Fig5\" class=\"InternalRef\"\u003e5\u003c/span\u003e). However, respondents reported that most of the time, vaccination is sporadic as there is no clear schedule, and they cannot vaccinate on their own because vaccines are not readily available in the area. In 2023, many respondents vaccinated their dogs, but there had been no vaccination for the past three years. The district veterinary officer also confirmed that resentment that mass vaccination was budgeted for the first time in three years in 2023, where community members were to contribute a maximum of 3000 TZS (\u003cspan\u003e$\u003c/span\u003e1.2).\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig5\" class=\"InternalRef\"\u003e5\u003c/span\u003e: \u003cb\u003eDog vaccination against Rabies in years\u003c/b\u003e\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec18\" class=\"Section2\"\u003e \u003ch2\u003eWillingness to pay for dog vaccination services\u003c/h2\u003e \u003cp\u003eRespondents were asked how much they would pay for dog vaccination services. The median maximum WTP for individuals was \u003cspan\u003e$\u003c/span\u003e1.5 (3,750 TZS), with bids ranging from \u003cspan\u003e$\u003c/span\u003e0\u0026ndash;12. Four percent of the respondents were unwilling to pay anything for the dog vaccination, claiming it should be free because rabies is a public health issue. Twenty-six percent (26%) were willing to pay less, while 62% were willing to pay more than the prevailing price for one dose (\u003cspan\u003e$\u003c/span\u003e1.2). Some felt that the cost of dog vaccines should not be higher than the price of food animals like cattle as dogs are not used for food as one of them resented, \u0026ldquo;W\u003cem\u003ehy should the cost of vaccinating a dog be raised when you can\u0026rsquo;t eat it\u003c/em\u003e?\u0026rdquo;\u003c/p\u003e \u003cp\u003e \u003cb\u003eFactors associated with willingness to pay for dog vaccination services.\u003c/b\u003e \u003c/p\u003e \u003cp\u003eThere were slight differences in willingness to pay for dog vaccination services depending on demographic characteristics, dog ownership, and risk perception towards rabies. Men were willing to pay more (\u003cspan\u003e$\u003c/span\u003e1.9) than women (\u003cspan\u003e$\u003c/span\u003e1.65). Respondents who were single or never married were ready to pay \u003cspan\u003e$\u003c/span\u003e1.6 more than the indicative price, while widowed or separated respondents were willing to pay an additional \u003cspan\u003e$\u003c/span\u003e0.3. On the other hand, there was little difference in WTP between dog owners and non-owners, as their bids were \u003cspan\u003e$\u003c/span\u003e1.81 and \u003cspan\u003e$\u003c/span\u003e1.84, respectively. Higher education levels were associated with a greater willingness to pay for dog vaccines (Fig.\u0026nbsp;\u003cspan refid=\"Fig6\" class=\"InternalRef\"\u003e6\u003c/span\u003e). Respondents with Tertiary education were willing to pay more (\u003cspan\u003e$\u003c/span\u003e2.76) than respondents with primary and secondary education (\u003cspan\u003e$\u003c/span\u003e1.86) and respondents with no formal education (\u003cspan\u003e$\u003c/span\u003e1.6). Linear regression analysis indicates that age and level of perceived risk are significantly associated with willingness to pay (p\u0026thinsp;=\u0026thinsp;0.024 and p\u0026thinsp;=\u0026thinsp;0.025, respectively). Younger age groups show a greater willingness to pay compared to older groups.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003cp\u003eFigure \u003cspan refid=\"Fig6\" class=\"InternalRef\"\u003e6\u003c/span\u003e: \u003cb\u003eAssociation of Respondents\u0026rsquo; level of education and Willingness to pay for dog vaccine\u003c/b\u003e\u003c/p\u003e \u003cp\u003eThere was an association between individual risk perception towards rabies and the willingness to pay for dog vaccination services (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). A person who a dog has never bitten is willing to pay \u003cspan\u003e$\u003c/span\u003e1.86 (\u003cspan\u003e$\u003c/span\u003e0.66 above the prevailing price), while the one who was bitten was willing to pay \u003cspan\u003e$\u003c/span\u003e1.6. On the other hand, a person who has ever seen a rabid dog is willing to pay \u003cspan\u003e$\u003c/span\u003e1.9 (\u003cspan\u003e$\u003c/span\u003e0.7 above the prevailing price), while someone who has never seen a rabid dog is willing to pay \u003cspan\u003e$\u003c/span\u003e1.56 (\u003cspan\u003e$\u003c/span\u003e0.36 above the prevailing price). A person who has ever seen a person with rabies was willing to pay the highest for rabies vaccination services compared to others.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAssociation between risk perception and WTP (numbers in brackets are the additional amount from prevailing price, \u003cspan\u003e$\u003c/span\u003e1.2)\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"3\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRisk perception\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRespondents WTP (In US Dollars)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eEver Bitten by a dog\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.6 (+\u0026thinsp;0.4\u003cspan\u003e$\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.86 (+\u0026thinsp;0.66\u003cspan\u003e$\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eHeard about rabies\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.84 (+\u0026thinsp;0.64\u003cspan\u003e$\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.25 (+\u0026thinsp;0.05\u003cspan\u003e$\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eEver seen a rabid dog\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.9 (+\u0026thinsp;0.7\u003cspan\u003e$\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.56 (+\u0026thinsp;0.36\u003cspan\u003e$\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\" morerows=\"1\" rowspan=\"2\"\u003e \u003cp\u003eEver seen a person with rabies\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.1 (+\u0026thinsp;0.9\u003cspan\u003e$\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.75 (+\u0026thinsp;0.55\u003cspan\u003e$\u003c/span\u003e)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec19\" class=\"Section2\"\u003e \u003ch2\u003eWillingness to pay for anti-rabies vaccine (Human PEP)\u003c/h2\u003e \u003cp\u003eThe range for the WTP for anti-rabies was estimated to be between 0\u0026ndash;80 USD, respectively, while the median WTP was \u003cspan\u003e$\u003c/span\u003e20. Respondents expressed willingness to pay the stated amount and added that human life is priceless. The willingness to pay differed across genders, with the average amount for men being \u003cspan\u003e$\u003c/span\u003e19.2 while for women being \u003cspan\u003e$\u003c/span\u003e14. The willingness to pay was associated with the respondent\u0026rsquo;s level of risk perception based on their experience. Respondents who had heard about rabies were willing to pay more (\u003cspan\u003e$\u003c/span\u003e18.1) than those who hadn\u0026rsquo;t (\u003cspan\u003e$\u003c/span\u003e4.9). Similarly, respondents who had ever seen a rabid dog were willing to pay 32% more (\u003cspan\u003e$\u003c/span\u003e18.9) than those who hadn\u0026rsquo;t seen one (\u003cspan\u003e$\u003c/span\u003e12.8). Moreover, those who had seen a rabies victim were willing to pay the highest amount of \u003cspan\u003e$\u003c/span\u003e21. One of the respondents even mentioned, \u0026ldquo;Human \u003cem\u003elife cannot be traded for any other thing, so I will pay whatever amount just to stay alive\u003c/em\u003e \u003cb\u003e\u0026rdquo;.\u003c/b\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Discussion","content":"\u003cp\u003eRabies remains a significant public health and economic problem in Tanzania, where canine rabies is endemic. Our study explored community willingness to pay for dog vaccines and human anti-rabies in Geita district, Tanzania, and the associated determinants. The results suggest that people are willing to pay slightly more for dog vaccination services (\u003cspan\u003e$\u003c/span\u003e0.3 above the prevailing price) compared to human post-exposure prophylaxis (PEP), in which the average WTP is the same as the prevailing price. Furthermore, the study revealed that 62% of the respondents were willing to pay above the prevailing price (\u003cspan\u003e$\u003c/span\u003e1.2) compared to 32% for PEP (\u003cspan\u003e$\u003c/span\u003e20). In dog vaccination and human PEP services, men are more willing to pay than women. The results also showed a strong association between age and WTP where young groups were willing to pay more than older groups.\u003c/p\u003e \u003cp\u003eThe study indicated that risk perception and experience with rabies-related incidents play a role in individual WTP. Particularly, a person who has ever seen a rabid dog or rabies victim was willing to pay the highest for dog vaccination (\u003cspan\u003e$\u003c/span\u003e0.9 above the prevailing price) and human PEP (\u003cspan\u003e$\u003c/span\u003e1 more) compared to others. This can partly be attributed to high awareness of rabies, including its transmission and symptoms in the dog. This suggests that individual experience and perception are critical factors when advocating for collective actions towards rabies control. Previous studies also support this, which shows that people are willing to pay for vaccines only when the perceived risk is high [\u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e29\u003c/span\u003e]. Respondents generally share that they attach the highest value to human life; therefore, they would do whatever it takes to protect it through PEP in case a stray dog bites someone. This sentiment also reflects a sentiment shared by many individuals when faced with the threat of a deadly disease like rabies.\u003c/p\u003e \u003cp\u003eCompared to specific rabies-endemic countries, the WTP value exceeded the estimated per-dog vaccination cost in Thailand (0.52 USD) while being lower than in the Philippines (1.67 USD) for dog vaccination [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e]. Several factors are associated with WTP for vaccination services. This study explored the association between dog ownership, number of dogs, age, income, gender, education, and risk perception with WTP to vaccination services for dogs and human PEP. However, it was found that only age and perceived risk were strongly associated with WTP. This contradicts previous studies on WTP for vaccines that explored the same factors [\u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e30\u003c/span\u003e, \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e31\u003c/span\u003e]. This may be explained by the homogenous nature of the visited villages in terms of economic activities, education level, and the number of dogs they keep.\u003c/p\u003e \u003cp\u003eGender differences were observed in WTP, with men expressing a higher average amount than women in dog vaccination and human PEP. This difference could be influenced by various socio-cultural factors and men's economic power in the household. The previous studies [\u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e32\u003c/span\u003e, \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e33\u003c/span\u003e] also show that men are more willing to vaccinate than women, contrary to the common narrative that women are risk averse than men. One potential explanation could be that willingness to pay involves financial decisions, which men often make.\u003c/p\u003e \u003cp\u003eOne noteworthy aspect is the comparison made by some participants between the cost of dog vaccines and that of vaccines for food animals like cattle. There is a sentiment that the price of dog vaccines should not exceed that of vaccines for animals raised for food production. This perspective reflects a utilitarian view of animals, whose value is primarily assessed based on their utility to humans, such as providing food. This sentiment is captured in the participant's statement, questioning why the cost of vaccinating a dog should be raised when it is not consumed as food.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study highlights the significance of economic consideration in rabies vaccination decisions. In addition to awareness, availability, and access to vaccines, it is crucial to consider socioeconomic factors and financial values individuals place on the welfare of animals. Greater awareness of the risks associated with the disease is necessary to persuade more people to pursue vaccination services. When developing vaccination programs to promote collective actions towards rabies elimination, it is also important to consider intersectional factors such as age and gender.\u003c/p\u003e"},{"header":"Declarations","content":" \u003cp\u003e \u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e \u003cp\u003eThe ethical clearance for this study was sought from the Research Ethics Committee of the Sokoine University of Agriculture (SUA). Research clearance was granted with reference number SUA/DPRTC/R/186/65. Permission to conduct the study at study sites was obtained from the President\u0026rsquo;s Office- Regional Administration and Local Government Authorities (PO-RALG). Before the interviews and questionnaire administration, participants signed a consent form after the consent declaration as per the Declaration of Helsinki (2013).\u003c/p\u003e \u003c/p\u003e \u003cp\u003e \u003cstrong\u003eConsent for publication\u003c/strong\u003e \u003cp\u003eThe authors have no conflict of interest to declare.\u003c/p\u003e \u003c/p\u003e\u003cp\u003e \u003ch2\u003eCompeting interests\u003c/h2\u003e \u003cp\u003eThe authors have no conflict of interest to declare\u003c/p\u003e \u003c/p\u003e\u003ch2\u003eFunding\u003c/h2\u003e \u003cp\u003eThe study was part of the TAPROD Research Small Grants Award (Ref #: TA/Tanzania/002) funded by the US Agency for International Development (USAID) through Transition Award 7200AA22CA00014 to Africa One Health University Network (AFROHUN). The funder had no role in the design of the study, data collection, analysis, interpretation, or preparation of this manuscript.\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eJG, MM, LK and GS: Conceptualize the study with critical input from JK, HM, DK and MC. JG, MM, LK and GS: Data collection. JG and MM: Data analysis, interpretation and preparation of the first draft of the manuscript. JG, MM, GS, LK, JK, HM, DK and MC: Substantively revised the first draft and subsequent modifications. All authors contributed to the article and approved the submitted version.\u003c/p\u003e\u003ch2\u003eAcknowledgement\u003c/h2\u003e\u003cp\u003eThis study was made possible by the generous support of the American people through the US Agency for International Development (USAID) Transition Award 7200AA22CA00014 to AFROHUN. The contents and associated materials are the responsibility of the authors and do not necessarily reflect the views of USAID or the US Government. We would also like to thank the Geita Regional secretariat, specifically Mr Shani Gervas (Regional Livestock Field Officer) and Dr. Israel Tarimo, district veterinarian from the Geita district council, for their immense support during the fieldwork.\u003c/p\u003e\u003ch2\u003eAvailability of data and materials\u003c/h2\u003e \u003cp\u003eThe datasets used in this study are available from the corresponding author on request\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eHagos WG, Muchie KF, Gebru GG, Mezgebe GG, Reda KA, Dachew BA. Assessment of knowledge, attitude and practice towards rabies and associated factors among household heads in Mekelle city, Ethiopia. BMC Public Health. 2020;20(1):57.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eChangalucha J, Steenson R, Grieve E, Cleaveland S, Lembo T, Lushasi K, et al. The need to improve access to rabies post-exposure vaccines: Lessons from Tanzania. Vaccine. 2019;37:A45\u0026ndash;53.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHampson K, Coudeville L, Lembo T, Sambo M, Kieffer A, Attlan M, et al. Estimating the Global Burden of Endemic Canine Rabies. PLoS Negl Trop Dis. 2015;9(4):e0003709.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eSambo M, Cleaveland S, Ferguson H, Lembo T, Simon C, Urassa H, et al. The burden of rabies in Tanzania and its impact on local communities. PLoS Negl Trop Dis. 2013;7(11):e2510.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWorld Health Organization (WHO). Rabies [Internet]. 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(ICTD \u0026rsquo;10).\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHarapan H, Wagner AL, Yufika A, Winardi W, Anwar S, Gan AK, et al. Willingness-to-pay for a COVID-19 vaccine and its associated determinants in Indonesia. Hum Vaccines Immunother. 2020;16(12):3074\u0026ndash;80.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBarbosa Costa G, Ludder F, Monroe B, Dilius P, Crowdis K, Blanton JD, et al. Barriers to attendance of canine rabies vaccination campaigns in Haiti, 2017. Transbound Emerg Dis. 2020;67(6):2679\u0026ndash;91.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAdetayo OA, Diaro MD, Adetayo OC. Willingness to pay for rabies pre-exposure vaccination among veterinary students and staff in Ibadan, Nigeria. Afr J Health Econ. 2021;10:1\u0026ndash;14.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBaumgaertner B, Ridenhour BJ, Justwan F, Carlisle JE, Miller CR. 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Hum Vaccines Immunother. 2021;17(11):3975\u0026ndash;81.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Rabies, Willingness-to-pay, dog vaccination, human post-exposure prophylaxis, Tanzania","lastPublishedDoi":"10.21203/rs.3.rs-4926351/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4926351/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground: \u003c/strong\u003eRabies remains a significant public health and economic problem in Tanzania, causing a high economic burden due to medical costs and productive lives lost due to premature deaths. Despite all the effort put into rabies vaccination campaigns, there are still new cases all the time, and vaccination coverage is still low. Therefore, this study aimed to explore the willingness to pay for rabies vaccination services and associated factors among communities in Geita district, Tanzania.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods: \u003c/strong\u003eA cross-sectional study was conducted among 312 respondents in Geita district from August to September 2023. The study deployed a willingness-to-pay (WTP) technique using a bidding game to elicit the maximum values respondents were willing to pay for rabies dog vaccination and human post-exposure prophylaxis. An interviewer-administered questionnaire was used to collect all the necessary data.\u003cstrong\u003e \u003c/strong\u003eLinear regression models were used to evaluate the WTP and associated factors.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e The results suggest that people are willing to pay slightly more for dog vaccination services ($0.3 above the prevailing price) compared to human post-exposure prophylaxis (PEP), in which the average WTP is the same as the prevailing price. 62% of the respondents were willing to pay above the prevailing price ($1.2) for dog vaccines compared to 32% for PEP ($20). In dog vaccination and human PEP services, men are more willing to pay than women.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion: \u003c/strong\u003eThis study highlights the significance of economic consideration in rabies vaccination decisions. In addition to awareness, availability, and access to vaccines, it is crucial to consider socioeconomic factors and financial values individuals place on the welfare of animals.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTrial registration: \u003c/strong\u003eNot Applicable\u003c/p\u003e","manuscriptTitle":"Willingness to pay for rabies vaccination services and associated factors among communities in Geita District, Tanzania","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-10-15 09:48:57","doi":"10.21203/rs.3.rs-4926351/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"fb830b67-08df-48f3-81fc-8de9e7bbc7b1","owner":[],"postedDate":"October 15th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-07-17T07:38:42+00:00","versionOfRecord":[],"versionCreatedAt":"2024-10-15 09:48:57","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-4926351","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4926351","identity":"rs-4926351","version":["v1"]},"buildId":"-HB7Z8yhvgn0wM9Nzuekk","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}