Evaluation of a One Health mass dog rabies vaccination campaign in a resource-limited urban setting: Evidence from Techiman, Ghana

ABSTRACT Background Dog-mediated rabies remains endemic in many parts of sub-Saharan Africa despite the availability of effective vaccines. Achieving and sustaining at least 70% vaccination coverage in dog populations is widely recognized as essential for interrupting transmission; however, there is limited operational evidence from municipal campaigns conducted in rapidly urbanizing, resource-constrained settings. We evaluated the implementation and outcomes of a One Health-coordinated free mass dog rabies vaccination campaign conducted in September 2024 in Techiman South Metropolitan, Ghana. Methodology A mixed-methods post-campaign assessment was undertaken two weeks after campaign completion. Quantitative data were collected from 200 dog-owning households using structured questionnaires, and administrative vaccination records were reviewed to estimate overall coverage. In addition, key informant interviews were conducted with veterinary officers, public health professionals, environmental health personnel, and community leaders involved in campaign delivery. Descriptive statistics were used to summarize household participation and awareness indicators, while qualitative data were analyzed thematically. Principal Findings Among surveyed households, 59.5% owned more than one dog and 51.5% reported vaccinating at least one dog during the campaign. Awareness that rabies is fatal increased from 45% (self-reported pre-campaign recall) to 75% after the campaign period, while awareness that rabies is preventable increased from 40% to 70%. Administrative records indicated that approximately 5,600 dogs were vaccinated, corresponding to an estimated 74% metropolitan-level coverage based on projected dog population figures. Stakeholders identified strong multisectoral collaboration and World Rabies Day mobilization as key facilitators. Reported challenges included vaccine supply delays, limited cold-chain capacity, inadequate access for peri-urban communities, and the absence of strategies to vaccinate free-roaming dogs. Conclusions/Significance These findings suggest that short-duration, one-health mass dog vaccination campaigns can achieve target coverage thresholds in resource-limited urban contexts. However, reliance on projected denominators and exclusion of free-roaming dogs may overestimate effective population immunity. Strengthening monitoring systems, decentralizing access, and incorporating structured strategies for free-roaming dog vaccination will be critical for sustaining rabies control and advancing toward elimination goals. AUTHOR SUMMARY Rabies is almost always fatal once symptoms begin, yet it can be prevented through vaccination of dogs, which are responsible for nearly all human infections in Africa. Global strategies call for vaccinating at least 70% of dogs each year to stop transmission, but there is limited evidence on how well this works in fast-growing African cities with limited resources. We evaluated a free mass dog rabies vaccination campaign carried out in Techiman, Ghana, using a One Health approach that brought together veterinary services, public health authorities, and community leaders. We interviewed 200 dog-owning households and reviewed official vaccination records. We also spoke with frontline staff involved in the campaign. Official records suggested that roughly three-quarters of the estimated dog population was vaccinated, meeting the recommended coverage threshold. Many households reported improved knowledge about rabies following the campaign. However, not all dog-owning households participated, and free-roaming dogs were not systematically vaccinated. Logistical challenges, including vaccine supply delays and limited access in peri-urban communities, were also identified. Our findings show that coordinated municipal campaigns can reach high vaccination numbers even in resource-limited settings. At the same time, accurate monitoring and inclusion of free-roaming dogs are essential to ensure that reported coverage reflects true protection. Strengthening these components will help Ghana and similar countries move closer to eliminating dog-mediated human rabies. Competing Interest Statement The authors have declared no competing interest. Footnotes The current e-mail address of the Authors dwaah.dwaah{at}biola.edu, ssquire{at}csir.org.gh or sylviaafriyie.squire{at}gmail.com, nanayaa4lyf{at}gmail.com or nyawua-boateng{at}aamusted.edu.gh, ddyar{at}aamusted.edu.gh or ddyar{at}uew.edu.gh, kandodavid{at}yahoo.com, abrahamnum{at}yahoo.com, helendjang2018{at}gmail.com, princessamissah53{at}gmail.com