Spatial and Behavioural Determinants of Low Rabies Vaccination Coverage Among Dogs in a Rural Zimbabwean Ward: A Mixed-Methods Study

Rabies is a fatal zoonotic disease and a significant public health threat in Zimbabwe, especially in rural areas where domestic dogs are the main reservoir. This study examined factors behind low rabies vaccination coverage in dogs in Ward 2, Gutu District. A cross-sectional survey combining quantitative and qualitative methods was conducted with 60 dog-owning households through structured questionnaires. GPS coordinates for 200 dogs were collected for spatial analysis, and in-depth interviews were held with 10 key informants until thematic saturation was achieved. Vaccination coverage was 57.5%, below the 70% needed for herd immunity. Spatial analysis showed significant clustering of unvaccinated dogs in certain areas ( P < .05). Of 14 dog bite cases recorded during the intensive study period, 3 (21.4%) involved vaccinated dogs, while 11 (78.6%) involved unvaccinated dogs or dogs of unknown status. Thematic analysis identified 5 main themes: financial barriers, knowledge gaps, cultural beliefs, accessibility issues, and communication challenges. A significant association was found between bites from unvaccinated dogs and fatal outcomes ( P = .04). The low vaccination coverage stems from the interplay of behavioural, structural, and spatial factors. The convergent parallel design revealed that spatial clusters of unvaccinated dogs correspond to areas where qualitative respondents cited accessibility and financial barriers. Interventions should include targeted mobile vaccinations in hotspots and culturally sensitive awareness campaigns.