Local solutions towards rabies-related human mortality elimination by 2030 in the Menabe Region (Madagascar)

In Madagascar, rabies is a significant public health challenge. However, due to the underreporting of many cases and a lack of awareness about post-exposure prophylaxis, the number of rabies cases is likely underestimated. To address this issue, focus groups were conducted following successive awareness- raising sessions about rabies. The main aim of this study was to gain insight into how communities perceive the global goal of eliminating rabies-related human fatalities by 2030. This understanding would help identify effective strategies for addressing the problem. As part of these focus groups, a video in the local language (Malagasy) was presented to all participants, explaining key information about rabies, including its symptoms and what to do in case of animal bites. This video allowed participants to share their own experiences, express their perspectives on rabies surveillance, and suggest practical actions to achieve zero human deaths from rabies by 2030, within their communities. The suggested actions can be summarized into themes (topics), which include improving access to medical care, educating relevant stakeholders, managing the local dog population, fostering collaboration among different stakeholders, reducing the number of stray dogs, implementing vaccination programs, enacting and enforcing relevant laws and regulations, managing dog bites and rabies cases, allocating and utilizing financial resources effectively, and examining local customs. The discussions typically framed these themes in terms of existing deficiencies or inadequacies. According to the insights gathered from these community-driven discussions, activities such as stakeholder education, awareness campaigns, and training should start promptly and continue over a long-term period. In this perspective on tackle rabies, issues related to financial resources were viewed as having a cross-cutting nature, offering potential solutions for short, medium, and long-term challenges. This study demonstrates that when people are well informed, they can recommend solutions that consider the specific realities of their municipalities and territories.