Abstract / Summary
Rabies elimination requires coordinated interventions across the human-animal-environment interface, yet sustained progress is often hindered by systemic gaps between dog population management, community engagement, and governance. This study investigated community perceptions and challenges related to rabies prevention and control across high-endemic areas in Thailand. Using a mixed-methods design, secondary provincial quantitative data were integrated with qualitative thematic analysis from 57 stakeholders in high endemic areas, including public health officials, policymakers, NGOs, animal-welfare liaisons, and community members. The findings indicated standard rabies awareness, 98.2% of participants demonstrated good preventive practices, recognized post-exposure prophylaxis (PEP) as essential, and 68.4% possessed good knowledge. Although most supported dog sterilization (59.6%) and vaccination (63.2%), only 19.3% perceived existing control campaigns as effective. Main challenges included constrained operational resources (57.9%) and limited local government budgets (40.4%). Free-roaming community dogs were prevalent, with 54.4% of participants identifying abandonment as the primary driver of population growth. Informal feeding networks provided localized care for community dogs. While public willingness to fund management was relatively low (33.3% willing to pay; 19.3% supporting co-payment), reflecting an expectation of local authority responsibility. Qualitatively, unclear boundaries between public health mandates and animal welfare legal frameworks added complexity to rabies outbreak response and sometimes introduced institutional challenges among local government and non-governmental sectors. Nevertheless, stakeholders strongly supported sustained sterilization and intersectoral collaboration. Addressing policy-practice gaps, stabilizing financing, and integrating community social dynamics into formal One Health governance are crucial for achieving sustainable rabies elimination.