Fidelity of the implementation of antirabies vaccination for dogs and cats in the Plurinational State of Bolivia.

The rabies virus is a serious global public health threat that primarily affects vulnerable populations in rural areas. Despite vaccination efforts, some countries, such as the Plurinational State of Bolivia, continue to report human fatalities and confirmed outbreaks in dogs caused by this virus. This study evaluated the fidelity of the implementation of an antirabies vaccination campaign for dogs and cats in the southern area of the Cercado municipality, Cochabamba (Bolivia), in 2021 to identify implementation gaps that may undermine rabies control as a public health strategy in endemic regions. A cross-sectional observational study was conducted using a purposive sampling approach, combining quantitative and qualitative methods through a parallel nonconvergent design. Seventeen health centers in the southern area of the study municipality were examined via a 27-point checklist to assess the fidelity of the implementation of the vaccination campaign in accordance with current national regulations. Additionally, semistructured interviews were conducted with 46 intervention providers and 108 dog and cat owners to explore perceptions regarding institutional responsibility and campaign functioning, following COREQ guidelines. All health centers demonstrated low adherence to the intervention content, with compliance rates below 80% in all participating establishments. A total of 70.6% (12/17) of the centers achieved adequate coverage, 82.4% (14/17) maintained an appropriate vaccination frequency, and 64.7% (11/17) reported a sufficient duration. Factors related to the antirabies vaccination campaign (including values associated with the intervention, inner-setting conditions, expected efficacy, and communication and coordination strategies) were identified as both barriers to and facilitators of implementation fidelity in the study area. Dog and cat vaccination campaigns face infrastructure, socioeconomic, and institutional barriers, along with weak oversight and communication. Nonetheless, health officials and pet owners recognize rabies as a serious public health concern that requires urgent control measures.