Dwaah, P. K.; Squire, S. A.; Awua-Boateng, N. Y.; Dekugmen, D. Y.; Kando, D.; Num, A.; Djang-Fordjour, H.; Amissah, P.

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.