Improve Implementation Fidelity of Rabies Vaccination

The Cochabamba evaluation shows that implementation failure, not vaccine efficacy, explains persistent canine rabies in this setting; fix cold chain, staffing, coordination, and communication to improve campaign outcomes.

A 27-item fidelity checklist mapped to Carroll constructs, triangulated with CFIR qualitative analysis, allows program teams to prioritize low-cost, high-impact operational fixes quickly.

• The primary study was published in PLOS NTD on July 10, 2026 and evaluated the September 2021 campaign in southern Cercado, Cochabamba.
• Across 17 health centers, 12 (70.6%) met vaccine availability but no center achieved ≥80% content adherence; content scores ranged 32%–79%.
• Cold chain risks were widespread, with 76.5% of centers lacking refrigerators, and 88.2% of centers had incomplete brigades, identifying clear operational priorities.

The quick summary: A mixed-methods implementation-fidelity assessment of the September 2021 dog and cat vaccination campaign in southern Cercado (Cochabamba) found pervasive operational gaps (cold chain failures, incomplete brigades, fragmented coordination) and quantified them across 17 first-level health centers.

Full article: PLOS NTD (Published July 10, 2026).

• Why it matters: low fidelity, not lack of vaccines, explains persistent canine rabies in this high-risk Bolivian setting.
• Audience benefit: program managers, implementation researchers, and field teams can use AI qualitative workflows to triage logistics, communication, and governance failures quickly.

The study used Carroll’s fidelity framework and CFIR to identify where fidelity failed and why it failed in this campaign.

The study used Carroll’s fidelity framework (content, coverage, frequency, duration) and CFIR for qualitative explanation. A 27-item checklist coded items YES/NO by documentary evidence; interviews followed COREQ guidance.

• No health center met ≥80% adherence on content; content scores ranged 32–79%.
• 12/17 centers (70.6%) met vaccine availability and postcampaign continuity; 5 centers failed postcampaign continuity.
• Frequency was largely adequate (14/17, 82.4%), but only 4/17 centers promoted campaigns ≥1 month in advance.
• Cold chain, staffing (missing channelers/registry staff), damaged coolers, and fragmented ETD–OTB coordination were the dominant barriers identified by CFIR analysis.

A practical pilot will diagnose and prioritize fixes in 10 business days using the study artifacts and a fidelity checklist.

• Day 1–2: Gather artifacts, upload the 27-item checklist, vaccination logs, WhatsApp export, and audio interviews.
• Day 3–4: Auto-transcribe and translate (custom dictionary for local terms); run PII redaction.
• Day 5–7: Auto-extract themes (CFIR), map themes to Carroll constructs, and produce a center-level fidelity heatmap.
• Day 8–10: Validate codes with field leads, generate an executive memo with visuals, and run stakeholder Q&A in the AI chat to create a 30-day action plan.
• Deliverable: prioritized list of three operational fixes per center with estimated cost and time to implement.

The Cochabamba study shows that implementation failure, not vaccine efficacy, is the main barrier to rabies elimination in this setting and that structured fidelity assessment can prioritize repairs.

Program teams that pair a structured 27-item fidelity checklist with CFIR-guided qualitative diagnosis can prioritize repairs to cold chain, staffing, coordination, and communication.

• Ready to run a pilot? Upload your campaign artifacts, align your checklist, and get a center-level fidelity heatmap in days, start at the platform homepage.
• Read the primary study: PLOS NTD for full methods and data (Zenodo dataset available).
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