RECOMMENDATIONS AND FUTURE DIRECTIONS

Based on the findings of this study, several recommendations can be proposed to strengthen future CNVR interventions and support the elimination of dog-mediated rabies.

Local government authorities should conduct baseline and follow-up dog population surveys before and during CNVR programs, incorporating age- and sex-specific information to facilitate evidence-based planning, monitoring, and evaluation. Annual surveys would enable a more accurate assessment of intervention outcomes and population dynamics. High-risk neighborhoods should be identified early and prioritized throughout the intervention period.

Urban areas should be divided into distinct operational zones according to anthropogenic characteristics, such as commercial districts, residential areas, and public spaces. Particular attention should be paid to ecological niches that may act as source or sink populations, such as cemeteries and abandoned areas, because these locations can substantially influence intervention outcomes.

The findings support establishing peripheral buffer zones around target areas. A minimum buffer radius of 3 km is recommended, although the optimal extent should be determined according to the roaming behavior and ecology of local dog populations. Because effective buffer implementation frequently extends beyond administrative boundaries, close collaboration among neighboring local authorities is essential.

To ensure equitable access to veterinary services, sterilization centers should be rotated among zones between campaigns. Animal welfare organizations implementing CNVR programs should actively collaborate with local authorities, community leaders, and religious institutions to improve logistics, community outreach, and identification of vulnerable areas.

As catchability declines over time, with the most approachable dogs being sterilized first, the success of long-term interventions increasingly depends on the expertise of the catching teams [25, 38]. Governments should therefore invest in recruiting and training professional dog catchers and establish certification programs. Maintaining dedicated regional catching teams would also reduce accommodation costs, which constitute a substantial proportion of operational expenditure.

Community participation should be strengthened through accessible reporting systems that allow residents to identify streets with high concentrations of free-roaming dogs. Voluntary dog feeders possess valuable local knowledge regarding dog movements and previously uncaptured individuals and should therefore be regarded as important stakeholders. Special approaches, including baiting and trapping, should be employed when dealing with stray and feral dogs that cannot be captured using conventional methods.

Public awareness campaigns should combine traditional and digital media, ranging from posters and handbills to social media platforms, to maximize community participation. Responsible pet ownership should be promoted from an early age through child-friendly educational activities. Stronger regulations governing dog breeding and sales are also necessary. Registration of breeders should be mandatory, and sterilization should be compulsory for all owned dogs that are not maintained by licensed breeders, thereby reducing the number of unwanted puppies entering the free-roaming population.

The findings of this study emphasize that sterilization programs should target both male and female dogs. Although many existing programs prioritize females, sexually intact males contribute substantially to population growth, nuisance behaviors, territorial aggression, and roaming. Awareness campaigns should particularly target first time owners and emphasize the importance of early age sterilization.

National governments should assume the leading role in mobilizing financial and human resources for large-scale CNVR programs while collaborating with animal welfare organizations and veterinary researchers. In addition to operational expenses, adequate research funding should be allocated for long-term (>5 years) surveillance, monitoring, and evaluation.

Future research should focus on long-term studies of sex-specific migration patterns, breeding behavior, and population dynamics of free-roaming dogs to improve understanding of the effects of mass sterilization programs. Further investigations should also explore owner demographics in high-risk areas and identify socioeconomic, logistical, and behavioral factors associated with poor vaccination and sterilization coverage. Such information will be essential for designing targeted interventions and accelerating progress toward the goal of zero human dog-mediated rabies deaths.