11 years of regular access to subsidized veterinary services is associated with improved dog health and welfare in remote northern communities.

Access to veterinary services can have positive impacts on animal health and welfare, and on human mental and physical health and well-being; however, many communities worldwide lack access to such services. At their request, the 5 communities of the Sahtu Settlement Area, Northwest Territories, Canada, have received annual access to preventive veterinary services through the University of Calgary's Northern Community Health Rotation since 2008. To determine the reach of the program, we conducted a dog census in 2017. We then conducted a chart review of 11 years of dog medical records from 2008 to 2018 to evaluate how the reach of the program, the uptake of veterinary services, and dog population demographics, health and welfare measures changed over the duration of the program. In the chart review, we used either multi-level logistic regression or generalized linear models, to determine how seven variables, including age, sex, breed, body condition, deworming, vaccination, and sterilization status upon clinic entry, changed over the course of program delivery. Our results suggest that program reach, veterinary service uptake, and dog demographic, health and welfare measures improved over time. We observed high rabies vaccination coverage in some communities (48 %-83 % of the dog population) and moderate overall sterilization status (25 %-56 % of the dog population) with female dog sterilization more common than male (75 % of dogs leaving the 2017 clinics, compared to 43 %). Several dog demographic, health, and welfare measures, including age, body condition, and vaccination, deworming, and sterilization status, were significantly better in later years of the program (all p < 0.001). Differences among communities, both in dog population numbers from the 2017 census (40-89 dogs) and in the uptake of veterinary services in 2017 (48 %-83 % of the dog population), were notable. Vaccination uptake was directly related to clinic attendance, but sterilization was impacted by additional factors, including community members' acceptance of the procedure. Some unintended consequences were noted, however, including the potential effect of sterilization on the availability of traditional dog breeds in the communities. Overall, our study findings demonstrate that subsidized veterinary services provided over a regular and extended period of time benefit animal population demographics, health and welfare, and could have positive impacts on human well-being. The framework of community collaboration and long-term commitment developed through this program serves as a model for achieving common health goals among communities in need and veterinary service providers.

Are we adequately evaluating subsidized veterinary services? A scoping review.

The World Health Organization (WHO) and the World Organization for Animal Health (OIE) both recognize the importance of veterinary services in controlling zoonotic diseases, in preventing human injury, and in protecting the welfare of non-human animals. Furthermore, both organizations recommend regular evaluations of veterinary programs. Accordingly, we conducted a scoping review to collate the available peer-reviewed evaluations of subsidized small animal veterinary services in terms of the effects on animal and public health. We summarized the evaluation methods used, identified key journals in this disparate literature, and identified gaps in knowledge. CAB Abstracts, PubMed, and Scopus were searched, yielding 1441 records published between 2009 and 2016 for initial screening. After examining titles and keywords, abstracts, and finally full articles, we identified 32 relevant papers that evaluated 27 distinct programs. The global distribution was broad, with half of the papers evaluating programs in Africa or Asia, all of which were rabies vaccination programs targeting dogs. Three program evaluation categories were identified: zoonotic disease prevention (9 papers), animal welfare and control (9 papers), and One Health promotion (14 papers). Nearly three-quarters (72%) of the papers used more than one method for collecting data. The most common data sources were questionnaires (22 papers) and administrative records, such as medical charts (21 papers). The most common indicators used for animal health-related program assessments were the number of animals reached by the program (27 papers) and any changes in animal population demographics (22 papers). These indicators were found in all three types of program evaluations (i.e., zoonotic disease prevention, animal welfare/control, and One Health promotion). For public health-related program assessments, the most common indicators consisted of determining barriers to a veterinary program's success (13 papers), followed by costs of a program (11 papers), changes in perceived threats or nuisances (11 papers), and community knowledge of a zoonotic disease (11 papers). The small number of papers identified in this review, n = 32, underscores that comprehensive evaluations of subsidized veterinary services are uncommon in the peer-reviewed literature. Yet, when performed, such evaluations can help guide program delivery and future research. Given the high stakes and the high costs of subsidized veterinary services, greater efforts in program evaluation are warranted.