Dog bites have been under the scrutiny of researchers and public health authorities for several years, since they can cause significant impacts on physical and mental health, but also on the economy (1). The severity of bites varies from small lacerations to severe injuries causing death (2). Mental health issues can also be associated with secondary fear, trauma or anxiety related to dog bites (1, 3). In addition, 3–30% of dog bites progress to severe infections, which require medical attention (1, 4–6). The risk of rabies transmission is also a concern in regions where the virus is present in dog or wildlife populations. Costs associated with dog bites include direct costs related to medical care and public health interventions, such as the prevention of rabies. Globally, Hampson and colleagues estimated the annual costs of rabies worldwide at $8.6 billion USD, of which the costs of the administration of rabies post-exposure prophylaxis would account for 20% (7). There are also indirect costs related to medical leave, hospitalization costs, post-traumatic stress treatments and insurance claims (2).

Dog bite incidence varies greatly depending on the local context (8, 9). The incidence at the Canadian level is not well documented. However, based on data of 22 Canadian municipalities between 2003 and 2005, the annual incidence of dog bites is estimated to be 0–9 per 10,000 inhabitants (10). Between 1990 and 2007, 28 fatal cases associated with dog attacks were reported in this country (9). A recent review suggested that people living in northern Indigenous communities are at higher risk of dog bites than the rest of the population, with annual incidence ranging from 0.61 to 59.6/10,000 inhabitants (8). Considering that rabies is endemic in wild canid populations in certain regions of the Arctic (11–13) and that knowledge about dog bites and rabies risks can be limited in some communities (14), the prevention of dog bites and the management of dog populations are of crucial importance in these contexts.

Dog populations in northern Indigenous communities can be challenging to define, since dogs can be kept by individual owners, or they can be considered as community dogs (shared by several owners), feral dogs (no owners), free-roaming owned dogs or owned dogs kept home. Currently, northern Indigenous communities are using different approaches and strategies to prevent dog bites and manage dog populations, including dog population management programs (e.g., spay and neuter clinics), the implementation of laws and regulations to reduce the number of free roaming dogs, dog culling (e.g., most often done using firearms in remote regions due to the lack of other means), as well as training programs to reduce risky behaviors (15–17). However, the effectiveness of these approaches sometimes lacks evidence, and their low acceptability may affect their implementation. In a previous study conducted in one Naskapi community and one Innu community in Canada, perceptions on whether dogs should be tied up or not varied amongst community members (14). Some perceived this measure as necessary, whether others perceived this as a form of abuse or a method that could increase dog aggression. This heterogeneity regarding this particular dog management practice is one example of the importance to better understand the upstream barriers to the implementation of dog management practices.

One major barrier to dog management is that most northern communities lack access to veterinary services, mainly due to their remote geographical location and to limited financial resources (15–18). When those services are available, other types of barriers can affect their use by community members, such as cost, communication issues about services, different perceptions and practices about animal health, and colonial history (15–17, 19, 20). Communities often rely on alternative approaches to manage dog populations, including culling of aggressive, problematic and/or free-roaming dogs in specific situations (e.g., over-abundance). However, if the culling of dogs is sometimes the only available measure to control dog overpopulation, its social acceptability has been described as low in several communities (16, 17).

Sometimes, communities receive short-duration animal health services from different organizations. These services can be administered by veterinary schools (16, 17), by the government or by various non-governmental organizations. For example, in the province of Quebec, the provincial government offers an annual free-of-charge rabies vaccination program for dogs in northern Indigenous communities included in the James Bay and Northern Quebec Agreement (12, 21). The types of veterinary services offered during these short-term services vary, but are usually mostly preventive, including for example vaccination against rabies for dogs, sterilization of dogs and deworming. Some organizations also offer at times other types of interventions, such as dog rehoming, and training programs regarding dog cares. These services vary greatly, lack consistency (17) and little is known about their acceptability and effectiveness (22–24). A better understanding of the contextual elements that impede or facilitate the operationalization of these measures is needed to enhance the effectiveness of dog population management and dog-related risks in northern Indigenous communities.

This study investigates factors influencing the implementation of dog bite prevention and dog population management measures in the context of two northern Indigenous communities located in Quebec, Canada, namely Kawawachikamach (KWW) and Matimekush-Lac John (MLJ). The objectives are (1) to describe the current access and uses of veterinary services, and (2) to identify the perceived barriers and opportunities related to dog population management practices currently implemented or that could be implemented in the future.

In total, 122 people completed the survey (Women: 67%; Men: 33%), of which 47 (39%) reported owning at least one dog. Most dog owners (n = 38) reported having only one dog. Amongst dog owners, 30% were from KWW and 46% were from MLJ-SCH. In total, 37 inhabitants completed the interview (KWW: 18; MLJ-SCH: 19), of which 66% self-identified as Indigenous.

This study describes perceived barriers and opportunities to improve dog bite prevention and dog population management practices in a Naskapi, an Innu, and a settler community located in northern Quebec, Canada. Results show a lack of acceptability of current practices and a need to strengthen access to veterinary and dog-related services. Raising awareness on existing services is also necessary, given that vaccination against rabies was considered unavailable by most dog owners despite the fact that there is a vaccination program offered annually by the government (12, 21).

The two main measures available at the time of the study – dog culling and short-duration veterinary clinics – were not perceived as fully acceptable or sustainable, which is coherent to findings from previous studies conducted in other northern Indigenous communities. In a study conducted in an Inuit village in Nunavik (Quebec, Canada) in 2015, 43% of Inuit participants were against culling biting dogs (12). In another study conducted in Sahtu communities in the Northwest Territories, there were also some ethical concerns and worries about the safety of dog culling when done using firearms (16), a practice that was also criticized by inhabitants of Cree and Assiniboine communities of Saskatchewan (30).

Regarding short-duration veterinary services, they were perceived differently amongst participants in this study. Since permanent veterinary services are not always available in northern communities, it is frequent that remote communities only have access to occasional services (15, 16). Occasional veterinary services have been reported as unsustainable, expensive and sometimes not culturally acceptable in other similar contexts (17, 30). Our study highlighted similar issues and suggests that these types of services need to be improved when offered in these communities. Indeed, the testimony of some interviewees suggests that informed consent of dog owners was not obtained and/or not fully understood prior to some interventions or before the dog was removed from the community for adoption, which raises ethical concerns on how these services are implemented. In Quebec (Canada), it is the responsibility of veterinarians to seek consent from a client before administrating veterinary services to their animal (31). It is also an obligation to provide post intervention services after an intervention (31). All organizations should deploy sufficient efforts and resources to apply these practices when providing veterinary services in these communities. Informed consent from dog owners should also always apply to the rehoming of owned dogs, which constitutes the vast majority of dogs in these communities, even though some of them are free roaming. Historical trauma, structural inequities, and massive culling of dogs during colonization make it essential that Indigenous communities regain control of their own decisions from now on (32, 33). Repatriation of decisions is part of the concept of decolonization (34). Obtaining free and informed consent is absolutely crucial for the implementation of decolonial practices in animal health.

This study also revealed a broader concern regarding rehoming dogs from northern regions, where Arctic fox rabies in endemic, to southern regions where it is absent. The risk of introducing rabid animals in southern regions was raised during the interviews, and it has happened in recent years. Indeed, between 2012 and 2022, five rabid dogs originating from northern Quebec were moved in southern regions for adoption (35). Dissemination of zoonotic pathogens by dog relocation is also noted in other contexts, such as the spread of Leishmania spp., rabies, Brucella spp., Echinococcus spp., or Leptospira spp. (36–38). As the rehoming service seems to be the most controversial, an alternative solution would be to separate completely the administration of veterinary services from adoption services in these particular contexts. This could maximize the acceptability of services that have the highest impact on animal and human health, such as rabies vaccination and sterilization of dogs in the community.

Despite these issues in the administration of some services, this study re-iterates the need for better access to veterinary services and other dog-related services such as shelters and training programs in northern Indigenous communities. This need was documented in other communities, including in an Inuit community in Nunavik (Canada) (12). The administration of permanent veterinary services remains a big challenge in northern communities due to the small size of villages, and their remote location. Other studies conducted with northern Indigenous communities have reported similar barriers, including costs related to services (which was also raised in this study), lack of trust of people from outside communities and lack of knowledge and awareness (14, 17, 39). Brook and collaborators (16) suggested that we take examples from the human medical practices in remote areas, where nurses can provide health care, but at distance from medical doctors (16, 40). The use of trained non-veterinarian animal health workers (or para-veterinarian, or also community-based animal health workers (CAHW)) has been implemented in low- and middle-income countries (41). Similar models could be implemented in remote northern communities in order to improve access to veterinary services.

Many interviewees mentioned a desire for training on different subjects on dogs for children and/or for adults, such as dog care, dog management, bite risk avoidance, etc. Gouin and collaborators (42) suggested that a multifaceted educational intervention targeting many stakeholders (children, parents, dog owners and the whole community) could be an avenue to reduce dangerous interactions with dogs leading to dog bites (42). It has been suggested that a multi-pronged approach may be best suited for addressing this issue, as: “meeting with mushers, dog obedience training classes, outside activities with dogs” (42). Brook and collaborators (16) combined training of the youth with their implication to the veterinary visits (16). Indeed, they held the clinics in schools. Students were implicated in facilitating communication with locals and training was provided at the same time (16). Some authors have raised uncertainties regarding long-term effects of training programs, since they are not fully evaluated (22–24). More studies are needed to document the long-term effects of training programs for reducing dog bites in the specific context of northern Indigenous communities. It is also important that such programs are developed with and implemented by local people in order to decolonize interventions in Indigenous communities.

Although northern Indigenous communities have their own particularities, it is interesting to note that some of the barriers limiting the implementation of dog population management measures are similar to those observed in other Indigenous communities around the world. For example, facilitating access to veterinary services such as spaying and neutering, as well as building new kennels was also preferred to dog culling by community members in a study conducted in Todos Santos in Guatemala (43). Similarly, lack of access to, high costs and distance of veterinary services were also identified as important barriers to manage dog populations in an aboriginal community of Australia (44). Sharing knowledges and examples of successful, effective and sustainable measures across these communities living with similar dog-related challenges should be highly encouraged in the future.

This study had some limitations. For the recruitment of the survey respondents, inhabitants and health care professionals were recruited through a convenience sampling strategy in order to achieve a certain sample size. Therefore, it is possible that with this strategy, population strata are not all represented adequately according to the source population. Some people that did not answer surveys and did not participate in interviews could have had different opinions on dog management practices. Opinions from interviewees could not represent the entirety of opinions. However, with the strategy of recruiting people until no new opinions are raised, being an iterative process until data saturation is reached, this decreases the risk of missing themes (45). Another limitation is that we only interviewed adults. This could limit our understanding of practices that could be accepted by children. Since this study was exploratory, it focused only on one Innu community and the only Naskapi community worldwide. This may limit the generalizations that can be made from this study and applied to other northern Indigenous communities.

This study reports on issues about and solutions to improve dog bite prevention and dog population management practices in remote Indigenous communities. Results show a lack of acceptability of some practices, especially regarding dog culling and rehoming of dogs outside the communities. The implementation of animal health measures coherent with a decolonization approach includes ensuring informed consent before the administration of any services, improving communication of actions, providing post-intervention follow-up services, separating veterinary interventions from rehoming services and, most importantly giving back to Indigenous communities the complete leadership over animal health in their communities. It is also essential to evaluate the effectiveness and sustainability of these interventions and measures on dog bites, rabies occurrence and also knowledge, attitudes and practices regarding dog bites and rabies. Indeed, little data exists to date, particularly for remote communities such as northern Indigenous communities.

The raw data supporting the conclusions of this article will be made available by the authors, without undue reservation.

The interview grid and survey questionnaire were reviewed by one representative of the targeted communities and approved by band councils. Consent forms for both parts were completed or consent was given orally (in English or French) beforehand. Oral consent is an accepted alternative way to obtaining consent in a way to respect the traditional oral information transmission (29) and this method was approved by the Comité d’éthique de la recherche en sciences et en santé (CERSES). Financial compensation was given to interview participants. Survey respondents were eligible to win a prize (draw). The project protocol was reviewed and approved by the ethical committee at the Université de Montréal (Comité d’éthique de la recherche en sciences et en santé; certificate number #CERSES191 19-048-P).

LD: study design, data collection, analysis and interpretation of data and redaction. AR and CA: study design, contribution to the data analysis and interpretation and revision of the manuscript. FL, KNM, YR, and AS: contribution to result interpretation and final revision of the manuscript. All authors contributed to the article and approved the submitted version.