In Zambia, healthcare services are characterised by insufficient health facilities and shortages of medical supplies and health workers (Prust et al., 2019). Knowledge of toxinology and snakebite treatment is especially inadequate (Ooms et al., 2020). Primary health clinics have turned snakebite victims away since they are unable to treat them. The launch of national snakebite management guidelines (Republic of Zambia Ministry of Health, 2024) represents progress but considerable efforts are needed to ensure its implementation. In practice, accessing adequate medical care is virtually impossible in many rural, remote areas in Zambia currently. From Mfuwe, for example, the nearest hospital with antivenom and ventilators (critical for neurotoxin management) is in the capital Lusaka (600 km) with transportation being unaffordable for most. Thus, the prevention of venomous snakebites must be given top priority in rural areas.

Living conditions in vulnerable communities necessitate special attention as they are directly linked to the risk of venomous snakebites (Figure 1). Potential dangers arise, for example, from housing that snakes can enter and lack of in-house sanitary facilities; over 90% of households in rural areas lack electricity (World Bank, 2025). In addition, livestock, firewood and rubbish in close proximity to dwellings provide hiding places and attract potential prey for snakes. Unprofessional attempts to get rid of snakes are associated with a high risk of snakebite. Moreover, a constant risk of snake encounters remains during daily activities such as walking cross-country without shoes and in the context of subsistence farming (Harrison et al., 2009), common in rural Zambia. Contact with wildlife is part of daily life in areas such as Mfuwe and wildlife is often within village areas. However, lack of knowledge and superstition are particularly pronounced with regard to snakes and further increase the risk of snakebite. Misconceptions and fear surrounding snakes are widespread in societies around the world and influence how people respond to these animals and to snakebite risk (e.g, Pandey et al., 2016; Musah et al., 2022; Tusabe et al., 2025), highlighting the need for education strategies that are adapted to local contexts. Health-related interventions that are effective elsewhere may fail if perceptions of illness and care seeking based on cultural beliefs are not taken into account (Sivalogan et al., 2023).

Community education aims to reduce the risk of snakebite, improve first aid and treatment seeking behaviour, and enable safe coexistence of humans and snakes. Minimum knowledge of snakes in the region, snake ecology, and ways to avoid dangerous snake encounters (e.g., using flashlights, snake-proofing houses) are crucial. Most people are unaware that their own behaviour can modify snakebite risk and of the existence of recommended preventive measures (Republic of Zambia Ministry of Health, 2024). In this context, knowledge of native snakes and snakebite prevention and care helps to overcome fear and enables safer responses in potentially frightening situations (Pandey, 2023; authors’ pers. obs.). An experience that cannot be overestimated is seeing and touching a live snake. It is not uncommon to believe that contact with a snake will lead to immediate death, a misconception that can be easily and effectively refuted.

Knowledge is a prerequisite for informed action but not necessarily sufficient to achieve behavioural change. A crucial but often ignored aspect is the context in which behaviour occurs and the decision architecture that influences choices (Kelly and Barker, 2016). In addition to teaching about risk mitigation, affordable access to helpful tools such as flashlights, closed shoes, bednets, etc. as well as infrastructural improvements are needed to empower communities and effectively reduce snakebite risk. Informing communities about first aid (Republic of Zambia Ministry of Health, 2024) and treatment seeking behaviour should be matched by capacitated health centres that can provide basic management and organise referral if needed. While community education can increase health literacy by enabling a conscious approach to snakes, it does not change underlying inequities (Nutbeam and Lloyd, 2021). Political commitment and accountable governance, for instance, are important elements to achieve improvements of general healthcare services (Manyazewal et al., 2016). It was noted that community engagement in sub-Saharan Africa often lacks cooperation, shared control, and opportunity for empowerment (Koricha et al., 2024). In the context of snakebite prevention, community education and volunteer training for safe snake handling and removal complement each other and help build relevant expertise among community members. When required, community snake removers are a safe alternative to dangerous behaviour such as killing or chasing snakes. This requires funds for training, equipment and expenses and could be an integral part of effective snakebite mitigation.

Apart from limitations due to a lack of financial resources, implementation challenges can be grouped into three main domains: i) logistics and information materials, ii) bureaucratic hurdles, and iii) community trust and superstition.

Trust is the basis for access and collaboration. Establishing this trust takes time, repetition, perseverance, and reliability. Over several years, the Mfuwe Snakebite Prevention Programme has conducted about 50 local engagement events across different settings, including villages, schools, businesses, and conservation organisations (Figure 2). In combination with appearances on community radio shows, this made the initiative widely known in the region and it is regularly contacted by community members requesting snake-related information and education. An increase in requests for identifications or assistance with relocations over the years illustrates the impact of these activities. Community volunteers that schedule village presentations, usually involving chief’s consent and support encouraging those living in that community, has proven helpful. Small incentives (snacks, juice drinks, school supplies) greatly increase attendance. Group sizes vary considerably, ranging from 10 to more than 150 individuals, with children consistently well represented. Presentations are informal, made relatable and unintimidating. Being able to present a snake is beneficial, attracts attention and promotes understanding through direct experience. The implementation of such events would enhance through provision of educational tools and through support of the authorities. For example, battery-driven portable projectors and screens would allow for more relatable presentation of snakes of the area and their behaviours, to dispel traditional beliefs. Accurate, ready-to-use, and customisable teaching materials and funds to sponsor them are crucial. The needs and perceptions of communities should be taken into account both in the development and effectiveness assessment of education and training. This includes using pictorial representations of learning materials instead of texts to facilitate learning for illiterate people and avoid translations in local languages (cost factor). Realistic and affordable snake models would be useful. A regulatory framework is needed to enable experienced and knowledgeable snake handlers to use snakes legally for educational activities. Ideally, this is complemented by funded programmes to educate, train and equip certified snake handlers who safely relocate snakes from conflict situations.

Funding remains a critical bottleneck for local snakebite mitigation. While financial support is urgently required, it is important to note that donor-directed priorities and methodology may not align with local needs and priorities. This also happens unintentionally through eligibility criteria established in high-income countries. Disparate perspectives and inadequate involvement of affected communities and local knowledge can raise questions about shared values, affect trust, and shrink solution spaces (Shah et al., 2025). Local expertise needs to be involved in the planning, conduct, and evaluation of outreach activities to make them effective and sustainable. This also allows the use of traditional methods of information sharing.

While future research on snakebite community education could help to develop evidence-based, best practice approaches and help convince funding bodies to support local initiatives and their expansion, this requires sufficient resources. Criteria for impact assessments may be straightforward for some health interventions (e.g., vaccination and screening rates for cervical cancer prevention), but the many-layer complexity of snakebite risk and the lack of baseline data complicate an evaluation perceived as scientifically acceptable. More importantly, research projects accompanying community education are well intended but could add to already existing challenges. Additional aspects, such as providing open-source teaching materials and tools, simplifying regulations and funding, and advocating for snake-focused outreach and mitigation activities in at-risk communities deserve more attention.