Aim: To comprehensively review the interventions made to address health and welfare challenges faced by working donkeys; to systematically analyze the reasons for failure; and triangulate them with donkey health and welfare. Study Design: A comprehensive desktop narrative review. Methodology: A systematic review of selected intervention strategies which included: (i) Knowledge change; through training donkey owners on donkey welfare, handling, feeding, working conditions, routine health checks and basic first aid skills for their donkeys. (ii) Refresher trainings to animal health service providers to enhance their capacity in handling equine diseases and conditions; (iii) Donkey health services provision (iv) Improvement of husbandry practices (v) advocacy and (vi) legislation.