Abstract
Antimicrobial resistance (AMR) represents an urgent global public health threat, with non-human antibiotic consumption in livestock production acting as a primary driver of resistance genes across the human-animal-environmental interface. In low- and middle-income countries such as India, livestock serves as a critical socio-economic lifeline for rural smallholders, yet veterinary antibiotic use remains widespread, unregulated, and inadequately understood from a sociocultural perspective. This qualitative explanatory study investigated the sociocultural, structural, and behavioral determinants governing antimicrobial usage practices among smallholder livestock farmers in rural Northern India. Data were gathered through 32 in-depth semi-structured interviews and 6 focus group discussions across four agrarian districts, engaging dairy and small-scale poultry farmers, informal animal healthcare providers, and local veterinary pharmaceuticals retailers. Inductive thematic analysis revealed that antimicrobial practices are shaped by an acute scarcity of accessible formal veterinary services, entrenched reliance on informal prescribers (para-vets and chemist shopkeepers), perceived economic precarity that mandates aggressive disease prevention, and deeply held notions regarding the rapid curative power of injectable pharmaceuticals. Furthermore, awareness regarding antibiotic withdrawal periods and systemic resistance transmission was virtually non-existent, overshadowed by the imperative to safeguard household financial capital. These findings demonstrate that AMR behaviors in rural agrarian settings are rational adaptations to structural and economic vulnerabilities rather than mere knowledge deficits. Effective containment strategies must transcend top-down regulatory bans by integrating community-centered One Health interventions, strengthening formal veterinary infrastructure, and aligning stewardship policies with the socioeconomic realities of rural livelihoods.
