Reducing antimicrobial use in chicken production in Vietnam: Exploring the systemic dimension of change.

Antibiotic use in livestock production is one of the drivers of antibiotic resistance and a shift towards better and reduced antibiotic usage is urgently required. In Vietnam, where there are frequent reports of the misuse and overuse of antibiotics, little attention has been paid to farmers who have successfully changed their practices. This qualitative study aims to understand the transition process of Vietnamese chicken farmers toward reduced antibiotic usage. We conducted semi-structured interviews with 18 chicken farmers, 13 drug sellers, and 5 traders using participatory tools and a socio-anthropological approach. We explored the farmers' histories, current and past antibiotic usage, methods used to reduce antibiotic use, and motivations and barriers to changing practices. Through the thematic analysis of the farmers' transcripts, we identified technical, economic, and social factors that influence change. Out of eighteen farmers, we identified ten farmers who had already reduced antibiotic usage. The main motivations included producing quality chickens (tasty and safe) while reducing farm expenditures. Barriers were related to poor biosecurity in the area, market failures, and the farmers' lack of knowledge. Innovation led to overcome these obstacles included the local development of handmade probiotics and the organization of farmer cooperatives to overcome economic difficulties and guarantee product outlets. Knowledge was increased by workshops organized at the communal level and the influence of competent veterinarians in the area. We showed that the transition process was influenced by several components of the system rather than by any individual alone. Our study demonstrated that local initiatives to reduce antibiotic use in Vietnamese chicken production do exist. As changes depend on the system in which stakeholders are embedded, systemic lock-ins must be removed to allow practices to change. The promotion of locally-developed solutions should be further encouraged.

Characterisation of chicken farms in Vietnam: A typology of antimicrobial use among different production systems.

The usage of antimicrobials in livestock production is a driver for antimicrobial resistance worldwide. Reducing the use of antibiotics in the animal sector is a priority and requires a change in practices. Vietnam has diverse husbandry and antimicrobial use practices. The objective of this study was to determine the socio-economic and technical factors associated with antibiotic usage patterns on chicken farms in the north and south of Vietnam. Semi-structured interviews (n = 34) and on-farm questionnaires (n = 125) were conducted to collect socio-economic, technical, biosecurity, health management, and antibiotic usage data. Using Multivariate Corresponding Analysis, we identified three production systems (A, B, C) and three patterns of antibiotic usage (1, 2, 3). Group A raised indoor exotic chickens in an intensive setting and was associated with group 1, which used antibiotics according to company recommendations for both treatment and prevention. Group C raised free-range chickens for their own consumption and was associated with group 2, which used antibiotics according to drugstore advice for treatment. Finally, group B was a market-oriented, semi-confined system associated with group 3, which practiced experience-based antibiotic use and overuse. Farms in the south of Vietnam were associated with group 3 and those in the north with group 2. The prediction of antibiotic usage patterns based on farming practices could lead to the identification of a group of farms to be targeted in order to foster the more prudent use of antibiotics in Vietnam.

Perception of Drug Vendors and Pig and Poultry Farmers of Imerintsiatosika, in Madagascar, Toward Risks Related to Antibiotic Usage: A Q-Method Approach.

Antimicrobial resistance is a One Health issue that must be tackled worldwide. In order to implement effective communication strategies in Madagascar, a better understanding must be gained of practices and perceptions related to antimicrobial use at the smallholder farm level. Our study used a semi-qualitative approach, called Q methodology, to identify patterns of opinion on antimicrobial use, or its alternatives, among pig and poultry smallholders and drug vendors in the commune of Imerintsiatosika, in Madagascar. Twenty-nine breeders and 23 drug vendors were asked to rank, respectively, 38 and 45 statements, produced from semi-structured interviews and secondary data, through a 7 grade scale from -3 (totally disagree) to +3 (totally agree) about antimicrobial use, related risks and alternatives. The interview ended with a discussion around extreme statements. The Q-sortings were analyzed by factor analysis and Principal Component Analysis. Regarding antimicrobial use, antimicrobial resistance and alternatives, the breeders and drug vendors were divided according to three discourses: "A: confidence in antibiotics" (respectively, 13 and 6 individuals), "B: belief in alternatives" (7 and 7 individuals), and "C: moderate approach to antibiotic use" (6 and 6 individuals), explaining, respectively, 57 and 60% of total variance. Group A was associated with the use of antibiotics as a preventive measure, poor knowledge of resistance and low trust in alternatives. Group B considered the preventive use of antibiotics to be a major problem for antimicrobial resistance and believed that alternatives, such as vaccines, were useful preventive methods. Group C seemed to have a hazy opinion. The presence of three main points of view offers the possibility to adapt awareness messages. Group B might also be used as a showcase to reduce the amounts of antibiotics used by the two other groups. This study revealed different practices and risk perceptions related to antimicrobial use that must be better characterized and accurately quantified.