What will it take for behavior to change? Findings from a baseline evaluation of an intervention to reduce antimicrobial use among smallholder poultry farmers in Zimbabwe

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Introduction Antimicrobial resistance (AMR) occurs when pathogens become immune to drugs designed to eliminate or suppress their growth. AMR is accelerated by the inappropriate use of antimicrobials, a common practice among small-medium scale poultry farmers. We conducted a mixed-methods baseline exploration for an intervention to strengthen biosecurity practices and prudent antimicrobial use (AMU) among small-scale poultry farmers in Zimbabwe, to identify key baseline behaviors and their determinants as well as potential intervention entry points. Methods December 2024 to April 2025, we iteratively conducted 45 qualitative interviews and six conversation events with purposively selected farmers. To explore the underlying drivers of behavioral practices, the Capability, Opportunity, Motivation, and Behavior (COM-B) model for behavior change was applied as an organizing framework. Results Overall, five key behaviors relevant to biosecurity and AMU in the poultry sector emerged from the analysis: (1) incomplete adoption of biosecurity practices; (2) self-diagnosis and self-treatment of poultry disease; (3) prophylactic antibiotic use; (4) non-observance of withdrawal periods; and (5) unsafe disposal of dead birds and poultry waste. In addition, a cross-cutting determinant, gendered distribution of household and poultry labor, was found to influence multiple behaviors by shaping female farmers' access to time, resources and opportunities to implement recommended practices. Analysis of these behaviors through the COM-B framework revealed how capability, opportunity and motivation interacted to shape farmers' practices. Conclusion AMU among poultry farmers is closely linked to a range of behaviors undertaken within production systems characterized by various structural and social factors. Interventions need to address the underlying drivers of AMU rather than its symptoms alone. Intervention components could include practical biosecurity training, low-cost biosecurity innovations, training on withdrawal periods, community-led disposal systems and, household workload-sharing strategies. The resultant intervention will need to be evaluated for effectiveness.