Knowledge, Attitudes, and Practices of Cattle Farmers Regarding Antibiotic Use and Antimicrobial Resistance in Selected Districts of Zambia

Background: Antimicrobial resistance (AMR) is increasingly recognized as a major public health challenge in Zambia. However, limited evidence exists on the factors driving AMR and antimicrobial use behaviours among cattle farmers. This study explored farmers’ knowledge, attitudes, and practices (KAPs) regarding AMR and antimicrobial use (AMU), and explored factors influencing them. Methods: Data were collected from Namwala, Mpongwe, and Chingola districts between January and April 2024. A total of 377 cattle farmers participated in a structured survey, supplemented by ten focus group discussions (FGDs) and seventeen in-depth interviews (IDIs). Qualitative data were analysed thematically to identify recurring patterns, while quantitative data were summarized using descriptive statistics and analysed using bivariate tests and regression models to assess key associations. Results: Overall, a small proportion of farmers demonstrated high levels of knowledge (33.9%), positive attitudes (40.4%), and good practices (19.6%) related to AMU and AMR, with significant differences observed across districts. Major drivers of AMU included poor implementation of biosecurity measures, limited access to veterinary services, high reliance on non-prescribed antimicrobials, and weak enforcement of regulations governing antimicrobial distribution. Conclusions: This study highlights critical gaps in AMR-related knowledge and widespread irresponsible AMU among cattle farmers in Zambia. Strengthening targeted AMU/AMR awareness campaigns, improving veterinary service infrastructure, and enhancing regulatory oversight on antibiotic distribution are urgently needed to protect both animal and public health. These findings can support policymakers in designing evidence-based interventions to curb AMR in the livestock sector.