Poultry Antibiotic Misuse Exposes Weak Stewardship in Madagascar’s Analamanga Region
Antibiotic use in Madagascar’s poultry sector is not drifting by accident. It is being shaped by informality, thin margins, easy access to veterinary drugs, and a production system where prevention often gives way to improvisation.
A qualitative study from Analamanga, the country’s most poultry-dense region, found recurring patterns of misuse across backyard and semi-intensive farms, including antibiotics used for viral illness and first-line reliance on fluoroquinolones. Those practices sit inside a broader ecology of weak regulation, limited veterinary inspection, and advice chains that run more through chick and feed sellers than through trained animal health professionals.
Informal Production Practices Leave Little Room for Stewardship
Interviews with 79 poultry farmers, 10 animal health professionals, and 10 agrovet shop sellers painted a sector that operates with limited formal structure. Backyard and semi-intensive farms alike were characterized by rare cooperative membership, little formal training, and an absence of farm registration. Irregular profitability sat at the center of those accounts, shaping what farmers could afford to do and how much they could invest in prevention.
The clinical implications are straightforward. When a flock is managed without regular veterinary input, a respiratory outbreak, enteric syndrome, or sudden drop in productivity is more likely to trigger empirical treatment than a diagnostic workup. In that setting, antibiotics become a default tool rather than a targeted therapy, and the risk of selecting resistant organisms rises with every unnecessary course.
Semi-intensive farmers were somewhat more knowledgeable about antibiotic use and antibiotic resistance than backyard producers, yet the difference did not translate into clean stewardship. They widely viewed antibiotics as essential to maintaining poultry health and productivity. In practice, that belief can be self-reinforcing: when margins are thin, the cost of a dead bird or a stunted flock may feel more immediate than the slower, population-level threat of antimicrobial resistance.
Easy Access and Misplaced Confidence Drive Repeated Overuse
The study found easy access to antibiotics across the poultry supply chain, and that access appears to lower the threshold for use. Farmers relied on chick and feed suppliers for health advice and for medicine purchase, a pattern that places commercial intermediaries at the center of clinical decision-making. When those intermediaries function as de facto advisors, they can become powerful gatekeepers for either good practice or misuse.
Misuse took familiar forms. Antibiotics were used for poultry viral infections, where they offer no direct therapeutic benefit against the causative agent. First-line fluoroquinolone use was also common, a particularly concerning pattern because fluoroquinolones are clinically important agents and broad use can intensify selection pressure. In a crowded poultry environment, where organisms can move quickly through shared water, equipment, personnel, and waste, that pressure does not remain confined to a single flock.
A single untreated prevention failure can ripple through an entire production cycle.
The paper’s discussion of limited veterinary inspection by competent authorities matters in a practical way. Without regular oversight, there is little to constrain over-the-counter acquisition, little to enforce withdrawal periods, and little to correct dose, duration, or indication. Stewardship depends on structure. Remove the structure, and the market tends to reward the fastest, easiest fix.
Market Pressure Shapes Clinical Behavior at the Farm Gate
The most important barrier was not a lack of interest in healthier birds. It was economics. Narrow profit margins, limited access to credit, and weak bargaining power toward poultry product buyers made preventive investments difficult to sustain. Vaccination, deworming schedules, treatment record keeping, and routine consultation all require time, money, and planning. In a sector where cash flow is fragile, those investments are easy to postpone.
This is where stewardship and livelihood collide. Farmers who cannot absorb a bad cycle are more likely to reach for a drug that appears to protect the flock now, even if the long-term consequence is diminished drug effectiveness later. The same pressure also explains why semi-intensive farmers, despite somewhat better knowledge, still perceived antibiotics as necessary to preserve productivity. Knowledge alone cannot offset an economic model that punishes delay and rewards immediate visible action.
Madagascar’s broader context intensifies the challenge. The country is among the poorest globally, livestock is central to rural livelihoods, and poultry is the most widespread livestock sector. In a setting where 78% of the population lives in rural areas and many families rely on livestock for income and self-consumption, poultry health is not a niche issue. It is a food security and income issue with direct antimicrobial consequences.
Why the One Health Stakes Are Hard to Ignore
The study arrives against a background of documented resistance in Malagasy poultry and the surrounding ecosystem. Prior work has shown resistant Campylobacter from chicken samples, ESBL-producing Enterobacteriaceae in industrial poultry farms, and evidence of transmission between humans, poultry, and the environment. Those findings make the current interview data more than a behavioral snapshot. They suggest that the use patterns described here are part of an active resistance cycle rather than a theoretical risk.
From a One Health perspective, poultry farms can serve as amplification sites when antibiotics are used repeatedly without strong indication or supervision. Resistant bacteria, mobile resistance genes, and contaminated environmental runoff can move beyond the farm boundary through workers, animals, food chains, and waste. The study does not quantify those transmission pathways, but the risk logic is clear enough from the setting and the existing microbiologic evidence.
Training the Supply Chain May Matter More Than Punishing Farmers
The proposed responses are pragmatic rather than punitive. Supporting professionalization of the poultry sector, expanding vaccination, reinforcing deworming schedules, promoting treatment records, and building capacity among chick and feed suppliers emerged as realistic entry points. Those intermediaries already influence farmer behavior, so training them to provide accurate advice could shift the entire decision chain.
There is a deeper policy lesson here. Stewardship programs that focus only on farmers may miss the commercial architecture that determines how antibiotics are accessed, recommended, and normalized. If suppliers remain the main source of health advice, then stewardship has to reach them as well. Otherwise, the formal message from veterinary authorities will continue to compete with the informal advice that arrives with the feed and the chicks.
The study’s design also places appropriate limits on interpretation. It used a convenience sample of stakeholders in one region, so the findings describe patterns and motivations rather than measurable prevalence across Madagascar’s poultry sector. Even so, the qualitative data are valuable because they expose the mechanisms that quantitative surveys often miss: economic pressure, weak oversight, and the social habit of treating antibiotics as a routine production tool. Future work will need representative sampling and quantitative validation to determine how widespread these behaviors are beyond Analamanga and how they vary across the country.