Sociocultural Determinants of Antimicrobial Resistance in the Islamic Republic of Iran: A Qualitative Study

Introduction: Addressing antimicrobial resistance (AMR) requires consideration of the One Health approach and the sociocultural context unique to each country. This study aimed to examine the sociocultural factors influencing the development of AMR in Iran. Methods This qualitative study employed in-depth, face-to-face interviews. A total of 57 policymakers, managers, and service providers from both human and animal health sectors were interviewed using purposive and snowball sampling methods. The data were analyzed using framework analysis. Findings The study identified several factors contributing to the development of AMR, including demographic changes, improper drug use by the public, cultural challenges for service providers, lack of awareness and knowledge among livestock farmers, and general public attitudes toward drug use. Conclusion Sociocultural factors in both the human and animal health sectors significantly influence the use of antimicrobial drugs and the escalation of AMR across different ecosystems. The wide range of sociocultural influences among various stakeholders—such as service providers (physicians and veterinarians), the general public, and livestock farmers—highlights the necessity for policymakers to consider these groups when planning interventions to control AMR.