Sociocultural determinants of antimicrobial resistance in Iran: a qualitative study

Antimicrobial resistance (AMR) is a growing global public health threat that is highly likely to undermine modern medicine and pose significant risks to health systems and national economies worldwide. As such, its complex nature, as affected by biological, environmental, economic, and sociocultural factors, requires a multidisciplinary approach to its control. Therefore, uncovering the sociocultural drivers of AMR is critical to designing effective interventions, particularly in low- and middle-income countries.

This qualitative study included a number of 57 semi-structured, face-to-face interviews with policymakers, managers, and service providers from both human and animal health sectors using purposive and snowball sampling techniques. The data were subsequently analyzed employing thematic analysis.

Several sociocultural factors were uncovered contributing to the development of AMR, in relation mainly with general public culture, public drug use culture, cultural barriers among service providers, and demographic changes in the country.

Sociocultural factors within both human and animal health sectors might significantly influence the antimicrobials usage and the proliferation of AMR across diverse ecosystems, underscoring the imperative for policymakers to consider them when devising interventions to combat AMR. Policymakers are advised to prioritize the development of clinical guidelines, enhance insurance oversight, and improve diagnostic capabilities in an effort to effectively address the challenge of AMR.