Study zone and selection of the participants

Our study was conducted in the Phu Binh district in Thai Nguyen province in the midland and mountain region of northern Vietnam. Thai Nguyen province is located 70km north of Hanoi, the capital of the country. Thai Nguyen was selected because of its large poultry production (15 407 million heads in 2020) [17], its diversity of chicken production systems, its proximity to Hanoi, and the existing collaboration with local partners. According to the Sub-department of Animal Health and Livestock Production (SubDAHLP) that represents the veterinary services at the provincial level, it is a leading province for livestock production and emblematic for what is likely to happen in other provinces. Together with SubDAHLP and the Thai Nguyen University of Agriculture and Forestry (TUAF), the district of Phu Binh was selected because of its size, the accessibility of the farms, the openness of breeders to share their experience, and information about the district.

The study was designed in two phases. Phase 1 aimed to gather information on the different production systems in the district, on antibiotic usage, and to identify farms with lower ABU. The aim of phase 2 was to explore the network of respondents who have reduced their antibiotic usage, identified in phase 1. In phase 1, 10 farmers and 10 drug sellers were selected by the agriculture service center of Phu Binh district and TUAF team members based on pre-defined criteria to maximize the diversity of participants. Farmers were selected according to the production system as defined by [16]: integrated farms, large-family commercial farms, small to medium-family commercial farms, and household farms. Drug sellers were selected according to their structural position in the veterinary drug value chain: communal veterinarians, agencies selling drugs, agencies selling feed and drugs, and independent veterinarians (unpublished data). Based on the interviews conducted in phase 1, additional farmers and drug sellers were recruited for phase 2, following information from local authorities and using the snowball sampling method. Interviews with traders working in the same district were also conducted to explore the influence of the market on changes in practice.

Data collection

In-depth, face-to-face interviews were conducted in December 2021 (phase 1) and February 2022 (phase 2) by the first author and a team of researchers composed of one researcher from TUAF, one from the Institute of Anthropology of Hanoi, two free-lance researchers in sociology and a variable number of students from TUAF depending on the phase. The translation was done by a student and one sociology researcher for phase 1 and another sociology researcher for phase 2. Members of the team were trained on research objectives, data collection methods, and participatory epidemiology. Before the data collection, a pilot study in Phu Binh district was organized in November 2021 with one farmer and one drug seller. As there were few changes made to the interview guide and considering the importance of the information collected, this farmer’s interview was included in the study.

The interview guide incorporated participatory epidemiology tools [36] and socio-anthropological approaches. It allowed us to understand why farmers behave the way they do and to explore the type of interaction between the different participants. These participatory approaches helped us to increase the involvement of respondents during the data collection process. The interview guide was tailored to the respondent’s profession (farmer, drug seller, or trader) and organized around four themes: 1) history of the farm/shop and the respondents; 2) technical characteristics (value chain, farm management, AB practice); 3) opinion on antibiotic use and antibiotic resistance, evolution of ABU; 4) antibiotic use reduction (barriers, motivations, impacts, solutions) (S2 File). We used a visualization method (timeline) and ranking and scoring methods (simple ranking and proportional pilling) [36]. First, to explore the evolution of the farms over time, we asked the respondents to draw a timeline of the different events that occurred at the farm level. Then, to explore the different methods used to reduce ABU, we asked the respondents to enumerate them and we wrote them on a card. Then we asked the respondents to rank them according to their perceived effectiveness and feasibility. Finally, to assess the evolution of the farm’s expenses over time and the consequences of ABU reduction on them, we used the proportional pilling tools. Farmers listed their farm expenses and were then asked to divide 100 beans according to the percentage of expenses in each category at the time of the interview. The same procedure was conducted for their expenses five years ago. The timeline of the farm events, ranking of the methods to reduce ABU, and the proportional pilling on farm expenditure were only done for phase 1. Methods during the second phase were only mentioned but not ranked. The interviews were completed by on-farm observation of feeding, housing, herding activities and drug packaging. With the drug sellers, we observed the different products sold in the shop and the interactions between the participants and other sellers or buyers. During phase 1 and phase 2, we stayed on two different farms that were interviewed during the data collection period to observe farm activities over several days (Fig 1).

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Fig 1. Summary of the data collection method for phase 1 and phase 2 in Phu Binh district, Vietnam, 2021–2022.

Top left: dates of the data collection: top right: sampling methods; bottom left: number of participants; bottom right: method of data collection.

https://doi.org/10.1371/journal.pone.0290296.g001

The study’s objectives were explained to the participants by the interviewers and written consent was obtained before starting the interview. The anonymity of the participants was guaranteed throughout the study. This study was approved by the Ethics Review Board for biomedical research of Hanoi University of Public Health with the application number 021-391/DD-YTCC. The permit to conduct this work was given by the Sub-department of Animal Health and Livestock Production (SubDAHLP) of Thai Nguyen province.

Inclusivity in global research

Additional information regarding the ethical, cultural, and scientific considerations specific to inclusivity in global research is included in the S1 File.

Data analysis

Interviews were recorded, fully transcribed in Vietnamese, translated into English by a professional and compiled with field notes. Data from farmers’ transcripts were analyzed by thematic analysis using the six-step method explained by Castleberry and Nolen [37]. Thematic analysis is an inductive approach, developed from grounded theory, that allows meaning to emerge from the data itself. The coding was performed on NVivo software (V.12,2, QSR International). The grid was first constructed a priori, according to the interview guide, and validated by the team. All the transcripts were first read in full, coded by the first author and the grid was refined during the analysis. When no new themes emerged from the transcripts, the codebook was validated after team discussion. The codes were analyzed together in light of the research questions and the context of the study to generate themes using thematic hierarchies. We used a backward and forward approach to data coding, the theme emergence, and analysis [37]. The transcripts of drug sellers and traders were not analyzed through thematic analysis but the information was used to explain some of the findings of the farmers’ transcripts analysis.

Respondents’ characteristics

Eighteen farmers were interviewed, one during the pilot study, ten during the first phase, and seven during the second phase. Three farmers were under contract with an integrator and raised hybrid or exotic chickens in confined housing with high levels of biosecurity in an intensive system, hereafter referred to as integrated farms. One farmer kept a small number of local breed chickens for his consumption, this is subsequently referred to as the household farm. Fourteen farmers raised free-range local chickens in a semi-confined system, these are later called family commercial farms. Four farmers were part of the same cooperatives (farmers 9, 11, 13, 17) and two farmers wanted to develop a cooperative together (farmers 3,4).

These interviews were completed by the interviews of 13 drug sellers, 11 in the first phase and 2 in the second phase. One drug seller was removed from the data analysis due to irrelevant and incomplete answers. Two drug sellers worked for a drug company (one was also a vaccine company and the other specialized in alternative feed additives), two were communal veterinarians (who were also private veterinarians), one worked for the agricultural service center, five were the owners of a level 1 drug agency, and three were the owner of a level 2 drug agency. Two inter-provincial traders and three traders for small-scale farms were also interviewed in the second phase. One farmer and one drug seller were interviewed twice during each phase because they were considered as key stakeholders and that further investigation in their role was required. Most of the respondents were male, the farmers were above 40 years of age while the drug sellers were between 25 and 40 years old. The education level of dug sellers was higher than that of the farmers. Most of the interviews were conducted in Tan Khanh commune or the neighboring commune. The socio-demographic characteristics of the respondents are summarized in Table 1. The characteristics of the farmers and their farm history are summarized in Table 2, the full table is presented in S1 Table.

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Table 1. Sociodemographic characteristics of farmers, drug sellers, and traders interviewed during semi-structured interviews in December 2021 (phase 1) and February 2022 (phase 2) in Phu Binh district, Thai Nguyen province, Vietnam.

https://doi.org/10.1371/journal.pone.0290296.t001

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Table 2. Farmer’s characteristics according to semi-structured interviews from December 2021 (phase 1) and February 2022 (phase 2) in Phu Binh district, Thai Nguyen province, Vietnam.

https://doi.org/10.1371/journal.pone.0290296.t002

In the district of Phu Binh, the most common farming system was to raise free-range local breed chickens (Gà Ta Lò) with access to a barn for 4 to 5 months (semi-confined housing). They represented 14/18 interviewed farmers. Most of these farmers had benefited from governmental programs to develop a brand of “hill chickens” (Gà đồi) from this area. Thus, most farmers had been raising chickens for a long time and the evolution in their farming practices was mostly related to an increase in flock size and infrastructure that was encouraged by governmental programs. Chicks were usually bought nearby from relatives or other farmers and feed and drugs were also provided locally. Most chickens were purchased by traders through middlemen for sale in the Bac Giang wholesale market and then distributed to Hanoi or Bac Ninh provinces. Moreover, according to the respondents, the number of drug sellers had also increased in the area together with the development of livestock production. Integrators with national or international influence were present in the district but represented a minority. In the case of integrated farms, the integrator provided farmers with feed, drugs, day-old chicks (DOCs), and advice and then collected and distributed the final products. White chickens were usually raised with a shorter production cycle than the local breed (around 55 days) and raised in a confined system with strict biosecurity protocols. Households represented a high proportion of farmers in the district, with local, entirely free-range chickens raised mostly for the family’s consumption as the household feed them with waste food or their agriculture products (paddy, vegetables). Only one household was interviewed as they were identified as low AB users.

Antibiotic usage

All farmers used antibiotics for the treatment of sick chickens. In the presence of disease, they deem antibiotics to be the only solution and a necessity for animal health welfare. The most common diseases mentioned by farmers and drug sellers were enteritis, typhoid, asthma, coccidiosis, and blackhead disease. Farmers also reported an increase in “bệnh ghép” also called “serious disease” by farmers and drug sellers. They perceived it as serious because it was a combination of several diseases and was more complicated to treat. In the case of bệnh ghép, they used a combination of several antibiotics, with higher dosages and higher concentrations of AB in the product (called “strong” antibiotic). Antibiotic use for treatment was seasonal, with greater use during the winter, a period particularly suitable for the development of E. coli and respiratory diseases due to heavy rainfall and cold weather. The dosage and route of injections depended on the severity of the diseases, with the injection identified as the most efficient form for severe disease. Dosage depended on the weight of the chickens, but even if farmers knew that they had to follow product instructions, they increased the dosage of their own accord or upon recommendations made by some drug sellers. They increased the dosage for “serious” diseases because chickens did not eat or drink all the products or because of the poor quality of the drugs. Antibiotics commonly used by farmers were amoxicillin, ampicillin, oxytetracycline, doxycycline, cefotaxime, enrofloxacin, and colistin. Antibiotics were supplemented with alternative feed additives to increase chickens’ resistance and cure them more quickly. Disease diagnostics (clinical examination and autopsy), and treatment choices were usually made by farmers according to their own experience in the case of family commercial and household farms. However, when facing a “serious” disease or unknown clinical signs other farmers were consulted for advice or relied on health care professionals. In this case, treatment choices were made based on the farmer’s description of clinical signs, farm visits, and autopsy.

Of the 18 farmers interviewed, 12 used antibiotics for prevention periodically throughout the animal’s life, during the first week usually to prevent typhoid, or at the change of season when it was going to rain, even though the chickens were vaccinated. In prevention, antibiotics were mainly used to prevent asthma and enteritis. Respondents reported more preventive use given periodically throughout the animal’s life for laying hens than broilers. antibiotics were mostly. In some cases, the AB used were different at each production cycle. The most common form was powder, which was then mixed with the feed. In prevention, they used lower concentrations of AB in the product (“weak” antibiotic), or they used half the dose as indicated on the packaging. Some farmers believed that it was necessary to use AB for preventive purposes, as this would reduce the disease incidence or its severity, that “prevention is better than treatment” and that it would lead to a reduction in costs. This belief was also shared by some drug sellers. No feed containing AB was found during our survey. Independent farmers reported that it was no longer possible to find feed containing antibiotics for adult chickens, and contract farms explained that they only used feed with AB in the early stages of the production.

“It is used periodically for 3 days/time. Sometimes 1 day use 1 day not, and sometimes 4–5 days/time. It depends, if I see chickens are weak, I will use 3 days/time, if they are good I use 1 day and 1 day don’t use it. It depends.” (Farmer 5)

For three farmers it was not clear whether they used antibiotics for prevention or not. Three farmers did not use antibiotics for prevention because, in their opinion, it should not be used at a preventive method but only for treatment. For the same reason and to avoid the overuse of antibiotics, some drug sellers did not recommend the usage of antibiotics for prevention.

Despite the common use of antibiotics, their overuse was also perceived negatively by farmers, drug sellers, and traders. They considered that the overuse of antibiotics would affect the quality of the chicken meat with changes in appearance (spots and rough feathers), unhealthy chickens, and improper growth. And as traders buy chickens based on their appearance, this would result in a loss of income (chicken with visual defects are usually bought 10% cheaper).

Perception of antibiotic resistance

Farmers were well-acquainted with the requirement to stop using antibiotics before selling chickens. They were aware of the negative consequences for human health due to residues in meat. One farmer who raised household chickens did not want to buy chickens from large farms because of the presence of residues and it was common for traders or consumers to wait a few days before eating the chickens. However, as one respondent reported, the withdrawal time was not always respected in practice. As farmers were using too much antibiotic, it took time to eliminate, and waiting would lead to an increase in expenditure (especially for feed) and a loss of income. This situation was facilitated by the lack of residue control on the traditional market. However, according to one respondent, traders were able to recognize if a chicken had been treated recently with AB. However, integrated farms were subject to random controls by the integrators and thus stopped using antibiotics 35 days prior to selling. The VietGAHP certificate (Vietnamese Good Animal Husbandry Practices) is a voluntary certification that allows products to be sold in supermarkets. Farmers with this certificate were also particularly concerned about respecting this withdrawal period.

“Some households even though their chickens were injected just 1–2 days before, still sell them to the dealer (…), if the middleman knows how to check the flock, he will find that the injected area will always be brutally bruised.” (Farmer 6)

Farmers were generally aware of antibiotic resistance, even though the level of knowledge varied between respondents. The most common definition of antibiotic resistance was that the antibiotic did not work and that they had to change antibiotics. A similar definition was provided by drug sellers.

“We often call this issue “nhờn thuốc” (antibiotic resistance), it means that that medicine doesn’t work although it is very new, very recent, very good, with a high antibiotic content” (Farmer 0)

ABR was identified as being mainly caused by the overuse or misuse of antibiotics and the continued use of the same antibiotics. Some farmers and drug sellers also believed that the cause was other farmers lack of knowledge on disease diagnosis. Farmers also reported that antibiotic resistance occurred because of the soil pollution. This meant that when several flocks of chickens were raised in the same area, there was higher disease incidence and the presence of antibiotics in the environment. The identified consequences of ABR were that chickens couldn’t be cured, they had to switch to other antibiotics and increase the dosage, and this resulted in decreased productivity. Most farmers had experienced this on their farms. However, few respondents made the link between antibiotic resistance and the risk to human health. Their main source of information about antibiotic resistance was workshops organized by agencies, drug sellers, governmental projects, and TV channel media.

“The first reason is the increasing population of chickens. Secondly, it’s because the area of land doesn’t change, but I don’t have much time to rest in between different flocks. The chickens are not raised in cages, but they’re pastured, so they would defecate on the land after eating. Therefore, the land would get polluted.” (Farmer 6)

Usage and motivations to reduce usage of antibiotics

The evolution over time of antibiotic usage was perceived either as an evolution in price or quantity (supplementary materials for the results of the proportional pilling). Respondents reported an increase in the price of antibiotics and thus in their farm expenditure. The increase in farm expenses was up to twice as high as a few years before, as confirmed by drug sellers. This was also related to higher amounts used (usually twice of the recommended dosage) due to higher disease incidence, intensification of production (overlap between two batches, higher density), and treatment difficulties.

We identified three ABU profiles (Table 2). Three farmers had increased their antibiotic usage and had no plan to reduce it in the near future. Five farmers had not reduced their usage but intended to reduce it. Ten farmers had reduced their antibiotic use, including three integrated farms, four farmers from the same cooperative, two independent farmers, and one household farm. Drug sellers reported an increase in chicken production in the area, with larger scale farms leading to higher AB sales. However, some of their customers were using less antibiotic because they were using more vaccines and applying better farming practices. Motivations and barriers to reducing antibiotics for each respondent are detailed in S1 Table. Integrated farmers were obliged to comply with the requirements of the integrator that sought to sell on the international market, by complying with norms and regulations, or to develop a new domestic market for quality products. One farmer chose a specific integrator because they used less AB. For family commercial farms, reducing AB was often perceived as a way to reduce farm expenditure, improve farming practices, be more productive, increase the quality of the products and produce products that are safer for consumers. The main barriers included the high disease incidence linked to the free-range production system, on-farm density, and high density of the farms in the area. The household farmer had reduced her ABU because she reduced the number of chickens on her farm. Production was then for her own consumption only and she did not want to use AB as it would be harmful to her health.

Adoption of technical solutions

Farmers adopted technical solutions that contributed to ABU reduction on their farms; these varied according to the participants and their different socioeconomic contexts. Methods for reducing antibiotics were vaccination, alternative feed additives (probiotics, vitamins, electrolytes, tonics), hygiene and sanitation, herbs, and improvement of farming practices. The results of the ranking of these methods by the first phase respondents according to their perceived effectiveness and feasibility are presented in S2 and S3 Tables.

Farmers reported an increasing use of vaccination. The main reasons for this were the intensification of poultry production and the higher disease incidence in the area, related to higher farm density. They also explained that an influential drug seller in the area was promoting good vaccination practices. This drug seller was well-equipped for vaccine storage and farmers trusted in his advice. Moreover, farmers communicated together on the need of using vaccines.

“We usually say to each other that the chickens live thanks to vaccines, they cannot live without vaccines.” (Farmer 3)

Farmers 9, 11, and 13—all members of a cooperative—used local handmade probiotics produced by the cooperative leader (farmer 17). The homemade probiotics were made at the farm-level in a dedicated room from the fermentation of leaves and fruits. It was then mixed with the result of the digestion of cereals by earthworm and flies’ larvae to increase chicken’s growth. They started using these products in line with the technical advice provided by the leader of the cooperative and also because they considered this method to be successful in many aspects. Indeed, probiotics helped to reduce farm expenditures by enhancing chickens’ resistance and thus reducing ABU, it also allowed them to feed the chickens with corn-based feeds that were cheaper than industrial feeds. There was less disease among the chickens and they were of better quality. For example, the farmer who developed these probiotics reported a reduction of 30% in his ABU. One disadvantage of using probiotics was the increased workload due to the need to grind the corn and mix the probiotics manually. To overcome this problem, the leader of the cooperative planned to buy a mixer that other farmers could use.

Using probiotics was also a way to obtain a better valorization of the products. Indeed, a new cooperative was created by farmer 17 where probiotics are a requirement. Chickens are sold with the label “fed with organic probiotics” so that obtain a higher price. A better valorization of products was also the objective of one integrator. Using herbs was thus a marketing strategy for the integrator to produce quality chickens and to move toward the production of AB-free chickens.

Integrated farms also had to follow the strict biosecurity standards of the company (pad cooling, disinfection, automatization, …) and perceived this as highly effective to reduce disease incidence. For family commercial farms, the most common biosecurity measures were hygiene and sanitation (i.e. cleaning and disinfection of the barn) as these were also seen to be a cheap and easy way to reduce the disease incidence. Reducing chicken density, observing a fallowing period and not overlapping flocks were identified as effective means to reduce the use of antibiotics. However, they were not always applied because of the perceived reduced profitability and the need for farmers to increase their volume of sales to maintain a sufficient income.

Several farmers improved their farming practices, usually by attending workshops, and thus reduced their antibiotic usage. They usually wanted to learn more about how to improve farming practices and reduce farm expenditure. One farmer completely changed his feeding and drinking systems to improve farming conditions and provide a safer environment for the chickens (“eat clean, drink clean, and stay clean”) and his ABU has since decreased. Another farmer considered that spending time with the chickens was an efficient way to reduce ABU. Indeed, on his previous farm, he spent limited time observing the chickens. Since he started working on another farm with more human resources, the disease incidence had decreased. Cooper sulfate, bio mattress, lime, and rice husks with probiotics were also used to keep the environment dry.

“Taking care of chickens in the right way can also help to reduce diseases. For example, if we don’t take care of them like children, they will be weak and thin. Conversely, if we give thoughtful care to them, they will rarely get sick.” (Farmer 1)

Influence of social networks on reducing antibiotic usage

Social networks supported the diffusion of practices and knowledge between farmers and with health professionals. The impact of social networks on changing practices was higher within the context of a trusted relationship rather than with a seller-buyer one. It also supported mutual aid and the diffusion of solutions. Most farmers participated in several workshops organized by the private and public sectors through the agricultural extension center. In these workshops, stakeholders explained new diseases, diagnostics, and treatments, and introduced new products or vaccines, without specific training on ABR. Usually, products (alternative feed additives) or goodies were distributed to the participants. Another example was the case of a farmer who, after meeting a professor, started to produce his own local handmade probiotics. Several governmental and research projects were also implemented in the area allowing farmers to change their farming practices. For example, one project aimed to increase on-farm biosecurity or to develop VietGAHP farms by providing farmers with technical support and financial assistance. However, the covid pandemic had slowed down the farmers participation of the workshops and on-farm intervention of such projects.

“Moreover, by attending seminars, I gained more knowledge about how to use medicine and antibiotics. It’s easier when I already have some understanding of it. Knowing how to use medicine is a way to prevent drug resistance among chickens.” (Farmer 9)

Relationships between farmers and drug sellers varied and so did the impact on their antibiotic use. Drug sellers had different backgrounds from high school education, without proper veterinarian training, to universities. To compensate for the difference in knowledge between drug sellers, one veterinarian was training other drug sellers. Most farmers interviewed bought drugs from the same drug seller (DS2 on the Fig 2). This drug seller was also a member of the SubDAHLP staff and was perceived to have a strong influence on the farmers because he had a lot of experience and knowledge. Farmers trusted him and followed his recommendations. In particular, this drug seller was concerned about ABR and ABU and promoted the usage of vaccination. Most farmers did not seek professional advice when they considered that the disease was not serious or for routine antibiotics (i.e. preventive use). They acted on the basis of their own experience. Drug sellers considered farmers to be experienced as they had been raising chickens for a long time. However, farmers asked veterinarians or drug sellers for advice when the diseases are too serious—bệnh ghép—because drug sellers know how to mix different drugs. Sometimes, drug companies visited farms directly, or when agents requested it, for difficult cases. Some companies advocated a reduced antibiotic usage and because they specialized in alternative feed additives, they could influence farmers to reduce their antibiotic use. However, most of the drug sellers interviewed did not actively promote a change in practice and it was unclear whether or not farmers would have listened to them. Finally, integrated farms received technical support from the company and were trained from the beginning to raise chickens.

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Fig 2. Relationships between the respondents, their antibiotic usage profiles, and factors influencing their changing practices from semi-structured interviews, December 2021 and February 2022, Phu Binh district Vietnam.

In brackets: factors influencing change. Circles are proportional to the number of relationships.

https://doi.org/10.1371/journal.pone.0290296.g002

“[Drug seller 2] has a lot of experience. He is loved by so many people (…) [he] would share the experience in dissecting and examining to diagnose the disease in chickens. Secondly, he would help us in vaccinating when chickens are 1 day old.” (Farmer 4)

The exchange of knowledge among farmers was common, especially because most people had relatives in the area. However, not all of them actively encouraged a change in practice. They would share their experience and farmers would decide whether or not to use the new technics. However, as the interview was conducted across a limited area, most of the farmers were relatives. This was the case of the farmer who started the cooperative and produced probiotics. This made it easier for him to convince the other farmers to try it. He also organized meetings to present his product.

“[Farmer 17] told me about that. He experimented with a few flocks and found it effective. (…) He is my wife’s uncle.” (Farmer 11)

Influence of the poultry supply chain on reducing antibiotic usage

Three different supply chain models were identified among the participants, with different influences on changing practices.

In the traditional system, economic factors were identified by farmers as a barrier to reducing ABU. Indeed, antibiotics were considered a safe way to maintain productivity. High market fluctuations in output and feed prices were a barrier for farmers to change their practices; this was confirmed by drug sellers and traders. Feed was considered the highest expenditure and costs have increased since the pandemic. Moreover, chicken prices fluctuated constantly. Between December 2021 and February 2022, the price for one kilogram of chicken increased by 50%. This was explained by the Covid situation in December, which considerably lowered prices and the approach of the Têt festival in February when consumption increased. But after these particular events, prices decreased again, as reported by the respondents. During difficult times, some farmers reported producing at a loss and it was also common for farmers to obtain loans from drug sellers and pay them back later. Drug sellers make a profit on antibiotics, but according to them, they would have higher income if farmers used fewer antibiotics. Indeed, this would mean that chickens would be healthier, so farmers would be wealthier and could pay them back. Poor market conditions have also affected the number of farms. Indeed, some people have stopped raising chickens and this in turn has had a negative impact on drug sellers. Certain farmers solved their economic difficulties by combining several jobs, to increase their resilience (the multiple sources of income helped them to absorb shocks).

‘They look beautiful, a good crest and shiny feathers’ (Trader 1)

The conventional selling of chickens at the traditional market was considered a barrier to changing practices. Most of the chickens were bought by traders, through middlemen, to be sold on the wholesale market, in Bac Giang, and then distributed to Hanoi or Bac Ninh provinces. Traders did not ask farmers about their ABU because it was not a market requirement, no control was done at this level and farmers did not usually tell them the truth. According to traders, consumers did not care about this issue and bought chickens only for their taste. Farmers stated that producing quality chickens (tasty and safe) was one of the main motivations to reduce ABU. However, farmers reported that quality chickens were not sold at a higher price on the market, even though their production cost was higher.

“They don’t care about this issue much. Traders just come to check our chicken flocks. They care about the chickens’ feathers and weight. They will be ok if the chickens have silky feathers and the same weight. If chickens are ugly, the feathers are shabby and sticky, traders will know that we use lots of medicines.” (Farmer 4)

“I’m always sure about the quality of my products. However, no one has requested quality products. Now, chickens are sold on the free market, so the prices are not different between farms. With the good quality of my chickens, the price should be higher but it’s not [the case] in the free market.” (Farmer 3)

Integrated farms must comply with the integrator requirements and the integrator must comply with state policies. Antibiotics were therefore only used in the feed for the authorized time and the withdrawal time was applied strictly. These products were sold in supermarkets under the VietGAHP certificate that should include testing of residues. One integrator also started a brand of herb-fed chickens to target a new domestic market. However, the market was still insufficient for these types of products as consumers were identified as customarily buying their meat at traditional markets. Independent farmers that had the VietGAHP standard were not able to sell their products in supermarkets. Indeed, one farmer reported a lack of consumer demand. He was therefore obliged to sell them on the traditional market, but as the higher production prices were not reflected in higher purchasing prices, the solution was not profitable for him.

“It seems that all Ta Lo chickens cannot be sold in supermarkets because the price is too high. Supermarket chicken meat is soft and cheap. The price of supermarket chicken meat is only as much as the price of our living chickens. So, if we sell them in the supermarket, the price of our chickens will be too high.” (Farmer 16)

A solution developed by farmers to overcome economic difficulties was to organize themselves into cooperatives. Among our respondents, four farmers were part of an existing cooperative (farmers 9, 11, 13, 17 on the Fig 2) and two farmers wanted to create a new one in the area (farmers 3,4 on the Fig 2). The existing cooperative was created in 2014 by farmer 17 and included 10 members. Half of the farmers had been feeding their chickens with local hand-made probiotics since 2018 as they had to be free-range and AB residue free. Inputs were purchased in common (AB from Drug Seller 2) and the cooperative supported farmers in the selling process. They had the VietGAHP certificate. Two governmental provinces supported the development of the cooperative. A second cooperative with 17 members was soon to be officially created with a focus on producing “organic” chickens with less AB the application of new technologies. They were still to be fed with the probiotics and corn, but they were to stop using AB for the last 2 months. Feed were to be processed in common and the leader aimed to develop processed meat. A new collaboration to sell chickens to a shop specialized in quality chickens in Hanoi was under development. The trader responsible for the sale would be associated with the cooperative and would also provide them with drugs. This trader started this business to produce “clean food, drug-free chickens” (Trader 2) after realizing that most chicken meats contained antibiotics. According to one member, this cooperation would guarantee a better valorization of their products (higher selling price). Chickens were to be sold under the brand of the cooperative. The leader also intended to be part of the “One Commune One Product” program, supported by the government and aiming to promote high-quality products from a commune. This was a way for producers to better valorize their products by increasing consumer trust.

According to the respondents, the advantages of being part of a cooperative were the lower prices of the inputs (feed, drugs, DOCs), the assurance of having stable outputs, the possibility to share their technical expertise, and it’s legal existence. Moreover, they received technical and financial support from the government. Farmers involved in a cooperative didn’t mentioned barriers to being part of a cooperative. But they explained that other farmers did not want to join due to a lack of awareness.

“Joining cooperatives is completely voluntary, the members discuss and implement together. There is no pressure and it is not required for everybody to follow. This is what the new type of cooperatives is like, so farmers feel comfortable. When joining, I can see many advantages.” (Farmer 17)