Animal health strategies in rural Colombia face significant challenges due to a gap between institutional technical approaches and the sociocultural contexts of local communities. This study examines the social representations of animal health and welfare among small- and medium-scale livestock producers in rural Huila. Through a qualitative methodology, semi-structured interviews were applied and focus groups were conducted in different municipalities with the objective of contrasting and enriching the findings obtained in the interviews. In total, the perceptions, knowledge, and practices of 263 small and medium livestock producers from 23 municipalities in Huila were explored with respect to animal vaccination campaigns and healthcare in rural settings. Findings indicate that health management is shaped not only by technical protocols but also by cultural values, collective imaginaries, and symbolic relationships with animals. Representations of animal welfare are diverse—ranging from emotional and economic to preventive and communal perspectives—and often diverge from scientific–technological frameworks. These differences influence the level of community adherence to national animal health programs. The study highlights the limitations of top–down approaches and underscores the need to incorporate local knowledge and practices into policy design. It concludes that promoting sustainable livestock farming requires acknowledging these varied representations, fostering intercultural dialogue, and adopting a territorial approach to integrated health. Recognising the sociocultural dimensions of animal care is essential for developing effective, inclusive, and context-sensitive animal health strategies.