The association between health literacy and pesticide use behaviors among sweet corn farmers in the Pak Chong district of Thailand: a cross-sectional study

Staying in or out? COVID-19-induced healthcare utilization avoidance and associated socio-demographic factors in rural India

BACKGROUND

Although evidence on healthcare utilization avoidance during COVID-19 pandemic is emerging, such knowledge is limited in rural settings. An effective policy to the COVID-19 shocks and stresses in rural settings require empirical evidence to inform the design of health policies and programmes. To help overcome this evidence gap and also contribute to policy decisions, this study aimed at examining COVID-19-induced healthcare utilization avoidance and associated factors in rural India.

METHODS

This study used the third-round data from the COVID-19-Related Shocks in Rural India survey conducted between 20-24 September, 2020 across six states. The outcome variable considered in this study was COVID-19-induced healthcare utilization avoidance. Multivariable Binary Logistic Regression Model via Multiple Imputation was used to assess the factors influencing COVID-19-induced healthcare utilization avoidance.

RESULTS

Data on 4,682 respondents were used in the study. Of this, the prevalence of COVID-19-induced healthcare utilization avoidance was 15.5% in rural India across the six states. After adjusting for relevant covariates, participants from the Bihar State have significantly higher likelihood of COVID-19-induced healthcare utilization avoidance compared to those from the Andhra Pradesh. Also, participants whose educational level exceeds high school, those who use government hospital/clinic, engage in daily wage labour in agriculture have significantly higher odds of COVID-19-induced healthcare utilization avoidance compared to their counterparts.

CONCLUSION

Our study revealed that state of residence, type of health facility used, primary work activity and educational level were associated with COVID-19-induced healthcare utilization avoidance in rural India. The findings suggest that policy makers and public health authorities need to formulate policies and design interventions that acknowledge socioeconomic and demographic factors that influence healthcare use avoidance.

The association between health literacy and pesticide use behaviors among sweet corn farmers in the Pak Chong district of Thailand: a cross-sectional study

Background: Pesticide toxicity is an important health problem in Thailand due to the intensive use of hazardous pesticides.  This study aimed to determine and discuss patterns of pesticide use, health literacy, pesticide use behaviors and whether there is an association between health literacy and pesticide use behaviors among sweet corn farmers in the Pak Chong district of Thailand. Methods: This work was carried out between May 2017 and July 2017 and 161 participants were enrolled. Participant questionnaires were completed during face-to-face interviews. Results: 161 sweet corn farmers (89.98%) were interviewed about patterns of chemical pesticide use. Two of the pesticides used in the pre-planting phase were moderately toxic: paraquat (used by 55.2% of farmers) and imidacloprid (used by 15.5% of farmers). In the pre-emergence phase, participants reported using two moderately toxic pesticides: alachlor (used by 48.8% of farmers) and chlorpyrifos (used by 2.4% of farmers). At the post-emergence phase, participants reported using six moderately toxic pesticides: chlorpyrifos (used by 60.7% of farmers), paraquat (used by 38.1% of farmers), imidacloprid (used by 7.2% of farmers), 2-4D (used by 3.6% of farmers), abamectin (used by 3.6% of farmers) and cypermethrin (used by 1.2% of farmers). Health literacy levels were moderate level (Mean score = 91.62, SD = ± 7.06) and pesticide use behaviors were low level (Mean score = 67.80, SD = ± 4.04). When examining the association between health literacy and pesticide use behaviors, we found that functional literacy was significantly associated with pesticide use behaviors. These findings suggest that health literacy, which includes self-management and decision-making skills, should be given greater attention as pesticide use behaviors were unsafe. Conclusion: It may be necessary to develop approaches to reduce pesticide use and promote health literacy, thereby protecting farmers, consumers, the environment (soil, water, and air) and ecosystems from pesticide-related hazards.