Potential Interventions for Preventing Pesticide Self-Poisoning by Restricting Access Through Vendors in Sri Lanka

Author:

Weerasinghe Manjula123,Konradsen Flemming24,Eddleston Michael234,Pearson Melissa23,Jayamanne Shaluka25,Gunnell David6,Hawton Keith7,Agampodi Suneth1

Affiliation:

1. Department of Community Medicine, Faculty of Medicine & Allied Sciences, Rajarata University of Sri Lanka, Anuradhapura, Sri Lanka

2. South Asian Clinical Toxicology Research Collaboration, Faculty of Medicine, University of Peradeniya, Sri Lanka

3. Centre for Pesticide Suicide Prevention, and Pharmacology, Toxicology and Therapeutics, Centre for Cardiovascular Science, University of Edinburgh, UK

4. Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark

5. Department of Medicine, Faculty of Medicine, University of Kelaniya, Ragama, Sri Lanka

6. Population Health Sciences, University of Bristol, UK

7. Centre for Suicide Research, Department of Psychiatry, University of Oxford, UK

Abstract

Abstract. Background: In South Asia, up to one in five individuals who use pesticides for self-harm purchase them immediately prior to the event. Aims: From reviewing the literature we proposed four interventions: (a) farmer identification cards (ID); (b) prescriptions; (c) cooling-off periods; and (d) training pesticide vendors. We aimed to identify the most promising intervention. Method: The study was conducted in Sri Lanka. We mapped stakeholders' interest and power in relation to each intervention, and followed this by a ranking exercise. Seven focus group discussions (FGDs) were conducted to assess facilitators and barriers to implementation. Results: Vendor training was the most supported intervention, being ranked first by the stakeholders. The participants in the FGDs strongly supported training of vendors as it was seen to be easy to implement and was considered more convenient. Farmer IDs, prescriptions, and cooling-off periods were thought to have more barriers than facilitators and they were strongly opposed by end users (farmers and vendors), who would potentially block their implementation. Limitations: Cost considerations for implementing the proposed intervention were not considered. Conclusion: Training vendors might be the most appropriate intervention to restrict sales of pesticides to people at risk of suicidal behavior. This requires field testing.

Publisher

Hogrefe Publishing Group

Subject

Psychiatry and Mental health

Reference24 articles.

1. Agriculture panel provides photo identification cards to farmers – Tamil Nadu. (2012, May 19). The Hindu. Retrieved from http://www.thehindu.com/todays-paper/tp-national/tp-tamilnadu/agriculture-panel-provides-photo-identification-cards-to-farmers/article3434866.ece

2. Methods for the synthesis of qualitative research: a critical review

3. Self-harm and self-poisoning in southern India: choice of poisoning agents and treatment

4. Stakeholder analysis: a review

5. The impact of firearm control legislation on suicide in Queensland: preliminary findings

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