A cross-sectional study to assess the morbidity pattern among female agricultural workers in the rural area of Central India: a study protocol

Introduction

“Morbidity is defined using three dimensions: the number of individuals affected by illnesses, the types of diseases they have, and duration of the illness (in days, weeks, etc.)” as stated by the WHO expert committee on health statistics. Agriculture poses unique challenges that put the health of its workers at risk, including exposure to excessive chemicals, organic products, long working hours, awkward postures, and the operation of dangerous machinery and equipment. furthermore, farmers living in villages face additional public health issues such as communicable diseases, inadequate nutrition, and unhygienic surroundings, which significantly influence their health and susceptibility to illnesses. The factors should be addressed, and efforts to sensitize people about these issues should be intensified.¹

In India, female agricultural workers face various occupational health issues due to their involvement in various challenging manual tasks. While musculoskeletal injuries, coal workers’ pneumoconiosis lung diseases, pesticide poisoning, and noise-induced hearing loss are recognised as significant concerns, other critical health issues affecting agricultural workers, such as animal bites, exposure to harmful chemicals, insect bites, physical risks under harsh conditions, and respiratory problems like occupational asthma, often do not receive adequate attention due to lack of awareness about their health.² Although Female agricultural workers, whether working in their own fields or as day labourers, face various forms of exploitation, making them more vulnerable and uncertain about their future. They typically labour long hours, both in agriculture and housekeeping, which puts them at risk of developing musculoskeletal conditions. While it has been observed that women perform farm tasks better than men, pay inequalities still persist.³

However occupational health risks in the agricultural sector can be mitigated by providing employees with a safe working environment. This includes the provision and proper use of personal protective equipment, along with adequate guidance and training on its correct usage and significance. However, farming-related health issues often arise due to the significant gap between agricultural health policymaking.⁴

A woman undertakes a wide range of demanding tasks within household roles, rural women play a crucial and active part in various farming related activities. Furthermore, especially in wealthier and well- resourced rural areas, There has been seen that the involvement of an Indian women in agricultural businesses and operations increases in recent times.⁵ This unorganised sector encompasses various areas of the economy, including agriculture, trade, transportation, communication, services, healthcare, education, building, and construction. Women are more likely to obtain jobs in the informal economy due to their lower education and skill levels.

However, working in this sector exposes them to additional risks as there are no formal occupational health and safety regulations, and they may be more susceptible to sexual assault.⁶

Agricultural workers, in general, face challenges such as unstable employment, lack of workplace safety, irregular income, and insufficient social security protection. The National Commission on self- employed conducted a study to assess the severity of occupational health issues among women in the unregulated industry. They found that women working in this sector suffer from various illnesses, including postural problems, communication issues involving hazardous substances, continuous work-related issues, lack of rest, and an unfavourable work environment.⁷ Women in agriculture may experience generalized body aches, respiratory problems and other associated health-related morbidities. Women’s likelihood of obtaining jobs in the informal economy is influenced by their lower levels of education and skills, as well as the availability of flexible work hours, which can be beneficial for mothers with young children.⁸ In conclusion, addressing the health and safety issues faced by agricultural workers, especially women in the informal economy, requires significant attention from policymakers and relevant authorities to implement measures that protect their well-being and ensure fair working conditions.

Methods

Discussion

India is renowned for its agricultural sector, and it has made significant strides in improving the health of its female population. While there has been a general decline in mortality leading to increased life expectancy, it remains uncertain whether there have been any changes in morbidity patterns. India has entered the fourth stage of health transition, characterized by the prevalence of various illnesses among females. According to the international labour organization, women constitute about 60% of the agricultural workforce in India, yet their work often goes unrecognized and undervalued. They face discrimination in terms of wages, working conditions, and access to resources. Many women work for long hours in agricultural or other fields to secure a stable income, but this has resulted in a higher likelihood of developing chronic illnesses such as respiratory issues, musculoskeletal problems, joint diseases, hypertension, diabetes, common cold, asthma, neurological disorders, cardiovascular disorders and joint diseases.

Female susceptibility to diseases starts in the early working years, peaks in the late working years, declines in older ages, and their health tends to deteriorate earlier than that of men.¹⁰

Although women stand to gain significant benefits from automation in farming, the majority of tools and equipment have been designed with a male oriented approach. This design orientation comes with both advantages and disadvantages. Many agricultural machinery, systems, and tools used for tasks such as field treatment, ridging, plucking, grain processing, culinary burners, and freshwater conveyance, especially in Asia, are characterized by their massive, bulky, weighty, and challenging to maintain nature which develop musculoskeletal conditions and other illness.¹¹

Due to lack of awareness or education among females, they are often unaware of the various government schemes designed for their health and wellbeing. The Indian government has implemented several schemes and programs to address these issues and enhance agricultural workers’ livelihoods, including women. For instance, the Pradhan Mantri Fasal Bima Yojana provides crop insurance coverage to farmers, including women farmers, while the Pradhan Mantri Kisan Samman Nidhi offers direct income support to small and marginal farmers, including women farmers.¹²

The primary objective of the study was to evaluate the morbidity profile of female agricultural workers in rural areas of central India, with an emphasis on creating awareness about social security schemes available to them. By understanding the prevalent health issues and increasing awareness of the support available. The study seeks to contribute to the betterment of female agricultural workers’ overall health and wellbeing.