EVALUATION OF
HEALTH STATUS AND ITS CORRELATES AMONG FARMERS
Health is a level of functional and metabolic efficiency of a living
being (Asenso, 2011). In humans, it is the general condition of a person in
mind, body and spirit, usually referred to as being free from illness, injury
or pain. The World Health Organization (WHO 2006) defined health in its broader
sense as a state of complete physical, mental and social well-being and not
merely the absence of disease or infirmity. According to the International
Labour Organization (ILO, 2004) health is a state of being hale, sound or
whole, in body, mind or soul, especially the state of being free from physical
disease or pains. Health is more than not being sick. It is a resource of
everyday living. It is the ability to realize hopes, satisfy needs, change or
cope with life experiences and participate fully in the society (WHO, 2004). In
essence, health status is the current state of individuals’ health which
includes the wellness, fitness and any underlying disease or injuries
(WHO, 2011).
Evaluation is a judgment about how
good, useful or successful something is. According to Ogunyinka (2014),
evaluation is said to be the systematic collection of information about
activities, characteristics and outcome of programmes to make judgment about
the programme, improve programme effectiveness and or information decisions
about future programme. Assessment of health status is important in
that it enables individuals to be sensitive to changes in their health and
serve to discover disease harbingers before its symptoms arise and before
clinical examinations are made (Erengin and Dedeoglu, 2007).
Correlates of health status are the
determinants of health status. A situation where two or more things are closely
related or connected to each other or one causes the other (Murray, 2009). Health
status can be influencedby factorssuch as: weight, nutrition, agility and
flexibility or ability to move, smoking, alcoholic consumption, caffeine
consumption, compliance with prescribed medical treatment,physical activity,
diet etc. (Ugwu, 2006). National Institute of Occupational Safety and Health
(2011) reported that many factors combine together to affect the health of
individuals and communities. Whether people are healthy or not, is determined
by their circumstances and environment, genetics, income and education level,
relationships with friends and family. All of these have considerable impact on
health, and more so, commonly considered factors such as access and use of
health care services have much impact on health status.
Donald (2006) posited that the importance of health as
a form of human capital cannot be overemphasized, that good health and
productive agriculture are important pairs in the economy of any nation
especially in the fight against poverty. He further postulated that good health
enhances work effectiveness and the productivity of an individual through
increase in physical and mental capacities. On the other hand, health
impairment or illness can affect the ability of people to perform essential
tasks and can bring severe distress or even destitution to families. Poor physical, mental or even social health
impacts negatively on individuals irrespective of their occupation, and this
may be particularly worse on farmers and their dependents.
Agriculture is one of the most important drivers
toward poverty reduction and the bedrock for economic growth, especially for
the billions of people in developing countries. In agriculturally based
countries, the sector generates on average, 29% of the Gross Domestic Product
(GDP) and employs 65% of the labour force (World Bank, 2007). Three quarters of
the world’s poor live in rural areas, particularly in Asia and Africa, and
depend on agriculture as their primary source of livelihood (Ravallion and
Jinadu, 2007). The World Bank (2007) suggested that, GDP growth originating
fromagriculture is at least twice as effective in reducing poverty as GDP
growth originating outside agriculture.
Studies based on cross country estimates found that agricultural growth
contributes significantly to reducing poverty and hunger, and added that
poverty is the world’s most ruthless killer and greatest cause of suffering.
However, the way agricultural productivity contributes to development varies
across countries depending on the extent to which it is a source of economic
growth and what percentage of the rural poor are strong and healthy enough to
engage in agricultural activities. The linkage between agriculture, health and
nutrition is bi-directional, and so health and nutrition also affect
agricultural systems (Asenso, 2011). Good health is an asset for agricultural
production, as healthy people can produce more and good nutrition contributes
to it. Conversely, agriculture is an asset which contributes to good health and
resilience, when both health and agriculture thrive, a reinforcing cycle of
health can result, but when either suffers, the cycle becomes one of lowered
agricultural productivity and lowered health status (WHO, 2010). According to
ILO, (2004), the agricultural sector is one of the most hazardous to health
worldwide. Agricultural work possesses several characteristics that are risky
to health such as exposure to harsh weather, close contact with wild animals
and plants, contact with agrochemicals, difficult working postures and lengthy
hours, and use of hazardous agricultural tools and machinery. It is also stated
that, agricultural
development and practice can exacerbate the occurrence of disease vectors
and parasites. More so, some agricultural practices have the effect of
encouraging breeding grounds for disease vectors causing a real clash between
the interest of food producers and health.
According to FAO(2006), more than 850 million people
face acute food insecurity and hunger on yearly basis, 80% of these live in
rural areas. This could be partly as a result of the difficulties farmers face
in agricultural production such as land tenure system,
insufficient capital, high cost of labour and machinery, poor processing and
storage facilities etc.Many small-scale farmers are unable to produce sufficient
quantities of food, even for self-consumption.As pointed out by the World Bank
(2007), illness and death from HIV/AIDS, malaria, tuberculosis, and other
diseases reduce agricultural productivity through the loss of labour, knowledge
of productive adults, and assets to cope with illness.When disease afflicts
farmers, their productivity is reduced and they remain in poverty, the effects
fall back on the nation at large.
Poor health brings hardships to households including debilitation,
substantial monetary expenditures, loss of labour and sometimes death. Poor
health lessons the farmers’ ability to innovate, experiment, and operationalize
changes in agricultural systems. For instance, “a farmer who is ill cannot
attend FarmerFieldSchool or interact with extension officers to learn about new
technologies and improve practices, and so may lack the knowledge to innovate
(Croppenstedt and Muller, 2010). Health also affects agricultural output,
particularly its demand. Antle and Pingali (2010) asserted that malnutrition
and disease patterns influence market demand for food-quality, quantity,
diversity and the price people are able and willing to pay. More so, health
status of adults affects the duration of labour force participation and their
intensity of work effort. Poor health will result in a loss of days worked or
reduce workers’ capacity, and is likely to reduce output.A research carried out
in Ethiopia by Croppenstedt and Muller, in 2010 estimated the impact of health
and nutritional status on efficiency and productivity of cereal growing
farmers. The results showed that, healthy farmers were found to produce more
cereal per unit inputs, earn more income, and supply more labour than farmers
affected by sickness.
Nutritional inadequacy impairs the ability of people to perform
biologically (diminishing strength and endurance) and this in turn affects
working capacity. Most of the rural poor
are engaged in moderate or heavy physical work so that the negative impact of
poor nutrition on performance is particularly severe for them. In 1978 the
World Health Organization (WHO, 1995) adopted the “Global strategy of Health
for all by the year 2000”, this action regarded health as a basic human
right. It stipulated that “all the
people in all the countries of the world should have at least such a level of
health that they are capable of working productively and participate actively
in the social life of the community in which they live. The aim was to ensure that all peoples have
adequate access to safe water, sanitary facilities, immunization against major
infections and local health care, yet many nations including Nigeria could not
meet the year 2000 deadline of “health for all”.
In AkwaIbomState, the problem of poor agricultural productivity is quite challenging,
(Ekong, 2006) as most farmers are involved in subsistence farming and their
ages are advancing. Like any other occupation, farmers are exposed to hazardous
conditions such as poor tools handling, routine contacts with various
chemicals, and gas emissions from chemicals/ grain storage rooms, long working
hours, exposure to extreme temperature (Akwa Ibom State Ministry of
Agriculture, 2008). Apart from this, farmers in Akwa Ibom State are faced with
most common diseases such as malaria, diarrhea, typhoid fever, rheumatism,
measles, tuberculosis, pneumonia, arthritis, chicken pox, injuries, cuts, and
more recently HIV/AIDS
which in many cases will lead to excess expenditure on health care services and
of course unexpected or premature death among farmers (Ekong, 2006),
Farmers are subjected to sprains, pains, fatigue, stress of financial
losses and uncertainties, intensified farm pressures, natural disasters and
intergenerational conflicts. In many cases, these farmers may not really know
the root or the way out of their health problems and as such may attribute it
to evil forces (Udoh and Umoren, 1997). On other occasions, they may try to
remedy their health problems through the use of local herbs which if care is
not taken; may end up worsening the problems.
1.2 Statement of Problem
International health development drivers like UNICEF and WHO observed
that health conditions of the people in many developing countries are still
unsatisfactory, and in many instances, the health status of their populations
remain below that of the dwellers in other developed countries (WHO,
2011).Nigeria as a developing country has a vast growth in population both in
urban and rural areas (Ojo and Iniodu, 2000). It is further observed that
increasing population has a significant effect on increasing demand for
increase in food production by the citizenry. But the occupational environment
for the agricultural industry present a wide variety of hazards to its workers
including exposures to poisonous chemicals, noise, organic dust, psychological
stress and medical and physical traumatic injuries (National Safety Council,
2011). For instance, the World Health
Organization estimates that 40- 50% of the world’s population are at health risk
related work (exposed to physical, chemical, biological, psychological and
ergonomics hazards) and that there are approximately 157 million new cases of
occupational work-related diseases each year. This is attributed mainly to
injuries sustained from the use of new technology, use of unsuitable imported
machinery and poor working conditions (especially in agriculture and
small-scale enterprises). The different types of injuries include amputations
of limbs, eye injuries, and respiratory diseases, pesticide poisoning and
musculo-skeletal disorders. This is
estimated to amount to an economic loss of 10-15% GNP in developing countries
(WHO, 2010). The health and safety of
farmers are vital not only for themselves but also for the entire nation, after
all without a safe production process, without safe producers, there cannot be
safe consumers.
Ekong (2006) opined that most
farmers still suffer from diverse diseases such as malaria, typhoid fever,
rheumatism, tuberculosis, arthritis etc as a result of poor nutrition,
hazardous nature of agricultural work, and poor usage of working
equipment.There isa high level of redundant or unemployed farmers, reduction of
farm labour and abandonment of many farming activities (Udoh and Umoren, 1997)
all linked to health status of farmers in the state.Disease deprives countries,
communities and households of their strongest, most productive people. It
strips away assets of all forms: human, financial, social, physical and natural
including its effect on ability of households to acquire enough nutritious food
for members to lead active, healthy lives, exorbitant health care cost, labour
shortages, declining asset base, breakdown of social bonds, downgraded crops,
and loss of livestock. According to
Akpabio, (2005) diseases lead to increase in dependency ratio due to the rise
in the number of dependents relying on a small number of productive family
members.
The Government of Akwa Ibom State of Nigeria has made numerous efforts
toward the provision of health care facilities and services to its population.
Notable among them are the expansion of medical education, improvement of
public health care services, and provision of Primary Health Care (PHC) centers
across the state(Akwa Ibom State Ministry of Agriculture, 2008). Despite the
observed concerted efforts made by the Akwa Ibom State Government on improving
health care of the dwellers, it would be pertinent to ask,“What is the health
status of farmers in the rural areas”. With uncertainties in respect of
empirical facts on health status index of Akwa Ibom farmers by extension
non-urban dwellers, there is the need to evaluate the health status of the
farmers, ascertain the correlates of health status, also the extent to which
health status can be influencedby the correlates, and assess the effect of ill
health on farming activities. Against this background the following questions
became pertinent: what are the
socioeconomic characteristics of the farmers in the study area?What is the
health status of farmers?What is the health status profile?What are the
correlates of health status? What are the effects of ill health on farming
activities?
1.3 Objective of the Study
The general objective of the study is to evaluate the health status and
its correlates among farmers in AkwaIbomState. The specific objectives of the
study are to:
(i) Identify the socio-economic
characteristics of farmers in AkwaIbomState
(ii) Assess the health status of farmers
in the study area
(iii) Analyze
the health status profileof the farmers in the study area
(iv) Ascertain the correlates of health status
of farmers in the study area and
(v) Assess
the effect of ill health on farming activities in the study area.
1.4
Hypothesis of the Study
The hypothesis of this study was stated in the null form as follows.
There is no
significant relationship between the health status of farmers and its
correlates (nutrition, and food security, exposure to harsh weather, alcohol
and caffeine consumption, use of safety measures, housing condition, compliance
to medical prescription etc) in the study area.
1.5
Significance of the Study
Agricultural production and functional health status are primarily
factors that relate with each other. This study evaluated the health status and
its correlates among farmers in Akwa Ibom State. It is expected that the
results of this study will be of immense value to farmers in their farming
communities, policy makers, extension agents, government and to the country at
large. The study will enable government not only to focus policies on
development of agricultural technologies but also make policy for increased
income to boost food security, enhance health status and expand the welfare
basis for rural communities. Furthermore, it will serve as a guide to
development programming oriented non-governmental organizations (NGOs) on
preventive measures which farmers should adopt in order to prevent or reduce
health risks, and then see the need to change to safer agricultural practices.
The study will enable scientists develop preventive measures and surveillance
systems for health problems. Finally, this study will assist researchers to
study on a broader correlation between health status of farmers and farm labour
productivity. This will go a long way towards boosting agricultural
productivity and sustainable development.
EDITOR SOURCE: evaluation
of health status and its correlates among farmers
