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.
Crisis. 2018 Nov;39(6):479-488. doi: 10.1027/0227-5910/a000525. Epub 2018 Jun 21.
In South Asia, up to one in five individuals who use pesticides for self-harm purchase them immediately prior to the event.
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.
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.
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.
Cost considerations for implementing the proposed intervention were not considered.
Training vendors might be the most appropriate intervention to restrict sales of pesticides to people at risk of suicidal behavior. This requires field testing.
在南亚,多达五分之一的自杀性农药使用者是在事发前立即购买农药的。
通过文献回顾,我们提出了四项干预措施:(a)农民身份证(ID);(b)处方;(c)冷静期;和(d)培训农药销售商。我们旨在确定最有前途的干预措施。
该研究在斯里兰卡进行。我们绘制了利益相关者对每种干预措施的利益和权力的关系图,并在此基础上进行了排名。进行了七次焦点小组讨论(FGD),以评估实施的促进因素和障碍。
供应商培训是最受支持的干预措施,被利益相关者排名第一。FGD 参与者强烈支持对供应商进行培训,因为这被认为是易于实施的,并且被认为更方便。农民身份证、处方和冷静期被认为存在更多的障碍而不是促进因素,并且它们受到潜在的实施障碍(农民和供应商)的强烈反对。
未考虑实施拟议干预措施的成本考虑因素。
培训供应商可能是限制有自杀行为风险的人购买农药的最合适干预措施。这需要现场测试。