Agrochemicals Use Practices and Health Challenges of Smallholder Farmers in Ghana.

BACKGROUND: Globally, Africa is one of the continents that uses the lowest quantity of agrochemicals in farming. However, unsafe chemical use practices are high among farmers in Africa, posing serious health and environmental consequences. This study seeks to address three questions: (1) What factors motivate/compel smallholder farmers in Ghana to use agrochemicals? (2) What safety precautions or unsafe chemical use practices can be found in the communities? (3) What are the health implications of agrochemical use among smallholder farmers in Ghana? METHODOLOGY: The study used purposive and simple random sampling techniques to select 136 individuals for the survey, out of which 31 individuals were eliminated, and 105 participants were selected for in-depth interviews and focus group discussions. Additionally, participants' observations were collected, workshops were facilitated, and documents analyses were conducted. Qualitative data were analyzed using NVivo software and the quantitative data were analyzed using SPSS version 23.0. FINDINGS: The study found that environmental challenges, activities of NGOs, government policy, lack of or high cost of labor, and competition among farmers were major factors influencing farmers' decisions to use agrochemicals. Present agrochemical use in Ghana poses a risk to health and the environment. Finally, the study discovered chemical poisoning and low self-reported health quality as major health implications of agrochemical use in the communities.

Protocols as curriculum? Learning health advocacy skills by working with transgender patients in the context of gender-affirming medicine.

Evidenced by leading journals in academic medicine, health professions education has taken up the call to advance equitable healthcare. One pressing area where gaps and inequities are apparent is transgender (trans) people's access to gender-affirming medicine such as hormones and surgeries. Reasons for the dire state of care include education gaps. While specific content knowledge has been identified as lacking in medical school curricula, less research has focused on the complex social practices required of clinicians and educators working in gender-affirming medicine, and how these skills are learned through practice. In order to inform health professions education in this key area of need, we conducted a study to better understand the social practices, and the learning that occurs therein, of gender-affirming medicine. We identified the work processes of 22 clinicians, clinician-educators, trans patients, and clinical care administrators with attention to how policies and protocols influenced practice, learning, and teaching. The results of our study elucidate: (1) that practicing of gender-affirming medicine is strictly dictated by standardized assessment protocols, which serve as a form of curriculum; and (2) how health professionals learn and teach health advocacy as a form of resistance to protocols identified as creating inequities. These findings suggest an opportunity to view protocols-and their inherent limitations-more deliberately as teaching and learning tools, specifically for learning advocacy.

Globalization, poverty and women's health: mapping the connections.

Poverty and other forms of inequity undermine individual and population health and retard development. Although absolute poverty has reportedly declined in recent years, research suggests that relative poverty or the gap between the rich and poor within and between countries has been exacerbated over this same period. There is growing concern about the feminization of poverty, and the impact globalization is having on this important social problem. Gender inequality persists in all regions, and women and girls continue to be over-represented among the world's poor. This suggests that women are not consistently benefitting from the economic, political and social gains globalization can offer. Instead, it appears that poor women and girls, particularly those living in developing countries, are disproportionately burdened by the costs of these swift changes to the detriment of their personal health and well-being. Immediate action is needed to correct these disparities and ensure that globalization supports both national and international commitments to poverty reduction, and the, promotion of women's health and human rights.