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Introduction: The broad objective of this study is to understand the challenges and barriers in treatment seeking for victims of pesticide poison in rural India from key stakeholders’ perspectives. Methods: A Cross-sectional multi-centric prospective study was designed using a mixed method approach in seven states of India from April 2019 to July 2021. Fifty key stakeholders' interviews were conducted with village heads/leaders, pesticide shopkeepers, doctors/health care professionals, and police officials, and 17 case studies collected information on the treatment-seeking behaviour of pesticide poison survivors. Findings: Unregulated buying, selling, and usage of pesticides have led to increased cases of pesticide poisoning in rural India. Some farmers cross the Indo-Nepal border to purchase banned pesticides. Self-poisoning is often hidden due to fear of police involvement, lengthy legal procedures, and negative family reputation. Lack of awareness about legal procedures and illiteracy are the main reasons for hiding self-poisoning incidences. Victims often do not receive necessary treatment due to a lack of hospital infrastructure, staff shortages, the high cost of medicines, and the distance of referral units from the villages. Conclusions: Awareness generation activities about the impact of pesticide poisoning, medico-legal procedures, and safe use of pesticides are urgently needed to be implemented in rural India to reduce deaths due to poisoning. Additionally, the frontline functionaries of health and police departments needed to be motivated to address these cases with empathy. To reduce fear of police and legal procedures, police departments need to leverage convergence activities between the Ministry of Health and NCRB. Key words: poisoning, rural, availability, stigma, community, perception
Singh et al. (Tue,) studied this question.