Enhancing Public Health for Agricultural Workers in Pakistan

Agriculture is the backbone of Pakistan's economy, employing nearly 40% of the workforce and contributing approximately 20% to the national GDP. The sector supports millions of rural households, yet the health and well-being of agricultural workers remain largely neglected. Many face poor working conditions, exposure to harmful chemicals, lack of protective equipment, and limited access to healthcare services, all of which significantly impact their productivity and quality of life.

One of the most pressing concerns is occupational health hazards. Farmers and laborers are frequently exposed to pesticides, fertilizers, and other agrochemicals, leading to respiratory illnesses, skin conditions, and long-term neurological disorders. According to the Pakistan Agricultural Research Council (PARC), nearly 30% of farmers suffer from pesticide-related illnesses annually due to improper handling and lack of awareness. Additionally, prolonged exposure to harsh weather conditions, extreme heat, and poor sanitation increases the risk of dehydration, heatstroke, and infectious diseases.

Another major issue is the lack of healthcare facilities in rural areas. Many agricultural workers do not have access to basic medical care, maternity services, or health insurance, leaving them vulnerable to preventable diseases. According to the Pakistan Bureau of Statistics, only 20% of rural workers have access to formal healthcare facilities. Women in agriculture face even greater health risks, including complications during pregnancy due to heavy labor and malnutrition.

Public health initiatives are crucial in addressing these challenges. The government must expand mobile health clinics, awareness programs on pesticide safety, and affordable health insurance for agricultural workers. Investing in occupational safety training, improved farm equipment, and accessible rural healthcare services will enhance worker productivity and ensure the long-term sustainability of Pakistan’s agricultural sector.

Challenges Faced by Agricultural Workers in Pakistan

Agricultural workers in Pakistan face numerous challenges that significantly impact their health, safety, and overall well-being. The nature of agricultural work exposes them to a variety of occupational hazards, including pesticide exposure, improper handling of heavy machinery, and prolonged physical labor. Many farmers lack protective gear, increasing their risk of respiratory diseases, skin infections, and chronic illnesses. Studies indicate that pesticide poisoning is a major health concern among farm workers, with long-term exposure linked to neurological disorders and cancer. According to the International Labour Organization (ILO), agriculture remains one of the most hazardous sectors globally, and the situation is even more dire in developing countries like Pakistan, where safety regulations are weakly enforced.

Beyond workplace hazards, healthcare access remains severely inadequate for rural agricultural workers. Many live in remote areas where basic medical facilities are scarce, and trained healthcare professionals are in short supply. According to Pakistan’s Health and Demographic Survey, only 30% of the rural population has access to proper healthcare services. The situation is worsened by financial constraints, as most farmworkers earn less than PKR 570 per day ($2), making it difficult to afford medical treatment.

Malnutrition is another critical issue, particularly among the families of agricultural workers. Limited incomes and lack of awareness about balanced diets contribute to widespread food insecurity and nutrient deficiencies. According to UNICEF Pakistan, 38% of children in rural areas suffer from stunted growth due to poor nutrition, directly affecting their long-term health and cognitive development.

Addressing these challenges requires stronger occupational safety regulations, expanded rural healthcare services, and targeted nutrition programs to improve the living conditions of agricultural workers. Investing in health and safety education, subsidized medical care, and improved farm technologies can enhance worker well-being and contribute to a more sustainable agricultural sector in Pakistan.

Impact of Climate Change on Agricultural Workers

Climate change significantly worsens the difficulties faced by agricultural workers in Pakistan, exposing them to rising temperatures, erratic rainfall patterns, and extreme weather events such as floods and droughts. These climatic changes directly impact on labor productivity, health, and food security, making agricultural work even more challenging.

One of the most immediate risks is heat stress, which reduces the capacity of workers to perform physically demanding tasks. Prolonged exposure to high temperatures can lead to heat exhaustion, dehydration, and even heat strokes, increasing health risks for farm workers. According to the Global Climate Risk Index, Pakistan ranks among the most vulnerable countries to climate change, with rising temperatures expected to significantly reduce working hours in the agricultural sector.

Increased rainfall variability and water scarcity further worsen conditions. Heavy rainfall can cause flooding, soil erosion, and crop loss, while prolonged droughts lead to water shortages and lower agricultural yields. As a result, farm workers face job insecurity and reduced incomes, making it harder to afford food and healthcare. Waterborne diseases also become more prevalent, as floods contaminate drinking water sources, increasing cases of diarrhea, cholera, and skin infections.

According to a 2021 study by De Lima et al., a 3°C rise in global temperatures could reduce agricultural labor productivity by 30% to 50% in South Asia, including Pakistan. This would not only impact on food production but also drive-up food prices by 5%, placing additional financial strain on agricultural workers and their families. Addressing climate change impacts through adaptation strategies, improved irrigation techniques, and access to healthcare is essential for protecting the livelihoods of Pakistan’s agricultural workforce.

Role of Public Health in Addressing These Challenges

Public health plays a critical role in improving the well-being of agricultural workers in Pakistan by addressing their health risks and enhancing access to essential services. One of the most impactful public health interventions has been vaccination and disease prevention programs. The Expanded Program on Immunization (EPI) has significantly reduced preventable diseases such as polio, measles, and tetanus among agricultural workers and their families. However, challenges persist, with nearly 20% of children in rural areas lacking access to routine vaccinations due to geographic barriers, misinformation, and limited healthcare infrastructure. Strengthening outreach programs can help close this gap.

The Lady Health Worker (LHW) Program, launched in 1994, has been a cornerstone of maternal and child healthcare in rural Pakistan. LHWs provide prenatal care, vaccinations, and health education, reaching millions of agricultural families. Despite its effectiveness, the program faces significant challenges, including underfunding, a shortage of trained personnel, and mobility constraints that limit its reach to remote areas. Expanding financial and logistical support for LHWs is crucial to sustaining and enhancing their impact.

One of the major occupational health risks in agriculture is pesticide exposure, which can cause respiratory illnesses, neurological disorders, and skin diseases. Public health initiatives, in collaboration with NGOs, provide training on pesticide safety, proper handling techniques, and the use of personal protective equipment (PPE). These programs have successfully reduced pesticide-related illnesses, but a lack of awareness and financial constraints prevent many small-scale farmers from fully adopting safe practices. Stronger enforcement of safety regulations and subsidies for protective gear could further improve outcomes.

Access to safe drinking water and sanitation remains a major challenge for agricultural communities. Programs like the Pakistan Approach to Total Sanitation (PATS) have improved water and sanitation facilities, reducing the spread of waterborne diseases such as cholera and diarrhea. However, 40% of rural households still lack access to clean drinking water, increasing their vulnerability to infectious diseases. Expanding infrastructure projects and promoting low-cost water purification solutions can enhance public health outcomes in these areas.

Malnutrition is another pressing issue among agricultural workers and their families. Initiatives led by organizations such as the World Food Programme (WFP) provide fortified meals and nutritional supplements to vulnerable populations. Additionally, nutritional education programs promote awareness of healthy eating practices. Tackling malnutrition requires a multi-faceted approach, including food security initiatives, improved agricultural practices, and social protection programs.

Finally, the mental health of agricultural workers is often neglected. Long working hours, job insecurity, and financial stress contribute to anxiety, depression, and other mental health conditions. Public health initiatives have recently started addressing this issue through awareness campaigns and counseling services, but efforts remain limited. Expanding mental health resources and integrating them into primary healthcare systems can help improve the overall well-being of agricultural workers in Pakistan.

Innovative Solutions and Future Directions

To further improve the welfare of agricultural workers, Pakistan must adopt innovative solutions and strengthen its public health infrastructure. Several key strategies can help address the health challenges faced by this vulnerable population.

One of the most promising solutions is the expansion of mobile health units and telemedicine services. These initiatives are particularly valuable in remote areas where access to healthcare is limited. Mobile health units travel to rural communities, offering medical check-ups, vaccinations, maternal care, and emergency treatments. Telemedicine platforms, supported by smartphone applications and internet connectivity, allow farmers to consult doctors remotely, reducing the need for long and costly travel. Expanding these programs with government and private sector investment can make healthcare more accessible and affordable.

Another crucial step is educating farmers on climate-resilient farming techniques to mitigate the health effects of climate change. Rising temperatures and increased pest infestations have worsened heat stress, vector-borne diseases, and pesticide exposure. Public health programs now focus on promoting drought-resistant crops, shaded workspaces, and integrated pest management strategies to reduce reliance on harmful chemicals. Strengthening such initiatives will protect both agricultural productivity and worker health.

Occupational safety training is another critical area requiring investment. Government agencies and NGOs are providing training on safe machinery handling, pesticide application, and first aid response. These programs have improved awareness but scaling them up through subsidies and regulatory incentives will ensure wider adoption.

Finally, international partnerships with organizations such as the Food and Agriculture Organization (FAO) and World Health Organization (WHO) have significantly improved nutrition programs, water sanitation efforts, and disease prevention campaigns. Expanding these collaborations will bring in technical expertise, funding, and policy guidance, ensuring a healthier workforce and a more sustainable agricultural sector.

Policy Recommendations

To ensure the long-term success of public health initiatives for agricultural workers, targeted policy measures must be implemented. Expanding rural healthcare infrastructure is a priority, as many workers lack access to Basic Health Units (BHUs) and Rural Health Centers (RHCs). The government should increase funding for rural healthcare facilities, provide incentives for doctors to serve in remote areas, and introduce mobile clinics to reach underserved populations. Strengthening occupational health and safety regulations is also crucial. Policies should mandate protective gear for pesticide application, regular health check-ups for workers, and training on proper machinery usage to reduce workplace injuries and long-term illnesses.

Increased funding for public health programs is essential for expanding successful initiatives like the Lady Health Worker (LHW) program and the Expanded Program on Immunization (EPI). The government should allocate a larger budget for rural healthcare, ensure timely salary payments for LHWs, and integrate digital health records to track immunization and disease prevalence more efficiently.

To address the impact of climate change, policies must promote climate-resilient agriculture. This includes subsidizing drought-resistant crops, encouraging drip irrigation, and introducing heat-resistant shelters for workers to prevent heat stress. The government should also work with NGOs and agricultural extension programs to educate farmers on sustainable practices, organic pest control, and soil conservation techniques to improve productivity without compromising worker health.

A multi-sectoral approach involving government agencies, research institutions, private stakeholders, and international organizations is key to implementing these policies successfully. Regular monitoring, feedback mechanisms, and incentives for compliance will ensure the sustainability of these reforms and improve the health and well-being of Pakistan’s agricultural workforce.

Conclusion

Public health is vital to improving the well-being of agricultural workers in Pakistan. By addressing occupational hazards, expanding access to healthcare, and promoting preventive measures, public health initiatives can enhance the livelihoods of one of the country’s most vulnerable populations. However, achieving these goals requires a systemic approach, involving collaboration between governments, healthcare providers, and communities. With sustained efforts and targeted interventions, Pakistan can ensure the long-term prosperity of its agricultural sector and the health of its workers.

Improving the welfare of agricultural workers in Pakistan requires a comprehensive and sustained commitment to public health initiatives. The challenges faced by these workers, including occupational hazards, limited healthcare access, malnutrition, and the impacts of climate change—highlight the urgent need for policy interventions. Strengthening rural healthcare infrastructure, enforcing occupational safety regulations, and expanding vaccination and disease prevention programs are crucial steps toward safeguarding worker health. Additionally, integrating mobile health services and telemedicine can bridge the healthcare gap for remote communities, ensuring timely medical attention.

Addressing climate change-related health risks through climate-resilient agriculture and sustainable farming practices is equally important. Public health policies should focus on preventive measures such as providing protective gear, promoting safe pesticide use, and improving sanitation facilities. Furthermore, increased investment in nutrition programs and mental health resources will enhance the overall well-being of agricultural workers and their families.

A collaborative effort between the government, research institutions, private sector, and international organizations is essential to implement and sustain these initiatives effectively. By prioritizing agricultural workers' health and safety, Pakistan can not only improve productivity and economic stability but also ensure a healthier, more resilient workforce that contributes to the long-term sustainability of the agricultural sector.

Please note that the views expressed in this article are of the author and do not necessarily reflect the views or policies of any organization.

Aima Munal is affiliated with National Institute of Food Science and Technology, University of Agriculture, Faisalabad, Pakistan.

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