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Effect of Community-Based Skin Health Assessment on Skin Disease Detection among Farmers in Nigeria

Abstract

Skin diseases are an important occupational and public health concern among farmers in Nigeria due to frequent exposure to sunlight, agricultural chemicals, pesticides, fertilizers, plants, soil, dust, insects, animal products, and other environmental agents. Prolonged exposure to these factors may contribute to occupational dermatitis, fungal infections, bacterial skin infections, allergic reactions, skin irritation, and other dermatological conditions. Many farmers may not seek medical attention for early skin symptoms because of limited awareness, financial constraints, geographical barriers, self-medication practices, and inadequate access to dermatological services. Consequently, skin diseases may remain undetected and untreated, potentially resulting in persistent symptoms, complications, reduced productivity, and impaired quality of life. Community-based skin health assessment provides an opportunity to identify skin abnormalities and possible skin diseases through community outreach programmes, primary healthcare centres, agricultural communities, mobile health services, and other accessible platforms. Early detection may facilitate appropriate clinical assessment, health education, treatment, exposure reduction, and referral to dermatological services where necessary. Against this background, this study investigates the effect of community-based skin health assessment on skin disease detection among farmers in Nigeria. The study will be anchored on Occupational Health Theory, the Health Belief Model, and the Health Systems Framework. Occupational Health Theory emphasizes the prevention, identification, monitoring, and management of occupational hazards and their effects on workers' health. The Health Belief Model explains how farmers' perceptions of susceptibility to skin diseases, perceived severity, perceived benefits of skin health assessment, perceived barriers, and cues to action may influence participation in community-based skin health assessment. The Health Systems Framework emphasizes service delivery, health workforce, health information, medical products and technologies, financing, and accessibility as essential components of effective community-based skin health assessment, referral, and management programmes. Collectively, these theoretical perspectives provide a suitable framework for explaining how community-based skin health assessment may influence skin disease detection among farmers in Nigeria. The study will adopt a quantitative cross-sectional analytical or quasi-experimental research design. The study population will comprise adult farmers aged 18 years and above residing and working in selected agricultural communities across Nigeria. A multistage sampling technique will be used to select states, local government areas, agricultural communities, farming groups, farms, and eligible farmers. Community-based skin health assessment will be measured using indicators such as availability of assessment services, assessment coverage, frequency of community assessment activities, skin examination, assessment of occupational exposures, evaluation of skin symptoms, assessment of pesticide and chemical exposure, availability of trained healthcare personnel, skin health education, use of protective equipment assessment, and referral arrangements. Skin disease detection will be assessed using indicators such as identification of abnormal skin lesions, dermatitis, fungal infections, bacterial skin infections, allergic skin reactions, persistent itching, rashes, occupational skin conditions, newly detected skin diseases, severity of identified skin problems, referrals for further dermatological assessment, clinical confirmation where appropriate, and linkage to appropriate treatment services. Data will be collected using structured questionnaires, skin health assessment forms, community screening registers, healthcare facility records, referral registers, occupational exposure records, and relevant agricultural health programme documents. Descriptive statistics will be used to summarize participants' characteristics, agricultural activities, occupational exposures, assessment coverage, skin findings, and patterns of skin disease detection. Inferential statistical techniques, including chi-square tests, correlation analysis, and logistic or multiple regression analysis, will be used to determine the effect of community-based skin health assessment on skin disease detection. Where appropriate, skin disease detection rates before and after implementation of community-based skin health assessment activities may be compared to determine changes associated with the intervention. Diagnostic tests will also be conducted to assess the reliability, validity, and robustness of the findings. The study is expected to find that community-based skin health assessment has a significant positive effect on skin disease detection among farmers in Nigeria. Farmers who participate in community-based skin health assessment are expected to have a higher likelihood of having previously undetected skin diseases or occupational skin abnormalities identified than farmers without access to such services. Community-based assessment may facilitate early recognition of dermatitis, fungal infections, allergic skin conditions, persistent rashes, occupational skin problems, and other dermatological abnormalities and provide opportunities for appropriate clinical evaluation and treatment. Bringing skin health services closer to agricultural communities may reduce geographical, financial, and time-related barriers and encourage farmers who rarely access specialist healthcare to participate in preventive assessment. Community-based skin health education may also improve awareness of occupational skin hazards, pesticide exposure, sun protection, personal hygiene, protective clothing, and the importance of seeking professional care for persistent skin abnormalities. Early detection may support timely treatment, exposure reduction, and referral to dermatological services where necessary. Conversely, inadequate assessment coverage, shortage of trained healthcare personnel, limited access to dermatological services, financial constraints, low awareness, self-medication, and weak referral and follow-up systems may reduce the effectiveness of community-based skin health assessment. The study therefore expects accessible and well-organized community-based skin health assessment to contribute significantly to improved detection and early management of skin diseases among farmers in Nigeria. The study is expected to contribute to the literature on community-based skin health assessment, skin disease detection, farmers' health, occupational dermatology, occupational health, agricultural workers' health, environmental health, preventive healthcare, community health services, and public health in Nigeria. The findings will provide useful information to the Federal Ministry of Health and Social Welfare, Federal Ministry of Agriculture and Food Security, National Primary Health Care Development Agency, state ministries of health and agriculture, primary healthcare centres, dermatologists, occupational health practitioners, community health workers, agricultural extension workers, farmers' associations, development partners, and policymakers regarding strategies for improving skin health among farmers. The study will also provide evidence-based recommendations for expanding community-based skin health assessment programmes, improving access to trained healthcare and dermatological personnel, strengthening education on agricultural skin hazards, promoting appropriate protective clothing and equipment, improving awareness of pesticide and chemical exposure risks, strengthening referral and follow-up systems, reducing barriers to healthcare access, and integrating skin health assessment into appropriate community-based agricultural and occupational health programmes across Nigeria.

Keywords: Community-based skin health assessment, skin disease detection, farmers, occupational skin disease, agricultural workers, occupational health, dermatological health, preventive healthcare, community health services, skin disease prevention, Nigeria, public health.