Climate Change, Pesticides and Health: Considering the Risks and Opportunities of Adaptation for Zimbabwean Smallholder Cotton Growers

Abstract

There is potential for increased pesticide-related adverse health outcomes in the agricultural sector linked to adaptive increases in pesticide use necessitated, in part, by climate change-related increases in pest populations. To understand the role of adaptation practices in pesticide use and health risks, this study assessed Zimbabwean smallholder cotton farmers’ adaptive responses linked to their climate change perceptions. In depth interviews were conducted with 50 farmers who had been growing cotton for at least 30 years. The study identified farmers’ adaptation practices that increased their pesticide use, as well as those that presented opportunities for reducing pesticide use through non-pesticide-dependent adaptation pathways. The findings show that due to perceived climate change impacts, such as a shorter growing season, farmers were adopting a range of adaptive practices. These included changes in pest management practices, such as increasing pesticide spraying frequencies due to keeping ratoon crops, which were increasing farmers’ overall pesticide use. Such incremental adaptive practices are potentially maladaptive, as they may increase farmers’ pesticide-related health risks. Other practices, however, such as reducing cotton acreage and diversifying crops, resulting in transformational adaptation, suggest the existence of opportunities for decreasing overall pesticide use or totally eliminating pesticides from the farming system.

Full text

International Journal of
Environmental Research
and Public Health
Article
Climate Change, Pesticides and Health: Considering the Risks
and Opportunities of Adaptation for Zimbabwean Smallholder
Cotton Growers
Cliff Zinyemba 1, Emma Archer 2and Hanna-Andrea Rother 1,*


Citation: Zinyemba, C.; Archer, E.;
Rother, H.-A. Climate Change,
Pesticides and Health: Considering
the Risks and Opportunities of
Adaptation for Zimbabwean
Smallholder Cotton Growers. Int. J.
Environ. Res. Public Health 2021,18,
121. https://dx.doi.org/10.3390/
ijerph18010121
Received: 27 November 2020
Accepted: 23 December 2020
Published: 26 December 2020
Publisher’s Note: MDPI stays neu-
tral with regard to jurisdictional claims
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affiliations.
Copyright: © 2020 by the authors. Li-
censeeMDPI, Basel, Switzerland. This
articleis an open accessarticle distributed
under the terms and conditions of the
Creative CommonsAttribution(CC BY)
license(https://creativecommons.org/
licenses/by/4.0/).
1Division of Environmental Health, and Centre for Environmental and Occupational Health Research,
School of Public Health and Family Medicine, University of Cape Town, Observatory, Cape Town 7925,
South Africa; cliff.zinyemba@gmail.com
2Department of Geography, Geoinformatics and Meteorology, University of Pretoria, Private Bag X20,
Hatfield 0028, South Africa; emma.archer@up.ac.za
*Correspondence: andrea.rother@uct.ac.za
Abstract:
There is potential for increased pesticide-related adverse health outcomes in the agricultural
sector linked to adaptive increases in pesticide use necessitated, in part, by climate change-related
increases in pest populations. To understand the role of adaptation practices in pesticide use and
health risks, this study assessed Zimbabwean smallholder cotton farmers’ adaptive responses linked
to their climate change perceptions. In depth interviews were conducted with 50 farmers who had
been growing cotton for at least 30 years. The study identified farmers’ adaptation practices that
increased their pesticide use, as well as those that presented opportunities for reducing pesticide use
through non-pesticide-dependent adaptation pathways. The findings show that due to perceived
climate change impacts, such as a shorter growing season, farmers were adopting a range of adaptive
practices. These included changes in pest management practices, such as increasing pesticide spraying
frequencies due to keeping ratoon crops, which were increasing farmers’ overall pesticide use. Such
incremental adaptive practices are potentially maladaptive, as they may increase farmers’ pesticide-
related health risks. Other practices, however, such as reducing cotton acreage and diversifying
crops, resulting in transformational adaptation, suggest the existence of opportunities for decreasing
overall pesticide use or totally eliminating pesticides from the farming system.
Keywords:
health risks; incremental adaptation; maladaptation; transformational adaptation; pesti-
cides; smallholder farmers; Zimbabwe
1. Introduction
Pesticides are associated with a range of acute and chronic adverse human health
effects that compromise health-related quality of life [
1
,
2
]. Acute effects of pesticide ex-
posure, such as skin irritation, nausea, vomiting, headache, dizziness, and eye irritation,
among other effects, are experienced immediately after exposure, and are often associated
with singular short-term exposures [
3
,
4
]. Chronic effects are associated with long-term
pesticide exposure and can manifest in a range of forms, including carcinogenic, endocrine
disrupting, reproductive, developmental, neurological, immunotoxic and genotoxic ad-
verse health effects [
5
–
8
]. A considerable body of research has demonstrated that varied
factors, including political, economic, social and personal factors interact to jointly impact
pesticide exposure and, thus, related adverse health outcomes [
9
,
10
]. In recent years, the
role of climate change in pesticide health risks has, increasingly, been considered due to
its potential for acting as an additional risk factor in pesticide exposure [
11
]. Evidence,
for example, suggests that climate change-related increases in temperature may lead to
pest population growth for certain species [
12
–
14
]. Warmer temperatures may, in addi-
tion, result in accelerated dissipation of pesticides by the processes of volatilisation and
photodegradation [
15
–
17
]. To cope with these counteracting processes, farmers could
Int. J. Environ. Res. Public Health 2021,18, 121. https://dx.doi.org/10.3390/ijerph18010121 https://www.mdpi.com/journal/ijerph

Int. J. Environ. Res. Public Health 2021,18, 121 2 of 11
resort to increasing the volume and frequency of pesticide applications as an adaptation
mechanism. Adaptation can be defined as the act of taking measures to enhance capacity to
cope with the effects of climate change by, for instance, adjusting or completely changing
practices [
18
–
20
]. However, for farmers to make adaptation decisions, they may have to
perceive climate change impacts on their farming systems. Several studies in different
parts of the world have shown that there is a link between farmers’ perceptions and their
adaptation actions to climate change [21–24].
In this article, we explored pesticide health-related risks and benefits of adaptation
in the pesticide-intensive Zimbabwean smallholder cotton farming sector. In Zimbabwe,
existing research shows that climate change is already altering the country’s natural farm-
ing regions and pest habitat ranges, with potential to impact pesticide use [
25
–
28
]. Study
findings suggest that by the year 2080, the areas climatically suitable for growing cotton
would have significantly increased in the country [
29
]. This could have adverse impli-
cations for farmers’ health as increases in the use of pesticides for adaptation may be
expected. In light of these possible impacts, understanding the health risks associated
with pesticide-dependent approaches and exploring the health benefits associated with
alternative methods would be important for decision making.
2. Theoretical Framing
Decision making theory suggests that farmers tend to adapt to the effects of climate
change by applying an incremental mode of decision making which enhances established
coping solutions [
30
–
32
]. Thus, for farmers who use pesticides, increasing pesticide ap-
plication may be considered a form of incremental adaptation [
31
,
33
]. Characteristically,
incremental adaptation focuses on ensuring continuation of desired crop production sys-
tems as climatic and environmental contexts change [
33
]. An alternative perspective
suggests that adaptation may be transformational, characterised by interventions that
fundamentally change the various components of a crop production system [
19
,
31
,
34
,
35
].
Transformational adaptation by cotton farmers may take a range of forms, including crop
switching and farm system transformation by, for instance, switching to animal husbandry.
When adaptation results in additional risks affecting other systems than initially posed by
climate change, it may be considered to be maladaptation [
36
,
37
]. In the case of pesticide-
based adaptation, the increased use of pesticides may be maladaptive when the potential
for the risk of pesticides exposure and resulting chronic and acute health effects increases.
3. Materials and Methods
3.1. Study Area
The research presented here, conducted from July to December 2015, was centred
on Rushinga district, located in the northwestern part of Zimbabwe, where farmers use
pesticides extensively for cotton production. Rushinga district covers part of the country’s
natural farming region IV, which is hot, dry and sensitive to climate-related deviations
in rainfall and temperatures. In the last population census in 2012, the district had a
population of 74,000 and 17,000 households; while cotton production was the main source
of income for approximately 90% of the households [38,39].
3.2. Data Collection
Ethical approval was granted by the Human Research Ethics Committee of the Uni-
versity of Cape Town’s Faculty of Health Sciences (HREC Ref: 300/2015). In Zimbabwe,
further approval was granted by the Ministry of Health and Child Care’s Epidemiology
and Disease Control Directorate, as well as the Ministry of Home Affairs.
Semi-structured in-depth interviews (Supplementary Materials) were conducted with
50 Rushinga cotton farmers. The farmers were recruited for the study by snowball sampling
when interviewed farmers provided contact information of other farmers meeting the study
criteria [
40
,
41
]. All participating farmers had consistently used pesticides for at least 30
years, a period long enough to make climate change inferences [
42
,
43
]. The selection

Int. J. Environ. Res. Public Health 2021,18, 121 3 of 11
process of participants was previously published [
44
]. Participants were asked about their
perceptions regarding temperature and rainfall, as well as whether they had observed any
changes in the past thirty years. The recorded perceptions were collated and validated
against recent analyses of rainfall and temperature change records by Nyakudya and
Stroosnijder [
45
] and the Ministry of Environment, Water and Climate [
46
]. Thereafter,
farmers were asked about changes in their farming practices being implemented, as ways
of coping with observed changes in rainfall and temperature. Following initial analysis
of farmers’ responses, interviews to confirm and corroborate farmers’ observations and
practices were conducted with key three informants who were agricultural extension
workers in Rushinga district. To ensure validity and reliability, questions regarding specific
events and those seeking exact numerical measures were avoided, since climatic events
may be subject to recall bias, as they may be wrongly remembered or misinterpreted [47].
3.3. Data Analysis
Qualitative data analysis software, NVivo (versions 11 and 12), was used for the
management and coding of all interview transcripts. To understand farmers’ perceptions
regarding climate change and their adaptation strategies, different coding methods were
applied in a four-stage process, starting with structural coding, followed by attribute
coding, descriptive coding and, finally, magnitude coding [
48
]. Structural coding, a first
cycle coding method for the initial categorisation of large amounts of textual data, was used
to code entire interview transcripts for further in-depth analysis within categories [
48
,
49
].
Data were first coded into five literature-derived a priori perceptions data categories
regarding key climate change metrics and observed effects, namely: temperature, rainfall,
growing season, acreage and cropping patterns [
25
,
26
,
29
,
47
] (Table 1). These five were
chosen as they are the most relevant for adaptation for the study farmers.
Table 1. Coding variables used for analysing interview responses.
Questions Structural Codes Descriptive Codes Magnitude Codes
In the past 30 years, have
there been any changes in
temperature?
Temperature Changes in
temperature
characteristics
Increase
No change
Decrease
Have there been any changes
in rainfall in the past
30 years?
Rainfall Changes in rainfall
characteristics
Increase
No change
Decrease
Shorter
Have changes in temperature
and/or rainfall affected your
cotton growing season in any
ways?
Growing season
Changes in growing
season
Longer
No change
Shorter
Have there been any changes
in your cotton acreage in the
past 30 years Acreage Changes in cotton
acreage
Increase
No change
Decrease
Have there been any changes
in your cropping patterns in
the past 30 years?
Cropping patterns
Changes in other
crops grown
Increase
No change
Decrease
Thereafter, all five categories were analysed in more detail using descriptive coding,
which is a topic coding technique that summarises a passage by assigning to it topic words
or phrases [
48
]. Descriptive codes to capture detailed perceptions were developed based on
participant’s statements, which depicted change over time, namely: changes in temperature

Int. J. Environ. Res. Public Health 2021,18, 121 4 of 11
characteristics, changes in rainfall characteristics, changes in growing season, changes in
cotton acreage, and changes in other crops grown (Table 1).
All descriptively coded sections of the transcripts were subjected to further and
more detailed analysis using magnitude coding, a technique which adds a statistical
texture to qualitative data by describing intensity or frequency of a variable of interest [
48
].
Magnitude codes developed illustrated the 50 participants’ perceptions regarding changes
that have happened over the past 30 years concerning rainfall, temperature, cotton growing
season, cotton acreage and cropping patterns. For example, analysing farmers’ responses
to the first question in Table 1regarding temperature change, three coding techniques
in the order of structural (broad), descriptive (narrow) and magnitude (specific) coding
were used. Magnitude coding was used to categorise the responses in the 50 perception
questionnaires to indicate either an increase or a decrease in overall temperature.
4. Results
4.1. Participants’ Demographics
The study participants’ ages ranged from 54 to 73 years. Thirty-six of the 50 interviews
were conducted with male heads of households, who had indicated that it was they who
had actively carried out pest management duties, such as pesticide spraying, on their farms
in the past 30 years. Nine interviews were conducted with female heads of households,
and the remainder (n= 5) were conducted with male–female couples, who indicated that
they had both been equally involved in pest management activities.
4.2. Farmers’ Perceptions Regarding Climate Change
All participating farmers believed that the local climate had changed in some way.
They identified effects in terms of three key climate change metrics of interest, namely:
increase in the average atmospheric temperature (84%), average decline in total rainfall
(54%) and shortening of the growing season (89%) (Table 2).
Table 2.
Participant perceptions in relation to key climate change metrics of interest and adaptive
responses (n= 50).
Structural Codes Descriptive Codes Magnitude Codes Magnitude
Responses n (%)
Temperature Changes in temperature
characteristics
Increase 42 (84%)
No change 08 (16%)
Decrease 00 (0%)
Rainfall Changes in rainfall
characteristics
Increase 01 (2%)
No change 22 (44%)
Decrease 27 (54%)
Growing season
Changes in growing season
Longer 00 (0%)
No change 01 (2%)
Shorter 49 (98%)
4.2.1. Changing Temperature Patterns
Most of the study participants (84%) believed that temperatures in Rushinga had be-
come warmer in the past 30 years. Fifteen percent believed there had been no change, while
none mentioned it becoming cooler (Table 2). Almost three quarters of the participants
who believed temperatures were increasing in Rushinga, indicated that summers were
hotter, characterised by episodes of above average and extremely hot temperatures above
40
0
C. Participants further observed that winters were warmer, in comparison to the early
1980s. Several participant quotes illustrate these perceptions in changes in temperature
over the past 30 years: “Since we have no means of measuring the temperatures, we cannot

Int. J. Environ. Res. Public Health 2021,18, 121 5 of 11
be very sure. However, I believe that the way it is hot nowadays is so different from how it
was in the past” (Participant CZ 08). “Yes, temperatures have changed a lot. It’s now much
hotter than in the past” (Participant TM 04). “There has been a change in temperature. It is
now warmer than in the past. High temperatures used to be associated with the rains, but
nowadays it just gets too hot without any rains falling” (Participant TM 26).
4.2.2. Changing Rainfall Patterns
Fifty-four percent of respondents noted that the overall seasonal amount of rainfall
had declined, while forty-four percent reported no changes in seasonal quantity
(Table 2).
Just one of the farmers reported an increase in seasonal rainfall amounts. There was some
consensus in farmer perceptions that rainfall patterns reflected changes in the annual
variability. Such respondents described rainfall as becoming more sporadic, and reported
droughts as being more frequent. The number of rainy days per year were seen as reducing,
as shown by the following comments: “Yes, there are great changes. We are no longer
receiving any rainfall. During the rainfall season, we can count the number of days that it
rains meaningfully, maybe just three times, the whole season. When the rain goes, it goes
for good. Around March, we are no longer receiving any rains like we used to in the past”
(Participant TM4). “I have only noticed that the way it rains now is different from how it
rained in the past. In the past, by the 24th October we would have already received rainfall
and planted our crops. In the recent years, however, we are looking at around Christmas
time to start receiving our first rains” (Participant CZ4). “Yes, there is a big difference. In
the past we would have rains till March. Nowadays the rains just come all at once, say
starting around the beginning of December, then when it stops raining in February, that
will be it; the end of the rain season” (Participant CZ17).
4.2.3. Shorter Growing Season
Most participants (98%) indicated that the cotton growing season had become shorter,
as compared to 30 years previously (Table 2). Only one participant was of the view that
the length of the growing season had not changed, and none of the farmers believed the
season had become longer. Participants observing a shorter season also described the
growing season as shifting to starting later and ending early. Whereas in the past, the
cotton growing season was six months long, commencing in October and ending in March,
observations by farmers suggest that it has shifted and shortened—with onset in mid-
December, ending towards the end of February or the beginning of March, as illustrated
by the following comments: “Yes, the growing season has changed. In the past, farmers
would have prepared their fields and put some lines in their fields and planted their cotton
around the 15th of October, but these days people are getting way into December before
they have prepared their fields” (Participant CZ1). “The season has changed because the
rains are coming late, and they are leaving us early. So, the season is now very short. In the
past, we had rains from around October till March or April” (Participant CZ4).
4.3. Adaptation Strategies
4.3.1. Incremental Adaptive Changes in Pest Management Practices
As a way of adapting to the shorter season, participating farmers reported a new,
but illegal, practice prevalent in the past 10 to 15 years, of keeping residue crop from the
previous season, called ratoon cotton. Participants indicated that the changing season
played a role in their reluctance to destroy cotton stalks as legally required to reduce
bollworm breeding, as illustrated in the following quotes: “The season has changed. By
now, I should have cut my cotton stalks and already prepared my land. But they are still
standing in the field, and it’s October. The season is now starting very late. Its starting
even on the 15th of December” (Participant CZ8). This was corroborated by one key
informant who is an agricultural extension officer who said the following: “There has
been a big change; pests have increased in their population
. . .
farmers are no longer
cutting and burning their cotton stumps. Those farmers who do not cut and burn them

Int. J. Environ. Res. Public Health 2021,18, 121 6 of 11
end up maintaining their ratoon crops which are pests infested. By the time the rains come,
bollworms and their eggs will already be in the plants” (KI 01). It was also noted that the
frequency with which farmers sprayed their crops in a season had increased compared to
when they started growing cotton in the early 1980s. Some farmers held the opinion that
pesticides were no longer effective in controlling pests.
4.3.2. Transformational Adaptive Changes in Farming Systems
Ninety-two percent of farmers reduced their average cotton acreage from 2.5 hectares
during the 1980s and early 1990s, to just over one hectare at the time of the study, in part
as a way of adapting to climate change (Table 2). These farmers cited low yields due to
poor rains and increasing pest populations, as some of the main reasons responsible for
the reduction in cotton acreage. Other reasons cited included a persistent low market
price that had acted as a disincentive, high input costs and old age, as the following
quotations illustrate: “We have reduced our cotton acreage and increased that of maize
because maize production does not need intensive use of pesticides. We have also increased
our groundnuts acreage because with ground nuts we can make peanut butter and sell”
(Participant CZ 24). “I have considered that in future I should completely stop growing
cotton and concentrate on the other crops. There have been major changes in harvests per
acreage mainly because of the changes in weather conditions. The harvests that we used to
have in the past when we used to receive reliable rainfall are so different from the harvests
we are currently having per hectare” (Participant CZ 25). “Yes, there have been changes. In
the past cotton was doing very well, but nowadays it is not growing well, and there are
now a lot of pests, that is why I am just increasing the acreage of ground nuts and maize”
(Participant TM 23). Only 4% of farmers reported having maintained their acreage, while
another 4% increased their acreage by between half and one hectare, hoping to maintain
the same level of cotton income in the context of falling yields and poor market prices. All
50 farmers reported that they had diversified cash crop types grown on their farms due to
perceived mean annual rainfall variability, the changing growing season and persistent
non-commensurate low cotton revenue. On average, two major crops were grown by
participating farmers during the 1980s and the early 1990s—maize for subsistence and
cotton as a cash crop. Participants reported having increased their average production to
four crops, with the addition of some small grains for subsistence and ground nuts as a
cash crop, starting from the late 1990s.
5. Discussion
Zimbabwean smallholder farmers of Rushinga district were asked about their percep-
tions regarding climate change and, thereafter, how they were adapting to the impacts of
climate change on cotton farming and whether these measures implemented were increas-
ing or reducing the use of, and health risks from pesticides. As already stated, perceptions
regarding climate change serve as a support for implementing adaptation decisions and
actions in smallholder agriculture [
22
,
47
,
50
,
51
]. Farmers’ reported climate change impacts
correlated with the findings in other studies.
Farmers’ perception of warming temperatures was consistent with available climato-
logical evidence for Southern Africa, which shows that the whole region has experienced
an overall increase in temperature over the recent past [
52
,
53
]. Zimbabwe, in particular, has
experienced a slightly higher rate of warming than the regional average, and is expected
to continue with this trend, due to its continental interior location, which makes it prone
to more rapid warming [
46
]. With regard to rainfall, participants’ perceptions seemed to
concur with earlier analyses that suggested a decrease in rainfall [
54
–
58
]. However, more
recent analyses indicate that climate change effects on rainfall are not yet statistically signif-
icant within the available historical rainfall record stretching back to 1920 [
59
]. Nyakudya
and Stroosnijder (2011) analysed Rushinga district’s rainfall data for the period 1980–2009,
and found that the district had not experienced a statistically significant decline in rainfall
amount during that period. They observed high variability for both annual and seasonal

Int. J. Environ. Res. Public Health 2021,18, 121 7 of 11
rainfall totals, however, with high incidence of droughts, which agrees with farmers’ obser-
vations. While farmers perceived that the cropping season was shifting, currently there are
limited published studies that show evidence of shifting growing seasons in Zimbabwe.
A study on farmers’ climate change perceptions carried out in two Zimbabwean districts
by Moyo and colleagues (2012) showed, however, that farmers largely believed that the
rainy season had shifted—starting late, and ending early and abruptly. There are recent
observations of late onset of rains over other places in Southern Africa [
60
], suggesting the
possibility of a regional shift in the growing season.
The perceived changes in all three key climate change metrics of interest were reflected
in farmers’ reasoning for implementing some adaptation strategies. In the study district
of Rushinga, the indication is that perceptions of a shifting season might be triggering
some incremental adaptive responses, shaping overall pesticide use in the district’s cotton
production system. For instance, previously published results highlight that, from the
early 1980s, cotton growers recorded increases in both pest populations and pesticide
use due to, among other factors, farmers’ perceptions regarding climate variability and
change [
44
]. To adapt to the shorter season, farmers increasingly found keeping ratoon
cotton as an attractive strategy. The ratoon crop can be harvested in a shorter time than a
newly planted one, as it is characterised by a well-established root system which enables it
to survive long dry spells [
61
]. Farmers, therefore, found ratoon cotton to be more suited
to a shorter and drier season. Ratoon cotton, however, provides shelter to pests, such as
bollworms, against which farmers use regulated broad-spectrum pyrethroid pesticides,
such as lambda-cyhalothrin, fenvalerate and deltamethrin, much earlier in the season
than is gazetted [
62
]. For instance, in Rushinga, pyrethroids are supposed to be used
between 25 December and 28 February only [
62
,
63
]. However, as bollworms harboured
by the ratoons appear much earlier, farmers spray pyrethroids as early as the beginning
of November—thereby compromising the opportunity for biological insect control [
63
].
Without biological control, farmers become increasingly dependent on pesticides to control
pests. As a climate change adaptive practice, ratoon cropping could significantly increase
the use of pyrethroid pesticides linked to health effects such as neurodevelopmental
disorders, adverse behavioural problems in children after utero exposure, brain tumours,
congenital abnormalities of the male reproductive system, adverse pregnancy outcomes,
among others [64–66].
Intensified pesticide application for adaptation purposes may, as discussed earlier,
temporarily control pest problems but end up being maladaptive—as this practice may
unwittingly result in increased pesticide exposures and associated health risks [
3
,
36
,
37
,
67
].
A limitation of the present study is that data on pesticide exposure were not gathered
and, therefore, conclusions based on the prevalence of pesticide poisoning in the study
area cannot be made. However, several researchers have expressed concern over high
levels of pesticide poisoning in the Zimbabwean smallholder farming sector [
61
,
68
–
70
].
Health risks of particular concern, particularly in the low-and middle-income countries
(LMICs) where pesticide exposures are high, are those associated with highly hazardous
pesticides, such as endocrine disrupting pesticides. These pesticides act by mimicking
hormones, compromising the optimal function of the organs and systems regulated by
affected hormones to result in a range of chronic adverse health effects [
6
,
71
–
73
]. Since
adverse health outcomes associated with endocrine disrupting pesticides may take decades
to appear, even among children of those originally exposed [
74
,
75
], any adaptive measures
influencing pesticide use decisions, potentially affect pesticide-related health risks both
in the short-term and the long-term. There is, thus, a clear and urgent need for the
strengthening and support of alternative less toxic adaption options through government
regulations, including banning of highly hazardous pesticides and continuous training of
extension agents.
In Rushinga, besides farmers following an incremental adaptation pathway, there was
also an inclination towards less toxic adaptation options—for example, reducing average
cotton acreage and growing other crops. These transformational adaptation strategies

Int. J. Environ. Res. Public Health 2021,18, 121 8 of 11
have several socioeconomic benefits, such as improving food security, minimising risks
associated with failure of one crop to reach maturity and increasing yield stability [
22
,
76
,
77
].
Health benefits include reduced pesticide-related health risks as crop diversification pro-
vides farmers an opportunity to grow less pesticide-dependent crops. Thus, contrary to
the expectation that climate change would lead to increases in pesticide use, some transfor-
mational adaptive options appear to create alternative opportunities for reducing pesticide
use. In many LMICs where pesticide-related adverse health outcomes are considered to
be high [
78
], there may be an opportunity for pesticide exposure minimisation that can be
integrated as part of climate change adaptation through transformational adaptation plan-
ning. Smallholder farmers who use pesticides should be encouraged, through agricultural
extension services, to diversify their agricultural ventures to facilitate transformational
adaptation. A move into nonfarm occupations, especially by younger cotton farmers, may
be an important transformational adaptation strategy with potential to result in long-term
health benefits. The health sector can also play an important role through health educa-
tion and promotion activities that equip farmers with knowledge regarding the harms of
adaptive increases in pesticide use and the health benefits of reducing pesticide exposures.
Through education, awareness and relevant policies, smallholder farmers should be able to
implement transformational adaptations that promote health benefits.
6. Conclusions
Perceptions regarding climate change may elicit adaptive responses by smallholder
farmers, which could amplify and perpetuate the use of pesticides with long-term health
risks. There are, however, opportunities for reducing pesticide use, including improved
national policies, strategies and extension support services. These opportunities could
assist farmers in transitioning from growing pesticide intensive crops to those which do not
depend on pesticides, as well as using less-toxic alternatives. Transformational adaptation
planning that promotes alternative crops can maximise health benefits of adaptation
for farmers as well as support agricultural sector resilience, thus allowing farmers to
realize multiple benefits. It is important that pest and pesticide management feature more
prominently in relevant climate change adaptation strategies.
Supplementary Materials:
The following are available online at https://www.mdpi.com/1660- 460
1/18/1/121/s1.
Author Contributions:
Conceptualization, C.Z.; methodology, C.Z., E.A. and H.-A.R.; validation,
E.A. and H.-A.R.; formal analysis, C.Z.; investigation, C.Z; writing—original draft preparation, C.Z.;
writing—review and editing, E.A and H.-A.R.; supervision, E.A. and H.-A.R. All authors have read
and agreed to the published version of the manuscript.
Funding: This research received no external funding.
Institutional Review Board Statement:
The study was conducted according to the guidelines of the
Declaration of Helsinki and approved by the Human Research Ethics Committee of the Faculty of
Health Sciences, University of Cape Town (protocol code - HREC Ref 300/2015).
Informed Consent Statement:
Informed consent was obtained from all subjects involved in the
study.
Data Availability Statement:
The data presented in this study are contained within the article and
Supplementary Materials.
Acknowledgments:
The authors would like to thank all farmers and key informants who took part in
the study for sharing their time, knowledge and opinions. Special thanks to research assistants, Shuvai
Chikombe and Tendai Mahove, as well as our field guide in Rushinga, Makorokoto. The authors
would also like to thank Mary Miller for her valuable input to draft versions. Acknowledgments also
go to the Alliance for Collaboration on Climate and Earth Systems Science, formerly the Applied
Centre for Climate and Earth Systems Science (ACCESS) in South Africa; the South African National
Research Foundation (NRF); and the African Climate and Development Initiative (ACDI) of the
University of Cape Town, South Africa, for a PhD bursary and field research funds awarded to C.Z.

Int. J. Environ. Res. Public Health 2021,18, 121 9 of 11
The authors would also like to acknowledge the Postgraduate Publication Incentive of the University
of Cape Town’s Faculty of Health Sciences which enabled CZ to write this article.
Conflicts of Interest: The authors declare no conflict of interest.
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