Assessing the effect of a two-day training on understanding and use of pesticide label pictograms and safety information: a cluster randomized controlled trial among Ugandan smallholder farmers

Pesticide labels serve as the primary means of communicating risk information and use instructions to ensure effective pest control and safeguard human and environmental health. However, comprehension and adherence among smallholder farmers in low- and middle-income countries (LMICs) remain low. We used a two-arm cluster randomized trial in 12 Ugandan subcounties to evaluate a two-day training for smallholder farmers. The training targeted comprehension of 13 pesticide pictograms and safety information (active ingredient names, hazard color bands, label instructions, recommended dosage). Data on pictogram comprehension and KAP of safety information were collected from 359 intervention and 180 control farmers at baseline (October 2020) and follow-up (October 2021). Logistic mixed-effects models were used to assess intervention effects. The intervention improved comprehension of seven of the 13 pictograms, including “Wear respirator” (Odds ratio (OR) = 4.8; 95% confidence interval (CI) [1.5, 15.30) and “Dangerous/harmful to fish and waterbodies” (OR = 2.4, 95% CI [1.1, 5.3]). Trained farmers were more likely to check for hazard color bands, and follow the recommended dose. Nonetheless, intervention effects on KAP were modest and pesticide labels were not reported among the main sources of pesticide use information. These findings suggest the need for integrated, behaviorally informed interventions that address barriers to safe pesticide use and for redesigned pesticide labels adapted to local and literacy contexts of LMICs.