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Abstract
This paper provides a synopsis of environmental and health impacts arising from agricultural water
development in sub-Saharan Africa and recommends ways to increase the sustainability of
investments in irrigation by giving greater prominence to health and environmental concerns. In
many places in the region, irrigation is a key means of enhancing agricultural productivity that can
reduce poverty and improve livelihoods. However, failure to adequately foresee, plan and manage
the negative environmental and health impacts arising from irrigation undermines the sustainability
of many schemes and can worsen poverty. To improve sustainability, environmental and health
issues must be at the core of future irrigation development with much greater emphasis on the
planning and management of potentially negative impacts. This paper presents a conceptual
framework for considering environmental and health issues in tandem; reviews current environmental
and health assessment tools; describes national and donor policies; and analyzes current constraints
to successful environmental and health planning and management. On the basis of findings, it makes
recommendations to improve planning and management across a range of scales. The
recommendations are of relevance to both water and agricultural planners and are timely, in the
light of recent calls for significant increases in irrigation investment as a contribution to achieving
the Millennium Development Goals.