The development of a health status measure, the Sickness Impact Profile (SIP), is described in terms of both its conceptualization and methodology. The need for a health status measure that is sensitive and appropriate, based on sickness-related behavior, and culturally unbiased, is discussed. A model of sickness behavior is presented as a guide for methodological development. The description of the initial developmental stage of the SIP includeds detailed discussion and documentation of the collection, sorting and grouping of items that comprise the SIP, scaling of the items, scoring of the instrument, and testing and revision of the prototype instrument. Results of preliminary tests of reliability, validity, and administrative feasibility are presented. Subsequent steps in revision and finalization, now under way, are outlined.

Attempts to structurally transform segments of the agri-food system inevitably involve trade-offs between the priorities of actors with different incentives, perspectives and values. Trade-offs are context-specific, reflecting different socio-economic and political realities. We investigate the potential of structured boundary objects to facilitate exposing and reconciling these trade-offs within the context of multistakeholder social learning processes with pastoral and mixed crop-livestock communities in Burkina Faso, Ethiopia and Tanzania. Building on boundary objects as items flexible enough to be understood by all without having one common definition, structured boundary objects visualize actors' input in a comparable format to facilitate knowledge sharing. Stakeholders in each country used a simulation tool and board game to explore the implications of changing livestock stocking and management practices for the environment and for actors' future socio-economic priorities. Using structured boundary objects elicited trade-offs between household food and animal feed, and between livestock for income, labour, and/ or cultural functions, reflecting the context-specific and subjective evaluations actors make when attempting to plan livelihood changes. Our findings suggest to policy and decision-makers that sustainable transition plans can be developed when stakeholders in local agri-food systems employ approaches that allow shared understandings of trade-offs inherent to sustainable agriculture to emerge.

The gap between milk demand and domestic supply in Tanzania is large and projected to widen. Meeting such demand through local production of affordable milk presents an opportunity to improve the welfare of producers and market agents through the income and employment generated along the value chain (VC). Efforts to maximize milk yields, production and profitability need to be balanced with long-term sustainability. We combined environmental and economic ex-ante impact assessments of four intervention scenarios for two production systems in the Tanzanian dairy VC using the CLEANED model and an economic feasibility analysis. Intervention scenarios propose increases in milk production through (i) animal genetic improvement, (ii) improved feed, (iii) improved animal health and (iv) a package combining all interventions. Results show that economically feasible farm-level productivity increases of up to 140% go hand-in-hand with increased resource-use efficiency and up to 50% reduction in greenhouse gas (GHG) emission intensities. Absolute increases in water, land and nitrogen requirements in mixed crop-livestock systems call for careful management of stocks and quality of these resources. An overall rise in GHG emissions is expected, with a maximum of 53% increase associated with an 89% increase in milk supply at VC level. The CLEANED tool proved effective to evaluate livestock interventions that improve incomes and food security with minimal environmental footprint. Here, our simulations suggest that due to current low productivity, the greatest efficiency gains in combination with relatively low increases in total GHG emissions can be made in the extensive agro-pastoral dairy systems, which represent the majority of herds.

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