Land degradation and climate change are intertwined global challenges, their implications on human health are driven by the unsustainable use of natural resources, resulting in the loss of vital ecosystem services that support human health. There are equity implications in that landscape degradation disproportionately affects vulnerable populations that live in the most fragile ecosystems. Solutions to reverse degradation are increasingly considered attractive because of their ability to meet multiple societal objectives, however, their implementation has outpaced research on impact; the research and evidence gaps are particularly acute in relation to quantifying the health and well-being impacts of nature-based solutions. This study documents the experiences of rural communities implementing Farmer Managed Natural Regeneration (FMNR) in Central Tanzanian drylands, which integrates trees in agricultural landscapes. FMNR technique has been hailed as the largest positive environmental transformation in African drylands due to its effectiveness in restoring landscapes at very low costs. Despite its success, the impact on human well-being is largely unquantified. We used in-depth group discussions across four villages to document how respondents perceive the health and well-being impacts of natural regeneration. We thereafter adapted the ecosystem services cascade model to conceptualise the pathways between natural regeneration and impact on health and well-being. Respondents across all study sites unanimously reported how FMNR implementation has reversed decades of land degradation, resulting in physical and mental health benefits that can be linked to food and nutritional security, improved air and water quality, income diversification, heat adaptation and gender equality. We demonstrate how the application of the cascade model can generate causal pathways that 1) map how changes in ecosystem structure, functions and services can result in measurable health outcomes, and, 2) support empirical investigation by defining concrete metrics for monitoring and evaluation of interventions.
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