It also highlights the main conclusions reached, arguing that the sustainable rural livelihood approach can play an important role in the elimination of poverty. A farmer who has access to an irrigation facility will be able to make multiple harvests which provide the needed food for the household as well as extra that can be sold as a source of income. Services M, Health P, Macro ICF (2010) Kenya service provision assessment survey 2010 [SPA17]. Conflicts have resulted in breakdown of public health measures, including vaccinations and surveillance ; populations from these regions may miss out on vaccinations necessary to protect them from certain infectious diseases . The two communities described above are exposed to two different environments and will likely be exposed to different animals and insects in their habitats. Changes in land use patterns have led to people encroaching into forest areas bringing individuals into close proximity to wild animals and new pathogens. engaging in activities that will assist in earning income and resources needed by the household. BRAC was also able to train community health workers who served the health needs in their communities. Availability of physical capital boosts productivity and enhances income earned by a household. Natural disasters can lead to poverty due to loss of income and income generating resources. Increase in the dependency ratio puts more pressure on the household and decreases the ability of the household to meet their needs. What influences emergence and re-emergence of diseases? The Sustainable Rural Livelihood Approach was considered to be the most promising of the various options. Natural disasters contribute to emergence and re-emergence of infectious diseases. This paper outlines a framework for analysing sustainable livelihoods, defined here in relation to five key indicators. It Lack of employment and/or loss of livelihood, the impact of HIV/AIDS and other chronic illnesses on a household and lack of income have rendered both men and women vulnerable to poverty. Robert Chambers and Gordon Conway defined sustainable livelihood and I quote; Saving and credit cooperatives and social cash transfer programmes have improved livelihoods but also brought challenges to many. The livelihood of the poor is gruelling as they find themselves in a state of poverty and lack basic necessities . Spontaneous livelihoods; that are taken up due to desperate situations where what an individual does is in principle determined by social economic and ecological situation. the livelihoods approach to evaluate and assess wildlife preservation projects in terms of their impact on the livelihoods of rural people. xiv+273 The ‘‘livelihoods approach’’ has become popular in the debate on poverty reductionduring the last decade, and there is an ever-growing body of literature on the topic. Livelihoods are an important part of human existence . Over 10 million scientific documents at your fingertips. Many people running away from civil wars and/or regional wars have found themselves hiding in the wild and thereafter migrating to neighbouring countries. Lack of infrastructure for education also denies communities the basic education that is needed in order to obtain further skills . The natural disaster may cause changes in the environment which can end up introducing vectors in new areas resulting in emergence of the vector-borne diseases in new areas and potential outbreaks. But there are also cases where a household may have less diversification, that is, only one or two income sources with a strong income base and well-established platforms and are achieving more from their livelihoods. World Dev 38(1):48–63. These bring serious threats to livelihoods with the rural poor being the most affected. Due to variations in ability to access the basic necessities, there are people who are rich, able to acquire all their basic necessities without difficulty and those that are poor, and lack one or more of the their basic necessities. Dependency ratio measures the population of dependants (people younger than 15 and those older than 64) against the productive population (ages 15–64). Cohen CR, Steinfeld RL, Weke E, Bukusi EA, Hatcher AM, Shiboski S, Weiser SD (2015) Shamba Maisha: pilot agricultural intervention for food security and HIV health outcomes in Kenya: design, methods, baseline results and process evaluation of a cluster-randomized controlled trial. BMC Health Serv Res 7:168. This also means that these people are very likely to be exposed to different disease causing agents that are found in their surroundings. Bull World Health Organ 87(11):824–832. Social capital plays a major role in productivity of an individual, organization and community (Ellis 2000 ) . Livelihood diversification is defined as the process by which rural families construct a diverse portfolio of activities and social support capabilities in order to survive and to improve their standards of living. 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