The population of Belize, particularly the poor, remains heavily reliant on the ability to sustainably use streams for livelihoods, sanitation, and water and food security. In southern Belize for example, at least 38 rural Maya communities rely directly on streams for customary foods and medicines, drinking water and/or sanitation. These streams are also of significant biodiversity value which, along with the ecosystem services streams provide, is increasingly threatened by poorly-planned development and agricultural activities2. More than two decades after ratifying the CBD, government, NGO, CBO, private sector and academic freshwater stakeholders continue to vocalise frustration at lacking capacity to monitor, assess and manage the impacts associated with stressors on biodiversity and the social, cultural and economic values placed on streams2. Monitoring tools to manage streams are often underpinned by goals for ecological integrity defined relative to conditions that exclude human-use. These ‘natural’ goals respond to biodiversity protection needs, and can provide a useful indication of the direction of environmental change. However, sole reliance on them and indicators of ecological integrity can fail to capture or reflect the social importance of streams locally, and risk the development of locally illegitimate or ambiguous management decisions, which may ultimately impede the use of streams by those most dependant on them.