Anthropogenic land use in Small Island Developing States (SIDS) drives catchment degradation that transmits sediment, nutrients, pollutants, and pathogens into adjacent reef systems. Currently, conventional monitoring tools are poorly equipped to detect or quantify catchment-derived microbial inputs, which are suspected to increase coral disease risk among inshore reef systems. This not only has implications for environmental health but also feeds back into human consumption and health risks. We use freely available satellite imagery and spatial analysis to characterise land-use change over time and assess catchment-reef connectivity across three sub-catchments in Fiji. This desktop component is complemented by physical ground-truthing and the initiation of direct engagement with participating communities. This research provides an example of how essential ecological and spatial context required for a subsequent ridge-to-reef field sampling program can be developed for low-resource regions, to guide the practical and targeted management of watershed interventions. Findings are expected to inform accessible, community-operable monitoring frameworks supporting place-based catchment-to-reef management across Indo-Pacific and SIDS coastal systems, with longer-term implications for integrated island management and planetary health outcomes.