Table 1

Key challenges to implementation of health and related SDGs

Political commitment
  • Unstable political environment.17 21

  • Policy and planning incoherence and lack of prioritisation.12

Institutional setup
  • Lack of institutional mechanisms for coordination between national and subnational agencies.17 22 23 27

Financial commitment
  • Limited financial resources.12–19 21–24 27

  • High dependence on donor funding/external assistance.15 16 19 21 24 27

  • Inadequate mainstreaming of SDGs in subnational planning and/or budgeting.15 17 22 23

  • Deleterious effect of climate change on economic productivity and human capacity.16

  • High indebtedness to international financial institutions.21

Multisectoral collaboration
  • Inadequate coordination between national and subnational agencies for multisectoral work.17 22 23 27

  • Inadequate empowerment of local governments.12

Stakeholder engagement
  • Lack of clear roles for various stakeholders.16 19 22 24 27

  • Lack of meaningful involvement of stakeholders/lack of coordination with government.16 22 27

  • Limited involvement of civil society and community,15 19 22–24 27 research institutions14–16 19 24 and private sector.15 16 19 24 27

  • Lack of resources to maintain well-structured collaborations, fair representation and managing high expectations.20

Role of development partners
  • Poor coordination between development partners.17

  • Development partner priorities take precedence over government.17

Improving equity
  • Appropriately disaggregated data to monitor access and impact across marginalised and disadvantaged groups.15 23

Capacity development
  • Capacity gaps in SDG costing and budgeting, gender mainstreaming, monitoring evaluation, policy formulation, technical capacity and management of statistical information.12 13 15 17 19 20 23 27

Monitoring and evaluation
  • Poor baseline data.15 27

  • Inadequate data management infrastructure and capacity.15 27

  • Focus on data gathering and management but limited analysis and use.19 27

  • Missing private sector data in national data management systems.27

  • Lack of availability of periodic data to monitor progress frequently.18 19 22 37

  • Data reliability issues.12 19

  • Lack of disaggregated data.12 15 17 21–23 35

  • Disharmony between national and subnational targets.15

  • Inadequate funding for data and monitoring.16

  • Exclusive focus on population survey data and inadequate use of routine administrative data.12

  • Limited technical capacity and infrastructure for data collection and management.20 27

  • Heavy reliance on donors for data collection.12

  • Institutional set up.

  • SDGs, Sustainable Development Goals.