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.