Monitoring Sustainable Development Goals ۳: Assessing the Readiness of Low- and Middle-Income Countries

Background The Millennium Development Goals (MDGs) availed opportunities for scaling up service coverage but called for stringent monitoring and evaluation (M&E) focusing mainly on MDG related programs. The Sustainable Development Goals ۳ (SDGs) and the universal health coverage (UHC) agenda present a broader scope and require more sophisticated M&E systems. We assessed the readiness of low- and middle-income countries to monitor SDG ۳.   Methods Employing mixed methods, we reviewed health sector M&E plans of ۶ countries in the World Health Organization (WHO) Africa Region to assess the challenges to M&E, the indicator selection pattern and the extent of multisectoral collaboration. Qualitative data were analysed using content thematic analysis while quantitative data were analysed using Excel.   Results Challenges to monitoring SDG ۳ include weak institutional capacity; fragmentation of M&E functions; inadequate domestic financing; inadequate data availability, dissemination and utilization of M&E products. The total number of indictors in the reviewed plans varied from ۳۸ for Zimbabwe to ۲۳۵ for Zanzibar. Sixty-nine percent of indicators for the Gambia and ۸۹% for Zanzibar were not classified in any domain in the M&E results chain. Countries lay greater M&E emphasis on service delivery, health systems, maternal and child health as well as communicable diseases with a seeming neglect of the non-communicable diseases (NCDs). Inclusion of SDG ۳ indicators only ranged from ۴۸% for Zanzibar to ۶۷% for Kenya. Although monitoring SDG ۳ calls for multisectoral collaboration, consideration of the role of other sectors in the M&E plans was either absent or limited to the statistical departments.   Conclusion There are common challenges confronting M&E at county-level. Countries have omitted key indicators for monitoring components of the SDG ۳ targets especially those on NCDs and injuries. The role of other sectors in monitoring SDG ۳ targets is not adequately reflected. These could be bottlenecks to tracking progress towards SDG ۳ if not addressed. Beyond providing compendium of indicators to guide countries, we advocate for a more binding minimum set of indicators for all countries to which they may add depending on their context. Ministries of Health (MoHs) should prioritise M&E as an important pillar for health service planning and implementation and not as an add-on activity.

کلیدواژه ها:

Monitoring ، Evaluation ، Sustainable Development Goal ۳ ، Universal Health Coverage ، Low- and Middle-Income Countries