monitoring sustainable development goals 3: 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 3 (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 3. methods: employing mixed methods, we reviewed health sector m&e plans of 6 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 3 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 38 for zimbabwe to 235 for zanzibar. sixty-nine percent of indicators for the gambia and 89% 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 3 indicators only ranged from 48% for zanzibar to 67% for kenya. although monitoring sdg 3 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 3 targets especially those on ncds and injuries. the role of other sectors in monitoring sdg 3 targets is not adequately reflected. these could be bottlenecks to tracking progress towards sdg 3 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.