In September 2015, all United Nations Members States jointly committed to The Sustainable Development Goals (SDGs). The 2030 agenda for Sustainable Development,” entails that; “Governments have the primary responsibility for implementation, follow-up and review, at national level, in relation to the progress being made in implementing the goals over the coming thirteen years”. The implementation of SDGs also needs every country to judiciously prioritize, and adapt the goals and targets in accordance with local challenges, capacities and resources available.

The aim of the study was to assess Zambia’s preparedness to implement the sustainable development goals on health A mixed methods design, combining a qualitative Case Study, document review and situation analysis was conducted in August and September 2017. Lusaka district, the capital city of Zambia was purposively selected because most program implementers and policy makers work in the city. Informants from the Ministry of Health were the starting point. Aseries of document review were conducted at national level. The qualitative Case study design was used to map institutional and stakeholders involved in the implementation of the sustainable development goals. Various Program Directors, Managers, Officers from the institutions referred to by MoH were identified using snowball sampling and interviewed for the qualitative approach. Thematic analysis was used to identify emerging key themes. An analytical framework that utilizes the Strengths, Weaknesses, Opportunities as and Threats (SWOT) approach was also used to guide and understand the findings.

We have foud that there are already existing systems and structure in place to facilitate the implementation of the SDGs. Most of the policies and documents being used are also carryovers of the Millennium Development Goals, and are being aligned to specific focus areas. The levels of stakeholder engagement and coordination seem to be in place. However, there seem to be some major challenges regarding Zambia’s preparedness to implement the SDGs on health. Firstly, there is lack of deliberate leadership structures, specifically tasked to steer, monitor and evaluation of the implementation of the SDGs. Secondly, we have found inadequacy in the domestication and prioritization of the specific indicators on selected SDGs in line to the Zambian context. Lastly, a central monitoring and evaluation system and strategy is also lacking.

The realignment of the SDGs efforts towards the existing structures and systems is an indication that there are continued efforts to the implementation of the SDGs on health. Incorporating SDGs into national strategic plans also shows a level of commitment to implementing the SDGs in Zambia. However, aligning SDGs to already existing structures can be uninformed. Further, lack of leadership is a challenge to implementation and tracking of progress towards meeting targets of SDGs on health by 2030. Failure to localize the SDGs to local context is a threat to the success of SDGs.

Additionally, in as much as restructuring in the different ministries such as the Ministry of Health may be beneficial, this still restrains continuity because the knowledge levels among the various civil servants vary largely, with others being completely clueless about the targets for the SDGs. Nevertheless, while the Cluster Advisory Groups (CAGs) are a good initiative for coordination of the activities of SDGs, there is need for a move beyond policy pronouncement to-appropriate action for effective coordination of country efforts to meet the SDGs on health. Setting up a leadership structure that allows the different national coordinating committees to be accountable regarding the manner in which the SDGs are implemented is critical if the SDGs are to be met in 2030. We believe that if this is done, it must be at the highest level of decision making so that accountability is guaranteed.