Developing an Original Framework for Monitoring Progress Towards Health-Related Sustainable Development Goals in Nigerian States

The health-related Sustainable Development Goals require robust sub-national monitoring frameworks that can track progress, identify disparities, and guide evidence-based policy decisions, yet Nigerian states lack standardised frameworks for SDG health monitoring that account for data system limitations, inter-state comparability requirements, and locally defined indicator adaptations. This study developed an original framework for monitoring progress toward health-related SDGs in Nigerian states. A framework development methodology was employed across five phases. Phase one conducted systematic mapping of 28 health-related SDG indicators and their data availability status across all 36 states and FCT through DHIS2, NDHS, vital registration, and NCDC data audit. Phase two analysed monitoring gaps including coverage inadequacy, data quality deficits, and indicator adaptation needs through structured assessments with 36 state health information system officers and six national health data specialists. Phase three synthesised evidence from UN and regional SDG monitoring frameworks applicable to sub-national use. Phase four developed the Nigerian State SDG Health Monitoring Framework (NSSDGHMF) through participatory workshops with 42 state health information system officers and SDG focal persons from all zones. Phase five validated the framework through expert review by 16 health metrics, SDG, and health information systems specialists. The NSSDGHMF covers 22 priority health-related indicators with adapted data sources, quality standards, frequency specifications, and baseline and trajectory calculation methods for Nigerian state contexts. Original contributions include a State SDG Health Progress Index enabling cross-state comparison and a missing data imputation protocol for routine health information system data gaps.