The objective of this research is to explore national institutional arrangements for Sustainable Development Goals (SDGs), describe the roles of different stakeholders in SDG implementation, and identify where gaps may lie at national and regional level. This paper analysed initiatives taken by seven South Asian countries towards implementing the health‐related SDGs thus far. The analysis for the paper is based on the findings of a research project on ‘Research Institutions and the Health SDGs: Building Momentum in South Asia’ conducted in seven South Asian countries led by Sustainable Development Policy Institute (SDPI), Pakistan and study conducted by country research teams in Afghanistan, Bangladesh, Bhutan, India, Nepal, Pakistan, and Sri Lanka. The extent to which SDGs have been localized and implemented varies across the South Asian countries. While, Bangladesh and Bhutan have initiated the adoption of SDGs with development plans and programs, others have established national level institutional structures and coordination channels. An overarching concern is inadequate ownership of the SDGs by the sub‐national governments for implementation and coordination. The level of engagement of non‐state stakeholders such as non‐governmental organizations (NGOs), civil society, think tanks, research institutes, academia, and media, however, varies across countries. This engagement ranges from raising awareness, to consultations, membership in committees, and planning and policymaking.

This paper uses the Bhutan Living Standards Survey 2012 to assess factors that affect the decision to use outpatient care when ill, outpatient utilization choice, and bypassing decision. Our attention is placed on geographical factors because of the unique geographical landscape in Bhutan, which may act as an important barrier for access to care in the country. We further analyze the pattern of multiple healthcare visits of individuals with the same health symptom. The methods employed for this study consist of binary logit and multinomial logit regressions as well as descriptive statistical approach. The results show that living in rural area, longer travel time, and residing in remote area reduce the chance of receiving formal care when ill, and among those who get formal treatment, these factors lead to higher tendency of visiting primary healthcare facilities and less propensity of getting care from secondary and tertiary providers. We also find that people with lower economic status have less access to care than their richer counterparts. By investigating the pattern of multiple outpatient visits, our analysis reveals incidence of bypassing primary care to higher level of care in Bhutan. There is also evidence of moving up to higher level of care during subsequent visits but in general people are very persistent in their provider choice.

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