Introduction: Ethiopia aligns the Sustainable Development Goals (SDGs) with its strategic plans. With only five years remaining until the 2030 SDG deadline, a comprehensive assessment of current performance, emerging gaps, and policy priorities is critical to inform national efforts toward SDG targets. The study aims to assess past trends, project trajectory toward 2030, identify enablers and barriers to achieving SDG3 targets. Objectives: The study aims to assess past trends, project their trajectory toward 2030, identify the main enablers and barriers to achieving SDG3; and predict the likelihood of achieving the 2030 SDG 3 targets Methods: A mixed methods design integrating quantitative, qualitative and scoping reviews was employed. A log-linear and linear regression models were used to estimate progress over the past two decades and project trajectories toward 2030. For the qualitative method, key informant interviews with 156 stakeholders were done and thematic analysis was done using NVivo software. Results and discussion: Between 2000 and 2023, maternal mortality ratio has decreased from 950 to 195 per 100,000 live births with a 6.7% annual rate of decline, neonatal mortality rate was reduced from 48 to 27 per 1,000 live births with a 2.6% annual rate of decline and under five mortality rate was reduced from 140 to 46 with a 5.0% annual rate of decline. Projection with the current rate of change showed that Ethiopia can achieve HIV incidence and contraceptive prevalence in 2030, while nine indicators will be achieved between 2030 and 2050 and the remaining indicators require more than 2050 to be achieved. The review results also informed health systems challenges – leadership and accountability, health workforce density and motivation, community engagement and emergencies– affecting the progress Conclusion and recommendation: Ethiopia has achieved remarkable progress over the past two decades; however, the country is not on track to meet most SDG3 targets by 2030 with the current annual rate of change. The study emphasizes the need for renewed commitment and acceleration of progress over the next five years, focusing on high impact and cost-effective interventions, contextualized to fit into specific geographies and population.

Shegaw Mulu is a public health specialist with over 17 years of experience. He holds an MPH in Reproductive Health and an MSc in Sustainable Regional Health Systems. His expertise centers on health information systems, program monitoring and evaluation, strategy development, health systems strengthening, and primary health care (PHC), with experience ranging from local health facilities to national-level policymaking. Currently, he serves as Director of Monitoring, Evaluation, and Learning for a PHC project at Amref Health Africa, while also working as a Senior Advisor for health information systems and monitoring and evaluation at the Ministry of Health of Ethiopia.