There are four major, inter-linked transitions in diseases, demography, development assistance for health and domestic health financing – the “4Ds” of global health transition – the associated challenges of which have been compounded by the COVID-19 pandemic. These transitions are particularly applicable to Sri Lanka, and can complicate the country’s efforts to achieve Universal Health Coverage (UHC). In this context, the study aims to understand how government, donors, and key country stakeholders in the health sector perceive these transition challenges and their impact on the progress towards UHC, where they see the biggest gaps emerging, and what actions can help to address these challenges and gaps.