What are the most critical challenges faced by small businesses today?

There just so many problems that plague small businesses, there is no one simple corner to start off with, however, (in no particular order) here are some major points that plague small businesses from a survey a colleague of mine conducted with over 400+ businesses (outside of US). The top 5 results were:

1. Finance & Accounting: Understanding finances (accounting) was the number 1 issues that plagues small businesses. Many businesses look at daily / weekly / monthly sales and monthly expenditure and the difference. They have no idea exactly how much does their Product &/or Services cost and are really worth, and what does it cost them to sell this. What does the $3,000 they have racked up on their credit card really mean for them? Alternate (read: cheaper) forms of financing, refinancing, etc. How much does that inventory on the shelf really cost them? The 30 days credit they give to their suppliers, what does it mean for them? Most small businesses owners have no education in finance or accounting. Not even basic courses to teach them this. They are passionate about what they do, but they rely 100% on their accountants and tax consultants for this (finance/accounting). Understanding finance and accounting for businesses is a must and many don't pay much weightage to this problem.
2. Sales! Sales! Sales! Most small businesses can make do with more sales. Not necessarily volume-wise, but sell those items (or services) that generate more profit for them in the least amount of time (or money) invested. Many businesses are attached to loss making products / services thinking its the umbilical cord for their business. Changing market dynamics, cyclical cycles, etc. are all important factors for businesses to understand with respect to their sales. After Finances, Sales is the second most important factor that small businesses need to understand. How to better price their products with respect to inflation, growth, market competition, their own time, etc.
3. Human Resources: Employing of personnel is another issue. Some businesses unnecessarily employ too many people, others too little, an adequate balance is seldom seen and even if it is seen, the work yields (performance levels) are low. Business owners are reluctant to let go of people (thinking time will sort the down cycles) and when they do let them go, it is too late already. Temporary hiring is one area where not enough attention is paid. Most small businesses owners are so intricately glued to their businesses 365 days a year, that it becomes a major stress for them. Afraid to trust others and afraid of letting it go.
   
4. Learning to say No/Letting Go: From people, to expenses, from clients to the products / services they sell, if something is costing you negatively or not making enough money for you, or is bleeding your books, you need to trim it, cut your losses. Let it go. Small businesses realize this factor the least. If they can save up on office rent by moving a few miles, they keep holding off such a decision (one which could save them money). If they need to close down (stop selling) a certain product / service, they debate it for too long. Procrastination of decisions that needs to be done, cost small business owners in piled up debt, which they could have easily avoided, had they acted upon immediately, as opposed to waiting.
5. Long Term Plan / Business Goals: Most businesses have no clue as to what they will be doing in 5 years as far as numbers are concerned. Most small business owners sigh at the very fact if you ask them would they still be selling the same product/service 5 years down the line? Do they have a plan on how to increase their sales? or how to grow out and expand? Maybe they want to cash out, do they have a plan for it? Many business owners are very myopic when it comes to what their true business goals would be 2, 3, 4, or 5 years down the line. They have no idea. They simply try to extrapolate their current conditions and give you the answer. This would bode well if they are making money, but if they are not, extrapolate that 5 years ahead and they would be in serious debt, if not out-of-business. Small business owners simply do not put much attention &/or effort to business plans. A pulse on what is happening, and how far down the road they are towards achieving their goal. If you honestly, ask them, "What are your 5 year goals?" shrugs and bewilderment are the common replies you will see. With such an obtuse outlook, it is no wonder small business owners are plagued with problems and frustrated by not being able to truly make it and break free, reason being, they have nothing to look forward to (read: goal).