Translating evidence into policy: a qualitative exploration of stakeholder insights from India's tuberculosis program.

BACKGROUND: The integration of scientific evidence into health policy is vital for building responsive and equitable health systems. However, translating evidence into policy is particularly challenging in low- and middle-income countries, where contextual, institutional, and operational complexities abound. India's National Tuberculosis Elimination Program, a centrally governed initiative, offers a rich context to examine evidence generation and its use in policymaking. METHODS: an exploratory qualitative study was conducted through 18 interviews with key informants from academia, program management, research, development agencies, and media. Interviews were guided by Jacobson et al.'s Knowledge Translation Framework, and were analyzed thematically using a hybrid inductive-deductive approach with MAXQDA software. Triangulation, member-checking, and reflexivity were employed to ensure analytical rigor and validity. RESULTS: The findings reveal that evidence uptake is influenced by leadership priorities, institutional structures, and alignment with policy windows. While formal platforms such as the National Technical Expert Group and Health Technology Assessment India facilitate evidence appraisal for clinical decisions, non-clinical areas such as communication and strategy lack systematic review processes. A disconnect persists between researchers and implementers, with limited co-creation of research questions. Operationally relevant evidence is often missing or inadequately disseminated, and global models are frequently adopted without sufficient local adaptation, reflecting isomorphic mimicry. The credibility of evidence producers and strategic brokering by intermediaries plays a significant role in determining policy influence. Participants emphasized the need for locally grounded, policy-aligned, and practically useful evidence. CONCLUSION: Improving evidence used in the National Tuberculosis Elimination Program requires co-creation, strategic dissemination, and alignment with institutional priorities, leadership timing, and contextual realities. SPANISH ABSTRACT: https://links.lww.com/IJEBH/A701.