Tracing the evolution of health policymaking in Saudi Arabia: a qualitative analysis of experts' opinion

Background: A combination of international policy adoption and local implementation strategies has historically shaped health policy development in Saudi Arabia. However, there is limited understanding of the factors driving these policy changes and the challenges encountered during implementation. Objectives: This study aims to explore the state of health policymaking in Saudi Arabia, how it is formulated, and how it has evolved over the years. Methods: This qualitative study used thematic analysis of expert interviews to identify key policy formulation and evolution themes. It analyzed expert insights from 10 semi-structured interviews with policymakers, thematically coded the data, and examined it using NVivo to uncover patterns in health policy evolution. Results: The findings indicate a shift from centralized policymaking to a more collaborative, evidence-based process. Interviewees highlighted various challenges in policy implementation, including a lack of policy governance and an insufficient policy evaluation process. Conclusion: This study underscores the importance of strengthening local policy capacity to reduce dependence on foreign experts and ensure that policies align with national needs. Additionally, establishing a centralized policy repository would improve transparency, while investing in a robust health data infrastructure would bolster evidence-based policymaking and adaptive health reforms.