‘We cannot just keep it in our palm’ A policy analysis of the integration of the case management of neglected tropical diseases into the health system of Liberia

This study investigates the development and implementation of Liberia’s policy to integrate the case management of neglected tropical diseases (NTDs) into the broader health system. The policy responded to persistent challenges of inequitable access and fragmented services, as outlined in Liberia’s 2016 national strategic plan for integrated NTD case management. Using a qualitative case study approach, the research draws on stakeholder perspectives to explore how integration was pursued and how policy was translated into practice. Guided by the Policy Analysis Triangle, this study examines the dynamics shaping policy development and translation. Triangulation of interview, document, and observational data informed the development of a conceptual framework identifying five interrelated domains—people, place, process, politics, and power—as central to the translation of health policy into practice. These domains were grounded in Liberia’s experience but reflect themes widely discussed in global health policy literature. The resulting framework provides a valuable lens for navigating the complexities of health policy development and translation, particularly for disease programme integration across key health system functions. While anchored in the NTD context in Liberia, the consistency of these themes across diverse settings reinforces the broader relevance and utility of the framework. With appropriate contextual adaptation, it offers practical guidance for policy-makers and implementers working to develop and translate complex health policies into effective and equitable practices. The findings contribute to global health systems thinking by underscoring the need for a shift from narrow, clinically focused policies towards more holistic, inclusive, and system-oriented approaches that reflect real-world complexity and engage diverse stakeholders.