 Our study identified for key stages in the process of establishing a policy support organization, PSO, in the health sector, awareness, development, assessment, and maturation. These stages are interrelated and influenced by political, research, and health systems contextual factors. The contextual factors have an impact on each other and the challenges that arise from one factor can be mitigated by other factors. This article was authored by Sultana Al-Sabahi, Michael G. Wilson, John N. Lavis, and others.