In the last 15 years there has been considerable growth in the amount of – and funding for – health policy and systems research. ¹ However, research addressing health policy decision-making, across all stages of the policy process, has been relatively neglected. ² Here we argue for an increased emphasis on policy in health systems research. We focus specifically on low- and middle-income country contexts where such research has an important role to play in improving health systems and health care delivery.