a (sometimes unstated) pro-poor agenda at external agencies, and the ability of Ministry officials to complement ‘scientific’ evidence with operational and health systems expertise. Among others, the UK Department for International Development and the Swedish development agency (Sida) have used power analyses to inform policy initiatives; however many development programs fail to consider such issues and, we argue, risk squandering their resources.Health policies in particular tend to be more context-specific than other policies, as they involve political, social, economic and cultural considerations (Walt and Gilson 1994)—but while accounting for political and contextual dynamics ‘might seem obvious . . . it is rarely the norm’ (Wild et al. 2015). Researchers and proponents of pro-poor health policies in LMICs should consider placing more attention on understanding individual country contexts, particularly as policies are unlikely to be successfully transferred when they conflict with national power structures