Convergent parallel mixed-methods design in health policy analysis: a worked example from South Africa’s non-communicable disease policies

Despite the growing burden of non-communicable diseases (NCDs) in South Africa, translating policy commitments into effective action remains a major challenge. Understanding this implementation gap requires methodological approaches capable of integrating policy content and process, and implementation realities to generate actionable insights for policy improvement. This article presents a worked example of a convergent parallel mixed-methods design for health policy analysis, combining qualitative document analysis of three purposively selected health policies and a quantitative provincial-level survey of health officials ( n = 57) from seven provinces in South Africa. Analyses were conducted independently and integrated at the interpretation stage to develop and validate policy-improvement strategies through a Delphi process. The design was theoretically anchored in Stages Heuristics and the WHO Analytical Framework for Social Determinants of Health (SDH). The integration of qualitative and quantitative findings identified three overarching policy issues: weaknesses in multistakeholder collaboration across the policy cycle, inadequate attention to SDH, and resource constraints affecting implementation. Convergence was observed in the recognised importance of stakeholder engagement, health system strengthening, and monitoring systems for effective NCD control. Complementarity emerged as policy documents articulated multisectoral, governance, and health system interventions, while officials highlighted practical implementation challenges, including inadequate human resources, financing, infrastructure, and technology. Dissonance was evident between policy commitments to multisectoral action and resource mobilisation and the limited collaboration and resource availability reported during implementation. Convergent parallel mixed-methods design enabled the integration of policy content, stakeholder perspectives, and implementation realities to identify policy gaps and inform validated improvement strategies. The approach offers a practical framework for health policy evaluation and strengthening in complex multisectoral settings.