In this episode, Alejandro is joined by Dr Pragati Hebbar, dentist, public health researcher, realist evaluator, and Assistant Director at the Institute of Public Health, Bangalore to explore what it looks like to transition from clinical practice into policy, embrace complexity, and use realist approaches to make sense of real-world implementation.Pragati walks us through the journey that led her from treating precancer cases in dentistry to questioning the systemic forces shaping tobacco use in India — andeventually into realist research. She shares how realist evaluation helped her unpack why one national tobacco control programme produces vastly different outcomes across states, and how she combined quantitative proxies, qualitative interviews, and field observations to build and refine programme theories.We talk openly about unlearning linear clinical thinking, navigating contextual variation, realist interviewing, and the challenges of matching policymaker expectations with the nuanced findings that realism often provides. Pragati also highlights the importance of accessible training, communities of practice, and the growing momentum for realist work across India and the Global South.

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“What did the council decide on item 42?” — answered with the speaker and the moment.

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