Background Political priority pertains to the agenda setting phase of the policy process whereby an issue emerges as one that draws the attention of and triggers action from high-level decision makers. Few studies have investigated why political priority fails to develop or reemerge for certain public health issues in middle-income countries. In Turkey, road traffic injuries are a major cause of mortality and morbidity. Although, the issue has gained attention in recent years, it has, unfortunately, not received political priority.

Methods Using the Multiple Streams Theory, the process and determinants of why road safety did not become a political priority in Turkey in recent years were explored. A mix-methods case study approach was used. Qualitative data were collected using key informant interviews (N = 27) and document review (N = 91) and analysed using deductive and inductive coding. Quantitative data were collected using an online survey (N = 95) and analysed using descriptive statistics and network nominations. All results were triangulated.

Results In recent years, road safety gained attention in Turkey due to the development of the global and problems streams as well as the presence of actors with personal ties to the Prime Minister. Findings, however, showed that the absence of major crises, an insufficiently favourable political environment, and the presence of a fragmented road safety community prevented the issue from reaching political priority in Turkey. Other barriers included the absence of key actors such as policy entrepreneurs who can champion the cause and strong advocacy-oriented NGOs that can place pressure on the government.

Conclusions Findings from this study can help these actors devise strategies to promote road safety in Turkey or in other similar contexts.