Dr. Cristian Herrera-Public policy informed by evidence: “A challenge that Chile should progress”

The search for knowledge, research as part of daily lives and work to improve health public policies in the country, are permanent challenges in Dr. Cristian Herrera´s life, Head of Health Planning Division of Heath Ministry of Chile.

Surgeon from Pontificie Universidad Católica de Chile and fellow researcher at the Public Heath Department of PUC.

MBA from Universidad de Chile and Master in Public Policy from London School of Economics.

He has extensive experience in health management.

His passion for science, for the construction of a fair and strengthened in matter of health, has led him work hard in knowledge for the use of technical-scientific evidence as the central hub for progress in public policies implementation informed by evidence.

Fundación Politopedia talked with Dr. Herrera about the importance of evidence in health policies for Chile, as well as the relevance for the country to democratize the concept of public policy informed by evidence.

As head of the Health Planning Department, how do you see the use of evidence in health policies and public policies in general for the country?

-In relation with this, there is an important challenge. Nacional evidence could improve much more. We use international evidence, we need to translate to our reality and see if it is applicable. However, there are increasing efforts to have greater national evidence, which will help decision makers found it more familiar.

For example, Fondo Nacional de Investigacion en Salud, has more than 10 years, moreover there is everything it does Conicyt through Fondef, Fondecyt and other funds, which has given us plenty studies. Additionally, we are connected to the Academy, where we ask or work together in researches. Despite this, we still have weaknesses, we must move forward, because is part of being developed, it that is what we want. We need to increase our resources and generate our own knowledge base in our reality.

At the political level. Are information and knowledge management used in legislative process?

-Yes. Many times before researchers were content to do their study and publish in a magazine, but not all had impact in public policy later, so now there is much more of this to push.

On the other hand, there are the policy makers that can apply and demand increasingly more knowledge to take decision based in information by evidence.

This has been increasing, it has been a gradual process that has grown by both sides.

How do you deliver information and make the descent of evidence?

-This is variable. In occasions it goes a summery document that is supported by a more extensive one behind. There are elaborated initiatives in terms of methodology where we take international experience, especially in the field of health technology assessment. There are methodologies to give answer to our questions that are more friendly to the decision maker.

For example, we work with “EVIPNET”, (Health Policy Network informed by evidence), a project from OMS, where the job is generating documents that have useful messages and summarize the evidence in a way that even translate the quality of it, and see where it comes from and what its magnitude.

We had included that type of methodology, even we have a fast track response service where within five to twenty business days the decision makers from different departments of the Ministry can ask and apply for information about the impact of health policies (such as, installing a milk bank in a hospital), so, we proceed within deadline agreed with the applicant to provide a structured and systematic format of informed answer where the decision maker can better target.

Furthermore, other factors and elements are added, but at least scientific evidence comes in a friendly, structured and reliable way.

Based in your experience in management and research, which countries are interesting to look forward in the path of public policy informed evidence?

-Some counties are very supportive from their public system in the generation of evidence and innovation. Canada, Norway, United Kingdom and the United States, most of their R+D comes from public investment, Japan also has a strong investment from the R+D, therefore, is addressed to public needs rather than private.

This is a balance that must be achieved.

Private entities generate research and development for the good of company and the field that interest them, what is right, but on the other hand, we need inversion and innovation in research in areas that are not private interest, rather than public. 

Which guidelines should follow to democratize the concept and came up with evidence to all the people?

-The effort has been to reach decision makers, managements and politicians, but less to the general public, that because documents are in its structure very technical and sometimes difficult to understand for the average citizen, perhaps we stay in the technical side. Also, we do not do effort enough to make research documents available for citizens.

On the other hand, Transparency Law has help us in this point, because people can ask for information, and we are obligated to deliver it, which is healthy for democracy in general and at the same time is healthy for citizens to be better informed and develop more based dialogues and so contribute the best way possible.

 Which are the challenges Chile faces in terms of use of evidence?

-The principal challenge and the one we have less progress is the assessment of public policies.

We have made many policies and some data show we are in a good path, but in general we lacked effort to evaluate and have more security with rigorous and independent evaluations, that can tell us about the results and impact in people´s health policies we had carried out, such as Auge, tabaco policies, among others.

Other big challenge it related to the increasing of the ability to transfer, so the decision makers manage the best way possible all the information that exists. In this we can move on especially now that are times of greater transparency and participation.

 What is your greatest motivation to work as head of health planning?

-As a general objective, strengthening the management knowledge in health area and improve health decision by the government, therefor to improve population´s health. I believe that is the greater objective we have and that we have generated together within the team division and finally, that is the way we can contribute from the DIPLAS to health and welfare of people.

Moreover, we believe it crucial, on one hand for people and on the other, to give the best use to resources, but not only financial, but people working in the area and that can be achieved with better knowledge, which will make our system more sustainable and to have more positive impact in other sides and in people´s life. This is what moves me. In addition, there is inspiration for science, for being into the analysis, generating new ideas, and this is the strongest area of the division. Those of us here is because we like it and it move us.