This interview is part of the initiative “Resonating Voices: Listening to the Voices of Evidence Users in the LAC Region”. The project is a collaborative effort with the LAC Hub acting as the implementer and Overton as the funder. In this conversation, the LAC Hub engages with José Enrique Velasquez from Peru.

José Enrique Velasquez is a medical physician with a master’s degree in Public Health and Clinical Epidemiology. He currently works as a university professor and as the General Director of Monitoring and Evaluation at the Ministry of Development and Social Inclusion (MIDIS) in Peru.

1. What are the priority issues or problems in your organization? 

In 2022, we approved the updated version of the National Policy for Development and Social Inclusion, a policy that gathers 14 sectors and identifies 81 services. This policy has five priority objectives, and we are currently working on three of them, which represent a significant social problem for our country.

The first one is related to food security. We are currently intensifying efforts to implement the most effective interventions to improve food security, especially among the poor and vulnerable populations.

The second issue is related to poverty. We are transitioning from measuring poverty monetarily to a multidimensional approach. Not only because of MIDIS’ own work but also because we believe that combining both measurements can provide a better understanding of poverty among the population.

And the third issue is related to the previous ones, which is childhood anemia. There is a need to improve the outcomes of anemia in children under three years old, particularly focusing on infants under 12 months old, as this is a period of intense neural connections formation.

2. What role has scientific evidence played in addressing these priority problems or issues, and what partnerships or synergies have supported or enabled this process?

I can take the example of the conditional cash transfer program in early childhood.

During the pandemic, there was uncertainty about how the closure of services and the absence of home visits would impact the immediate postnatal population.

We had to conduct an intense search for international evidence because we did not have national evidence to identify whether significant developmental outcomes could be expected in early childhood with a conditional cash transfer program. We found all kinds of evidence, categorized them, and created an evidence matrix.

Thanks to this initiative, we implemented an innovative pilot by adapting an existing program called “Juntos.” We expanded assistance to pregnant women and mothers of newborns, adding services such as screening for anemia, iron supplementation, and access to vaccination, coordinated with the Ministry of Health. By fulfilling these minimum responsibilities, a household transfer was immediately granted.

The evidence supported the design and implementation of the pilot program, facilitating support from the Ministry of Economy and Finance and subsequent approval by an emergency decree from the Ministry of Development and Social Inclusion.

After a year of implementation, the initial evidence was complemented with new data, including an evaluation of malnutrition and access to services for early childhood. These results, together with international and locally generated evidence, supported the proposal to extend and scale the program nationally and in rural and urban sectors.

For this work, we received support from the Inter-American Development Bank, the World Bank, an expert in conditional cash transfers, and academic institutions.

3. What are the main barriers and facilitators you identify for institutionalizing and systematically incorporating evidence into the decision-making process?

Barriers

The time between the political decision required and the technical work necessary to gather the best available evidence. The demand for evidence to make these political decisions can be as short as a week, while technically, it may take months to provide that evidence.

The second barrier is related to budget constraints. We would like to have sufficient budget to conduct all the evaluations and studies required to generate our own evidence, but resources are extremely limited.

The third barrier I would like to highlight is access to quality information sources and resources, which includes access to search engines. While there is increased investment in democratizing evidence, we still face difficulties in accessing certain types of evidence.

A fourth point I would like to highlight as a barrier is the need to always work on maintaining a culture of evidence at the institutional level, one that facilitates alliances with other institutions within the country, not only with academia but also with different organizations from the public and private sectors.

Finally, more of a challenge we have is to disseminate evidence and make it available to different target audiences and ensure they understand the real scope of the evidence. This means translating knowledge for different audiences.

Facilitators

Once evidence is used to make decisions, if a conducive context is maintained, a snowball effect can be generated. So, starting from something small, something increasingly significant can be achieved, generating a minimum culture of decision-making always supported by the best available evidence, and that is something that needs to be emphasized and reinforced.

We have achieved outstanding results by sharing our evidence on the MIDIS portal and involving international researchers in other spaces. These collaborations have allowed us to access new international evidence, strengthening our evaluations and results. Identifying and seizing similar opportunities can lead to more positive outcomes.

4. What advice would you give to researchers and decision-makers who want to improve the impact and use of scientific evidence in policy decisions?

Decision-makers need to understand that their decisions will have greater support, better outcomes (which can also be measured politically) as long as they are evidence-based. Decision-makers are subject to judgments, questioning, and internal control for the decisions they make, but these can clearly be satisfactorily defended if they are evidence-based.

It can also present a different image to the media, positioning them differently.

The needs of decision-makers in the political sphere may differ from those in academia. Therefore, for researchers to ensure that decision-makers use evidence, it is crucial to identify needs in the political sphere.

Researchers, especially in academia, because there are also researchers in other areas, need to understand that politicians have to make quick decisions.

Finally, once the best available evidence has been collected, it is essential to make it available in dissemination and reflection spaces when and with whom it is appropriate.

Interviewee contact: jvelasquez@midis.gob.pe

This interview is part of the initiative “Resonating Voices: Listening to the Voices of Evidence Users in the LAC Region”. The project is a collaborative effort with the LAC Hub acting as the implementer and Overton as the funder. In this conversation, the LAC Hub engages with John Edison from Colombia.

John Edison is a Health Administrator and Lawyer, with a Master’s degree in Epidemiology. Currently, he serves as an Advisor to the Vice Minister of Social Protection at the Ministry of Health and Social Protection of Colombia.

1. What are the priority issues or problems in your organization?

The financial sustainability of the healthcare system is a pressing issue we have been working on. Particularly, issues related to the production of new health technologies. This has been a recurrent issue not only in our system but worldwide, as it has led to a rapid increase in costs in recent years, causing significant concerns about resources.

Another issue is related to the implementation of comprehensive and integrated service networks and primary healthcare strategies, especially involving the primary level of care.

Lastly, the main activity I am currently supporting is the reform project for the General System of Social Security. It is a reform project explicitly led by this Vice Ministry. We are generating everything related to the proposal of this project and all the progress currently being made in the Congress of the Republic.

2. What role has scientific evidence played in addressing these priority problems or issues, and what partnerships or synergies have supported or enabled this process? 

Evidence is crucial. Most of us involved in this reform process come from academia, and every decision and article being worked on and agreed upon is based on the best available evidence.

Regarding primary care strategies, specifically concerning basic health teams and reducing healthcare expenditure, different departments of the Ministry have been conducting literature reviews. Specifically, the Promotion and Prevention (PYP) department has focused exercises on defining which professionals should make up these basic health teams and estimating the expenditure on these strategies, based on what has been done in other healthcare systems. Likewise, literature reviews have focused on the activities that could be carried out in terms of extramural care.

We also create collaborative workspaces to define questions in the PICO (Patient, Intervention, Comparison and Outcome) structure and conduct a literature review. Particularly, an evidence map was created with support from BIREME (Latin American and the Caribbean Center for Information in Health Sciences) and the OPS. This led to a synthesis of evidence that guided the aforementioned expenditure estimation for PHC (Primary Health Care) teams and is now used as support to justify most of the requests made by senators, congressmen, and civil society, who demand this type of evidence.

Regarding partnerships, we have agreements with universities such as the University of Antioquia, the National University, the University of Los Andes, and the Javeriana University.

There are other types of agreements from previous governments, such as the one with Health Metrics to conduct economic burden studies of diseases.

In terms of international cooperation, once again, we have agreements with the OPS, USAID (United States of America Agency for International Development), IOM (International Organization for Migration), and the French Development Agency, among others, which include research centers and evidence-generating institutions.

3. What are the main barriers and facilitators you identify for institutionalizing and systematically incorporating evidence into the decision-making process?

Barriers:

The main barrier is time. Often, we receive requests for evidence within a short period, during which we must gather the best available evidence and support a decision that has been made or is about to be made.

Another barrier is the lack of continuous training or education in terms of new research techniques and strategies.

The definition of competencies and the job manual can also become a barrier, as sometimes the times or the specific profile for carrying out activities related to evidence production and use are not defined.

The current structure of the system, created more than 30 years ago, perhaps was not planned particularly with the urgent and immediate need to include evidence-generating groups within public institutions. This has led many institutions to undergo transformations.

Lastly, the economic resources available to each entity can be a barrier. Budgets are designed for specific functions, and rarely do they include specific functions for matters like evidence review. There is no explicit budget for that, nor are there people dedicated exclusively to it.

Facilitators:

The dynamism and modernization of the state, where we seek to review those functions well, and where we hope that there can be specific functions for supporting evidence use. When institutions have access to the best available evidence, they transform.

Support from international cooperation organizations, agreements developed with study centers, research centers, and institutions dedicated to working with evidence.

The precision of the evidence is a very important facilitator because every administrative act is subject to public scrutiny. In that sense, evidence is a very important supporting and defense mechanism that we have against oversight bodies.

The easy of access to evidence is also an important facilitator. Scientific literature is more accessible than it was a few years ago.

Another facilitator is that we currently have the Ministry of Science, which is also part of the decision-making bodies.

Lastly, thanks to agreements with universities and academic programs, opportunities have been created for certain officials to receive training, generating benefits in terms of capacity building.

4. What advice would you give to researchers and decision-makers who want to improve the impact and use of scientific evidence in policy decisions?

For researchers, the advice is to be very aware of the political reality of the system. Different research topics stem from there to guide decision-making. Often, researchers only focus on the context they can discern in study centers and rarely know the political and contextual reality of the system as a whole. If we manage to get academia into these political scenarios, I believe an important synergy can be generated.

And for those involved in decision-making, the main advice I would give them is that in practical terms, evidence reduces the uncertainty of decisions, and that can contribute to generating accurate public policies that fit the reality of the population. We always have oversight bodies watching and paying attention to the decisions we make, and evidence becomes a probative mechanism to defend the decision made. All of this helps ensure that the success of any decision can better translate into the framework of public policy.

Interviewee contact: edison.betancur@udea.edu.co

This interview is part of the initiative “Resonating Voices: Listening to the Voices of Evidence Users in the LAC Region”. The project is a collaborative effort with the LAC Hub acting as the implementer and Overton as the funder. In this conversation, the LAC Hub engages with Dayana Brunetto, from Brazil.

1. What are the priority issues or problems in your organization?

Working in the new National Secretariat for LGBTQIA+ Rights has been a challenging and rewarding experience at the same time. It is the first secretariat for LGBTQIA+ rights in the world, so it is very much in focus, both due to conservatism and from other parts of the world, for being the first structure in a second level of government to take care of these policies and these people, as well as transforming their lives.

In our secretariat, we face a series of priority issues that directly impact our work, our objectives, and mainly LGBTQIA+ people. One of them is the absence of data or the insufficiency and instability of available data. Although IBGE data addresses sexual orientation, usually it is the head of the family who responds, so if it is a lesphobic father or mother, for example, they will not say that their daughter is lesbian, contributing to an underreporting of this data.

Another priority problem is tackling the powerful effect of hate speech in society, especially regarding the LGBTQIA+ community. The spread of the so-called “gender ideology” has harmed the gender approach by teachers, researchers, leading to the devaluation of research and the persecution of professionals in the field.

2. What role has scientific evidence played in addressing these priority problems or issues, and what partnerships or synergies have supported or enabled this process?

One of our main efforts is the production of stable and reliable data. Together with ANPEd – National Association of Graduate Studies and Research in Education – and other organizations, we created a standard form that can be used by public bodies to collect relevant information about these groups. The form was approved by the National Human Rights for LGBTQIA+ Council, and we are working on a technical note with an opinion sent to all public bodies that collect data, with suggestions for questions, for its implementation. However, we face institutional obstacles and resistance from those who do not share our values and objectives.

In this process, we seek different sources of information and scientific evidence to support our decisions. We also have the support of the National Human Rights Observatory and ReneDH – National Network of Evidence in Human Rights, which was established within the Ministry of Human Rights and Citizenship – MDHC. One of the approaches we have adopted is to work in partnership with specialized consultancies. We believe that these partnerships can fill important gaps and provide us with valuable insights.

A significant example of research conducted by organized social movements is the National LesboCensus, a fundamental academic activist research to establish a concrete government agenda, culminating in the creation of the National Agenda for Combating Lesbofobia and Lesbo-Hate. An inter-ministerial partnership together with the Ministry of Racial Equality, Ministry of Women, and with the Ministry of Indigenous Peoples.

The census revealed impactful data, indicating that eight out of ten lesbians in Brazil have already experienced lesbophobia, with 21,050 responses nationwide. These results have driven debates and actions in areas such as health, education, and public safety. The next phase involves interviews to deepen the quantitative data and political training to promote evidence-informed public policies.

We also established the National Council for LGBTQIA+ Rights, with 38 representations, 19 from the government and 19 from social movements. We believe that public policy needs evidence from social participation, which is who is in the territory. Therefore, we establish a continuous dialogue between the social movement and the government, ensuring that the proposed policies are viable and effective.

3. What are the main barriers and facilitators you identify for institutionalizing and systematically incorporating evidence into the decision-making process?

Barriers

One of the main barriers we face is the effects of hate speech in society. This speech permeates various spaces, including public administration, university, and school, making it more difficult to implement evidence-based policies in this area. This reality is especially painful for those working with human rights, as we confront the denial of the right to equality and respect for human dignity daily.

Another significant challenge is the restricted budget and the lack of consensus on the importance of investing in evidence and research, which impact not only the obtaining of evidence but all our activities. However, even with limited resources, we seek to carry out training and initiatives that promote the fight against transphobia and other forms of discrimination.

The negotiation for data production also ends up being a barrier because we still have a lot of confusion with the main concepts that minimally systematize our subjectivity, as LGBTQIA+ subjects, in addition to our agenda not being agreed upon by a broad front of political actors. Therefore, this theoretical, epistemological, and political confusion adds to the issue of conservatism, which is moralism, which hinders many data collection stages.

Facilitators

Despite these barriers, I recognize that there are opportunities to advance in this process. One of them is strengthening partnerships with social movements, academia, and international organizations, which can provide support and expertise in the production and use of evidence. Additionally, we must seek creative alternatives to institutionalize evidence-informed practices, even in the face of a lack of legislative support.

There is still much work to be done to overcome these barriers and ensure that our policies are informed by solid evidence and directed to the real needs of the population. We believe that, with a collaborative and evidence-informed approach, we can make significant progress in promoting rights and addressing inequalities.

4. What advice would you give to researchers and decision-makers who want to improve the impact and use of scientific evidence in policy decisions?

Regarding researchers, it is important for them to establish effective dialogue with the people and communities affected by the research topic, even if they are not necessarily part of that group. It is not necessary to be a specific subject to research a certain topic, but it is essential to listen to and understand the experiences and perspectives of the people involved. Researchers must be open and receptive to changes and movements in society, adapting and learning from these continuous transformations.

There is also a need for collaboration between researchers and decision-makers at all levels, from federal to local levels, to ensure that policies and decisions are informed by robust and relevant evidence.

As for decision-makers, there needs to be an ethical-political commitment to providing quality services to everyone, regardless of their personal beliefs. Additionally, it is important to provide adequate training for professionals involved in public policies and the need to listen to and consider the evidence and experiences of users of public services to ensure equity. Decisions made should be informed by evidence and respect the human rights of all.

It is of paramount importance not to violate human rights and to consider the profound consequences of discriminatory acts, such as exclusions, offensive jokes, and disdainful looks, which can have serious impacts, including suicide. Therefore, it is crucial to promote and protect human rights in all actions and decisions.

As an advocate of “small revolutions,” I believe in the importance of transforming spaces and groups gradually and constantly. Our Secretariat is committed to leaving a positive legacy, and I firmly believe that investing in evidence and data is fundamental to achieving this goal. It is a challenging journey, but I am determined to move forward, fighting for a more just and equal future.

Interviewee contact: dayana.brunetto@mdh.gov.br

This interview is part of the “Voices of Evidence Users” series, which offers valuable perspectives from people who use evidence in decision making – a collaboration between Hub LAC and On Think Tanks. In this conversation HubLAC interviews Cristian Cofré about the role and regulatory mechanisms for food in Chile related to the scientific evidence.

Cristian Cofré Sasso is a technical advisor at the Ministry of Health of Chile. Expert in Public Health and Nutrition Policies/ Consultant in public policies and regulation in food and nutrition. He is part of the ministerial advisory committees on food taxes, regulation on labeling and alcohol advertising, among others. He is a member of the Advisory Commission of the Food Sanitary Regulation; he is also Co-Coordinator of the National Codex Alimentarius Committee on Food Labeling and Coordinator of the National Codex Committee on Nutrition and Foods for Special Dietary Uses.

1. What are the priority issues or problems in your organization?

There are many questions to be asked because there are so many policies being developed. Specifically in my food and nutrition department, one of the topics that we currently spend the most time on (although not the only one) are those related to regulatory policies. Everything associated with the evidence available on what kind of policies exist in relation to food and nutrition regulation, specifically in aspects related to food labeling and advertising in order to provide information to the consumer.

2. What role has scientific evidence played in addressing these priority problems or issues, and what partnerships or synergies have supported or enabled this process?

There is a work in progress on the regulation of nutritional information in fast food restaurants. Its objective is to know the best location where this nutritional information or labeling should be. The work has been done with a unit of the Ministry of Health, the Evidence Informed Health Policy Unit (UPSIE).

This unit has in turn linked with other actors such as the Catholic University of Chile to develop systematic literature reviews and citizen dialogues.

Precisely in the latter, the literature review and regulatory proposals are socialized in order to have the opinion of citizens and key actors for the implementation of future actions in this regard. This information is processed to generate a report that will support decision making to design the regulatory policy for fast food. In Chile there is a pioneering initiative in the world, the front-of-package labeling, and the objective to replicate this initiative with fast foods. Similarly, we have the National Food and Nutrition Policy, whose lines of action are also based on evidence, these are experiences of evidence-informed policies.

Regarding the frequency of evidence requests, this is not previously defined but depends on the priorities established by the health authority regarding an issue of interest. In the area of nutrition, for example, there is a very relevant issue: the increase of obesity in the child population and in general. This means that the request for evidence for the construction and design of policies to address this health problem has increased in recent years.

3. What are the main challenges and opportunities you identify for institutionalizing and systematically incorporating evidence into the decision-making process?

The main challenges we face are the lack of specialized human resources, those who dedicate the time available for evidence-based decision making. There is a high demand for questions, which implies prioritizing many of them due to the absence of human resources. This process takes time and can lead to delays in the generation of evidence. On the other hand, the chances of finding evidence on innovative public policies are low due to the scarcity of supported information. If it comes to public policy formulation, not only technicians should be involved with the use of evidence; but also decision-makers should be aware that policies need to be informed by evidence. 

On the opportunity side, international organizations encourage the State to produce evidence-informed policies. This is done through organizations such as the UN, WHO/PAHO, FAO and academia, among others.

4. What advice would you give to researchers and decision-makers who want to improve the impact and use of scientific evidence in policy decisions?

The advice to researchers is to show patience for their work to be reflected in public policy. This will depend on many factors and priorities, but if you are patient, it will be achieved anyway. The impact will not be from one month to the next or from one year to the next; the disposition of a policy will take longer than that.Researchers must take advantage of contextual opportunities for evidence-informed policy development. There needs to be a close linkage between research and public policy.

The advice to decision-makers is that their actions will impact on those people who have placed their trust in them; these may be their peers or senior decision-makers, but more important are those people who live in the territory. Decision-makers must follow the principles of effectiveness and efficiency in following evidence-informed policies. These policies should be for the benefit of society and solve the problems that occur. Evidence-informed policies are important for any area, especially in sensitive areas such as health care.

Contact: cristian.cofre@minsal.cl

This interview is part of the “Voices of Evidence Users” series, which offers valuable perspectives from people who use evidence in decision making – a collaboration between Hub LAC and On Think Tanks. In this conversation HubLAC interviews Carlos Castaneda about the role and mechanisms of evidence use and generation in Colombia.

Carlos is an economist from the University of Antioquia, has a master’s degree in economics from the University of Los Andes and a master’s degree in Public and Social Policy from Pompeu Fabra University. He is currently Director of Public Policy Monitoring and Evaluation at DNP – National Planning Department of Colombia.

1. What are the priority issues or problems in your organization? 

The priority issues are the evaluation of strategic programmes linked to the country’s National Development Plan (NDP). Precisely, one of the responsibilities of the National Planning Department (DNP) is to elaborate this plan together with the Ministry of Finance and the other sectors of the National Government.

Precisely, the DNP defined 5 strategic lines and 2 transversal lines on which we believe the country should focus for development in the medium and long term, these lines are: 1) Land management around water with environmental justice: climate change, 2) axis of human security and social justice, 3) human right to food (transformation of the agricultural sector, food production and food security), 4) productive transformation, internationalisation and climate action and 5) regional convergence. All of this is framed within two cross-cutting themes: comprehensive peace and macroeconomic stability. We also work within the framework of the 2030 Agenda of SDGs.

2. What role has scientific evidence played in addressing these priority problems or issues, and what partnerships or synergies have supported or enabled this process?

A concrete example of the use of evidence has been the use of evidence gap maps to identify which actions have worked in the world in relation to the citizen income programs. I mention this because Colombia intends to migrate from conditional cash transfers to unconditional cash strategies. This is one of the ways to make evidence available to decision makers in future programs.

Another example is the “Mi casa ya” programme, a housing programme that subsidised middle and lower-middle class people so that they could obtain housing. We did an impact evaluation about 2 years ago and the results of that evaluation made it possible for the Ministry of Housing to make decisions that allowed the programme to be restructured.

Regarding the types of evidence, these can be different depending on the degree of maturity of the programs. What we do is try to be innovative in the way we provide or transmit evidence to decision makers, sometimes an evidence map is more useful, sometimes an infographic, video among others.

All the evidence we generate is taken to the decision-making bodies, to the councils of ministers and to the medium-term expenditure framework committees, which is where the budget allocated to each sector is defined.

We work in several stages to identify where evidence is needed and we rely, as mentioned above, on the different agencies in the ministries and on consulting firms and national institutions such as Fedesarrollo, Think tanks, the National and Javeriana University of Colombia. We also partner with international agencies such as The Global Evaluation Initiative, University of Berkeley, University of Toronto and professors associated with the University of Chicago.

Regarding the involvement of the citizens’ perspective, we have the citizen perception survey that is conducted every year and we seek to know their perspective on how the evidence and the government’s offer are used. This allows us to monitor the gaps between what the government states. 

Everything we generate is public, citizens can download reports, data, surveys, etc., to replicate exercises, or go deeper into the results. We want citizens to come closer and for the government to participate as well.

3. What are the main challenges and opportunities you identify for institutionalizing and systematically incorporating evidence into the decision-making process?

Among the existing challenges, we find that to develop rigorous evaluations we need more time than we actually have. To accompany this process, we try to have a database in order to perform exercises quickly. In this sense, if there is no academic research, we incorporate faster tools such as machine learning that allows the generation of evidence in a timely manner.

Another challenge is that we have seen that the use of evidence is anecdotal, as there is no systematic measurement of how it is used. We are developing an evaluation use index that will allow us to measure how and when the evidence we are generating is being used. This allows us to see when recommendations are implemented, and how changes are taking place.

On the other hand, there is not always political will among decision-makers; in other words, the guidelines of a program may not require it to be evaluated.

Another major concern is to find the best way to communicate the results of the evidence because the documents are often very large and risk not being read. The evidence is already being displayed on different platforms to attract the general public to get short and eye-catching information.

Among the opportunities, we also have robust tools with the technical quality to inform and make decisions, which we share with countries such as Costa Rica and Peru in order to keep up to date with what is happening in neighboring countries.

And finally, in Colombia we have CONPES 4083 of 2022 for the strengthening of the use and institutionalization of evaluations for decision-making. This gives us the legal framework that obliges us to implement all actions related to evidence and offers an overview of the use of evidence in the country along with improvement actions to consolidate our organization (SINERGIA).

4. What advice would you give to researchers and decision-makers who want to improve the impact and use of scientific evidence in policy decisions?

The advice to researchers in decision making consists of facilitating evaluations so that policy recommendations can be used. It is necessary to use mechanisms to communicate what is most relevant. For example, a matrix for the use of recommendations is advised to encourage the presentation of results in a clear and simple way to experts.

The advice to decision-makers is to better understand what evaluations and different types of evidence are reporting. For example, 90% of decision-makers often claim that what they need is an impact assessment and when we clarify what the assessment consists of, they realize that they do not need this type of evidence but other types of evidence. Decision-makers need to be better informed about the evaluation method that their program requires in order to reach a common agreement with those in charge of the research. Finally, it is necessary to mention the need to establish synergies between researchers and decision-makers to discuss and analyze the different types of evidence.

Contact:

cacastaneda@dnp.gov.co

Welcome to the “Voices of Evidence Users” interview series, offering firsthand insights from the people who use evidence in decision making – a collaboration between the Hub LAC and On Think Tanks.

In this conversation Hub LAC talks to Samara Mariana de Castro, a lawyer with a career in the field of law marked by her work in Electoral and Party Law, Digital Law, Privacy, and Data Protection. 

In 2023, Samara assumed the position of Director of the Department for the Promotion of Freedom of Expression at the new Department of Digital Policies of the Secretariat of Communication of the Presidency of the Republic (SECOM), where she has had the opportunity to pioneer an environment for informing digital public policies in Brazil with the best available evidence. In this interview, she discusses the progress and challenges that she and her team have encountered on this journey.

How would you describe your role and what are the top priorities as the Director of the Department for the Promotion of Freedom of Expression in the Department of Digital Policies?

We’ve been dealing with several challenges. This includes supporting the sustainability of journalism amidst changes in advertising, regulating digital services to combat disinformation, and promoting strong values of freedom of expression in a digital era. 

Additionally, the department operates in a pioneering environment, where many problems still lack available evidence. 

As an unprecedented Secretariat we face the challenge of being part of a Ministry, meaning we don’t have permanent staff. In this regard, we don’t have the institutional memory that other ministries have; we are now creating our own history. 

The previous SECOM was under the Ministry of Communications, and there was no smooth transition in critical areas, so we are redesigning a new structure. Our work today also contrasts with the processes created by the previous government, which operated with a logic of disinformation and distrust towards adversaries and other branches of government, in what became known in the media as the ‘hate cabinet.’ 

Our challenges are not specific to the Brazilian context. These are challenges that democratic governments worldwide are simultaneously facing, as they involve new and emerging issues.

What is the role of evidence in addressing these priorities? How do you cooperate and seek support from research centers and networks within the government and civil society to better inform yourself about the challenges and potential solutions?

Evidence plays a crucial role in decision-making. The government relies on evidence to persuade legislators on regulatory issues, primarily using executive reports containing quantitative and qualitative research. 

The active search for this evidence is done in partnership with civil society organizations, academia, and industry, along with my personal network of contacts and direct channels with the legislative and judicial branches. 

We also seek international experiences, primarily from Latin American and other global contexts, to create institutional advertising policies focused on ensuring a reliable and trustworthy information environment, that does not directly or indirectly finance illegal, dangerous, or misinformative content, while ensuring equality and rights.

To this intent, a new secretariat was created at SECOM, the Secretariat for Analysis, Strategy and Articulation (SEART), designed to support decision-making informed by evidence for digital policies. We can say that we also act as an evidence hub for other ministries, coordinating interministerial actions on specific issues that require our collaboration.

A recent practical example of our team’s work was the creation of a strategic plan to combat misinformation on vaccination. Calls were made to different areas of the government (Ministry of Health, Attorney General of the Union-AGU, Ministry of Justice, Ministry of Management and Information, Ministry of Science and Technology, Ministry of Communications and Comptroller General of the Union), carrying out meetings with each ministry, according to the points that needed to be aligned to achieve integrated work between these spheres. 

Communication tools, even the most informal ones, such as WhatsApp, are being used to disseminate reliable information in a simple and friendly way, easy to understand for public managers with different levels of knowledge in their areas of activity. We also seek to ensure social participation through public surveys and open meetings in decision-making.

What are the main challenges you see in systematically incorporating evidence into the decision-making process?

Some of the main challenges we face include the lack of reliable data and limited access to information from digital platforms. 

What we have is rough data that indicates general trends but does not explain phenomena at the granularity necessary to inform our policies.  

These are contemporary challenges, and there are still information gaps. There are not many successful experiences, and we have to contend with anti-democratic regimes that steer policies in the opposite direction of what we are striving for.

Furthermore, there is a shortage of funding to institutionalise decision support structures. Within the government, I perceive fragmentation and difficulty in organising, curating, and analyzing the vast range of information we receive almost every day.

What advice would you give to researchers and decision-makers looking to improve the use of evidence?

For researchers, it is crucial to build an advocacy network, connecting to organisations that can provide the most relevant information to decision makers in a way that is personalised to their demands. 

It is important to emphasise this: the delivery of evidence must be adapted to the target audience, avoiding standardised reports that do not dialogue with those who need to make decisions based on them.

As for decision makers, it is essential to establish channels  for evidence to reach those who need it and in a timely manner. 

Training is also needed so that evidence can be processed optimally. Translating information to facilitate understanding and action is crucial to ensuring that evidence has influence and impact, especially in a context where misinformation is widely disseminated.

Samara Castro

Email: samara.castro@presidencia.gov.br

LinkedIn: https://www.linkedin.com/in/samaramcastro/

Listening to partners: Caribbean Centre for Health Systems Research and Development (CCHSRD)

Presentation: the Caribbean Centre for Health Systems Research and Development (CCHSRD) is a Research Centre at The University of the West Indies, St. Augustine, Trinidad and Tobago (T&T). The Centre was established in 2018 to pursue a program of work in Health Policy and Systems Research (HPSR), to address pressing policy and system issues faced by decision-makers in the Caribbean region. We engage in several activities within four core functions: Research Execution, Knowledge Translation, Health Human Resource Training and Development, and Citizen Engagement. For this newsletter, we spoke with Kershelle Barker, Junior Fellow, Evidence Synthesis at CCHSRD.

Hub LAC: Tell us a little bit about the Caribbean Centre for Health Systems Research and Development and its research focuses on evidence-informed policy-making.

K.B: With a mission to generate and facilitate the use of research evidence to strengthen health systems and policymaking processes, much of our work focuses on building individual and institutional capacity in evidence-informed policymaking (EIP). To this end, CCHSRD has conducted Needs Assessments with the Ministries of Health; Labour; Planning and Development; Social Development and Family Services; and Sport and Community Development in T&T, to understand their policymaking processes, their use of evidence, and their EIP training needs. Subsequently, we hosted priority setting exercises and EIP capacity building workshops, and provided coaching and mentoring to selected staff as part of two major projects – the WHO Building Institutional Capacity for HPSR and Delivery Science (Knowledge to Policy Centre Mentorship Program) and the Partnership for Evidence and Equity in Responsive Social Systems (PEERSS) project.

Additionally, CCHSRD successfully launched its Evidence to Policy Fellowship Training Programme in 2020, to promote evidence-informed policymaking and practice by building the capacity of policymakers (to use evidence) and researchers (to support the policymaking process).

The Centre has produced / co-produced several knowledge translation products to inform multisectoral policy or programmatic action. These include six (6) Evidence Briefs for Policy and four (4) Rapid Response Briefs on priorities in health (human resources, sexual and reproductive health services, mental health, and service delivery); and other social sectors (labour, education, social welfare, and community development). We have also hosted a stakeholder dissemination meeting and two stakeholder dialogues, and are engaged in follow-up/advocacy activities to encourage uptake of the evidence.

Hub LAC: What specific regional efforts has the CCHSRD undertaken to enhance decision-making in the Caribbean context? Could you provide a few brief examples to illustrate?

K.B: The second cohort of CCHSRD’s Evidence to Policy Fellowship Training Programme was open to decision-makers in the Caribbean. One fellow from Guyana successfully completed the programme, and an Evidence Brief for Policy aimed at improving access, quality and equity in health service delivery in Guyana was produced. This Brief contained local evidence on the problem, as well as proposed policy elements to address the problem, informed by the best available evidence. Though the fellowship programme has since ended, we intend to further engage with stakeholders in Guyana, to provide training and capacity-building in EIP skills and processes.

In 2022, CCHSRD collaborated with the Latin American and Caribbean (LAC) Evidence Hub to host a virtual learning workshop. The objectives were to identify local and regional EIP needs; connect key stakeholders from three Caribbean countries (T&T, Barbados and Jamaica); and generate knowledge about EIP in the LAC region. This workshop provided valuable insights about common barriers and facilitators to EIP in the Caribbean, and the factors needed to build a strong evidence ecosystem.

Also, CCHSRD is home to the Caribbean Community of Practice for Health Policy and Systems Research (CoP4HPSR), which is a network of 135 researchers, health professionals, policymakers, and other stakeholders from 14 countries, who are committed to building HPSR capacity in the Caribbean region. Through information-sharing and frequent discourse on HPSR topics, we aim to continue strengthening decision-makers and researchers’ understanding of the crucial role of evidence in policymaking/decision-making in the Caribbean.

In your opinion, what significant contributions can a regional collaborative Hub make to address the knowledge translation needs in an evidence-informed policy-making ecosystem in our LAC region?

K.B: A regional collaborative Hub is important in fostering a shared understanding of and commitment to utilising evidence in decision-making in LAC. Common challenges we face on a regular basis, which hamper this effort, include a disconnect between research outputs and policymakers’ needs; and a lack of contextualised data and evidence to inform policies, programmes or interventions in-country.

Having a regional body dedicated to filling this gap and generating knowledge translation products and services tailored to the LAC region would result in policymakers/decision-makers being provided with timely, relevant evidence to inform actions that are more likely to: (i) be feasible and make better use of already limited resources; (ii) counteract potential context-specific barriers to implementation; and thus (iii) achieve positive impact, such as improving health and other population outcomes.

Collaboration at the regional level can also help increase decision-makers’ buy-in to the research/evidence-to-policy process, and strengthen relationships between countries, to pool resources and efforts in order to address regional health and social priorities.

Listening to partners: Women in Global Health

Presentation

Starting its journey in 2015 as a Non-Profit Organization, Women in Global Health (WGH) now represents a global movement of action and leadership for gender equity in health. Currently, the organization has 47 chapters in

43 countries, over 5000 members and 100,000 people in some way involved in its activities across more than 100 countries, establishing a broad network of allies in favor of strengthening gender equal leadership in global health. For this newsletter, we spoke with Janessa Oliveira, PhD in Public Health, who currently coordinates the Brazilian chapter of Women in Global Health.

Hub LAC: WGH has actions both in advocacy and as a platform for different initiatives and partnerships. In this sense, could you give us a concrete overview of the initiatives that you develop?

J.O: WGH has been active for eight years through various initiatives to promote gender equality in the health sector. Our advocacy and stakeholder coordination front, dedicated to collaborating with influential organizations in the field proved to be a crucial part of our work. In fact, regional and national chapters are encouraged to seek alliances and contacts to implement actions that generate noticeable change at the local level. Moreover, the organization promotes events for showcasing successful experiences in other countries, so that other chapters can be inspired to lead their own initiatives. A final aspect we consider critical to our work is participation in global events, as a way of encouraging the

representation of women in these spaces, and being actively engaged in debates towards tackling gender inequalities in the health sector.

Hub LAC: What are the main pieces of evidence that support your understanding of the nature and magnitude of challenges to gender equality in health?

J.O: As it stands, we rely chiefly on secondary data provided mainly by the CNES – National Registry of Health Establishments, and we are working on establishing local alliances to gather information and glean a better understanding of the demographic profile of health professionals in Brazil. With regard to investigating pay inequality, we are in contact with professional councils to obtain robust data. Finally, concerning the various forms of violence that can affect the healthcare workforce, the Brazilian chapter is pursuing data gathering via professional councils and by running its own survey. We do realize this is a sensitive topic, so in order to maximize participation in this survey, we have been forming alliances to disseminate the questionnaire across the country and ensure a more representative sample.

Hub LAC: WGH now has an extensive global network, spanning across five continents. How are these initiatives engendered, considering the particularities of each region or even between countries?

J.O: WGH’s leadership accords a lot of value to creating regional and global collaboration mechanisms between the chapters. To this end, several regional Hubs were put in place, where chapters can come together to align priorities, organize joint activities, among other things. There are also monthly global meetings where chapters engage, share their updates and discuss a range of current issues in the field of global health advocacy.

In order to promote the exchange of experiences and ideas, WGH Global also organizes events and activities with the aim of showing how various themes manifest in different regions. An example of this type of activity were the four regional townhalls (assembly-type meetings) on the subject of Sexual Exploitation, Abuse and Harassment (SEAH) in the health sector, to which representatives of governments, NGOs and activists were invited to discuss proposed issues on the topic.

During these events (which were held for the regions of Eastern and Southern Africa, Asia, Latin America and the Caribbean, Francophone Africa), interesting initiatives were presented, expanding the exchange of ideas and experiences between representatives of these sectors in different countries. The Brazilian chapter was one of the co-sponsors of the event for the Americas and Caribbean region. See here the results of the events.

Another initiative we’d like to mention, which is more in line with the new WGH proposal, launched at the end of last year, focuses on Universal Health Coverage. We’ve secured funding for projects along these lines and our first initiative will be to work with podcasts. We believe that podcasts are an excellent tool for disseminating quality content in remote areas where internet coverage is limited, as is the case in the Amazon region. We want to disseminate content that promotes female leadership and improves the quality of healthcare in these areas.