Translating Research for Better Policy: Advice from Dr. Patricia García, Former Minister of Health of Peru
By Justin Kaplan
“It’s not enough to do the research and write your papers.”
Too often, publication of research findings is the final step taken by so-called health practitioners. Their ingenious methodologies, critical results and astute recommendations rest behind journal paywalls, collecting virtual dust and never reaching their intended beneficiary: the public. But this failure to enact does not necessarily mean inaction on the part of researchers. In reality, translating health research into policy can be an incredibly onerous process.
Dr. Patricia García, MD, PhD, MPH, former Minister of Health of Peru and current Menschel Senior Leadership Fellow at the Harvard T.H. Chan School of Public Health, can certainly vouch for this. A leader in global health policy implementation, she draws her expertise from years of experience running research and governmental institutions in Peru, including roles as Dean of the School of Public Health at Cayetano Heredia University (UPCH) and Chief of the Peruvian National Institute of Health.
Put frankly, Dr. García is no stranger to the roadblocks that obstruct the research-to-policy pathway. She’s also no stranger to overcoming them.
Under her oversight, Peru saw the rollout of numerous notable public health policies, including labeling specifications for processed foods, the expansion of electronic health records in Peruvian hospitals, and the country-wide implementation of point-of-care syphilis testing, among many others. But these accomplishments did not happen overnight. Dr. García spent years on the research front lines, diligently building the evidence base for the myriad policies she later spearheaded.
Voices in Leadership was honored to welcome Dr. García on September 6, 2018, for her talk, “Translating Research for Better Policy.” Speaking candidly with Dr. Rifat Atun, Professor of Global Health Systems at the Harvard T.H. Chan School of Public Health, Dr. García discussed the challenges she has faced in her career as a researcher-turned-policymaker, and gave experience-informed advice for addressing them. Below are three key takeaways from this unique event with an implementation expert.
Proceed with Patience
Dr. García was patently clear about the role of patience when crafting policy — it’s a requirement, not a suggestion. She described the translation process as gradual, even natural:
“[D]on’t be impatient. Things take time. It’s like nurturing a little plant. When you put [in] a seed, things will grow, and eventually, you will have what you need.”
But for politicians and others holding elected office, time is a fleeting commodity, and planting seeds is sometimes all that can be accomplished before political turnover. Not to mention, the impacts of health programming can take years — or even decades — to actualize.
“It’s hard,” recalled Dr. García, “because you have to try to do things in such a short time.” For those pressed by the limited duration of office, Dr. García recommended they “try to build the roots for whatever will come next.”
Identify Champions to Create Ownership
On their own, aspiring policymakers (or researchers with big dreams) have little chance of convincing the public and politicians that their health programs are worth funding. However, Dr. García was resolute that with the right “champions” — stakeholders from the community, NGOs and politics who understand, vouch for and upkeep your efforts — garnering support is a much easier task. She suggested searching for policy champions as early as possible:
“[T]ry to create networks, and try to identify what I call the “champions.” And there are champions everywhere… [but] this is not something that you create just when you need it. It’s something that you should be nurturing from the start of your career.”
She added that those developing policy, especially researchers, must aim to create a sense of ownership among champions and the community:
“Funders are always asking you to make everything scalable and sustainable. But for that, you need time. And you need to create ownership. And this ownership — and creating ownership — not only takes time, but [requires you] to identify the right people that could be the ones that are transformed by what you are doing.”
She gave an example from her own experiences, when working on point-of-care syphilis testing in Peru. “From the very beginning,” Dr. García said, her team developed the policy with input from local governmental agencies, physicians and community midwives. The successful implementation attracted attention, and ultimately won an award for good government practices from an NGO. But instead of the recognition going to the research team behind the work, it was the local government that received the honor.
Dr. García said that her “team was really upset” for the snub. However, she had a different reaction — one of joy. “This was our project,” she told her team, “but this was … their achievement.”
Don’t Ignore Corruption — Expose It
Speaking bluntly, Dr. García brought up a hard truth often left undiscussed in public health circles: corruption in healthcare is common.
“One of the main challenges as a Minister has been corruption. Corruption is something that people don’t talk [about]. Researchers and academicians … we don’t talk about corruption. But corruption is something that is quite important. And there is no budget that will be enough to do things if we have corruption behind it.”
She outlined the bold steps her administration took to shed light on financial fraud during her time as Minister of Health:
“[W]e created an open reporting [system] for allegations of corruption, so people could report through email … by phone, or they could send things in writing. And we started a system that was much simpler, so people [would] not feel threatened about telling us the kinds of things that were happening.”
This push for culpability paid off, said Dr. García — over 450 tips were sent in for investigation during her tenure. And her efforts to combat corruption didn’t stop there. In a bid to enhance budget transparency, the Ministry of Health began making their processes as public as possible. When working on medication procurement, for example:
“We put everything in the newspaper, in the radios … it was completely open. And actually, we were able to save 10% of the budget.
While the former Minister of Health acknowledged she was unable to curtail corruption entirely during her tenure (an impossible task, if you ask me), she urged future leaders to consider ways to simplify their bureaucratic processes. “[Where] things are too complicated,” she said, “that’s where corruption can be hiding.”
For Harvard students looking to learn more from Dr. García and other Senior Leadership Fellows, be sure to take advantage of their expert office hours. Who knows — you may become Dr. García’s next champion:
“I learned in my life that every single thing that I did really took me to where I am. And I know that even what I’m doing here at Harvard is going to help me … later on.”
Story by Justin Kaplan, Managing Editor of the Voices in Leadership student blog and a second year student in the Master of Public Health program in Health and Social Behavior at the Harvard T.H. Chan School of Public Health.