The Global Health Network Annual Report 2019




for Better


Annual Report


The Global Health Network

enables easier, faster, and

better research in the world’s

most challenging settings.


04 Introduction and Executive Summary

06 A Digital Platform for Knowledge Mobilisation in Global Health

11 Building Communities of Practice in Global Health Research

16 The Global Health Training Centre

22 Leadership from the Regions to Drive Capacity for Research

28 Developing Careers and Fostering Team Capabilities

30 Assessing Barriers and Enablers to Research, and Measuring the Impact of the Platform

32 What next? The Strategic Development Plan


Chairman’s View

Professor Pontiano Kaleebu, Chair, The Steering Committee

Almost ten years have passed since this idea was first brought to me

whilst we were sitting under some trees outside a capacity development

meeting we were holding in Entebbe. I’m so delighted to see how this

straightforward idea for health researchers to share what they have

learnt and what they do has flourished in this remarkable way!

We need more research to be led from Africa and the other regions,

and to make this fundamental shift our researchers need to access

information, training, resources AND each other! I am very happy to see

that The Global Health Network is now really the place our teams can

go to and find all they need for running excellent world-class studies.

This platform is filling the gaps and joining up everyone working on

different diseases, in different places and allowing for the sharing of

‘how to’ between them.

I think we need to look forward now and see how we can use this

platform to take research findings into practice and policy, to see how we

can improve, how we do studies and really make evidence generation

part of how we work better to manage, treat and prevent the worst

diseases that cause such devastating mortality in our communities.

I am proud and delighted to chair the steering committee of The Global

Health Network, and I hope you enjoy reading this annual report –

more importantly I hope it encourages YOU to get involved with this,

if you are not already. Please use this platform to share your methods,

tools and knowledge and help make health research faster, easier and

better across the globe.


Professor Pontiano Kaleebu,

Director MRC/UVRI Uganda Unit

Head - Basic Sciences Programme

Introduction and Executive Summary

Professor Trudie Lang, Director, The Global Health Network

Research is critical to solving

the world’s biggest health


Research is critical to solving the world’s

biggest health challenges. The Global Health

Network facilitates the sharing of knowledge,

methods and tools between disease areas,

regions and organisations to amplify research

outputs. Research teams and professionals

are being trained and supported to lead and

undertake health research in the world’s

most challenging settings. This is achieved

by applying the best digital technology and

harnessing the sharing phenomena to enable

the capture of life-saving data. Here we set

out the achievements of the past year to

highlight the impactful work being delivered

by the research groups who are using this

platform for knowledge sharing between

their partners and wider networks.

The Global Health Network has two highly

integrated elements; facilitating Communities

of Practice through The Network Member

Hubs for research consortia to enable

knowledge exchange, and alongside this,

delivering research capacity development

through training, career development and by

providing guidelines, tools and resources. This

is all about tacit learning; sharing the ‘knowhow’

between organisations, roles, diseases

and regions.

This report provides an overview of

the range of knowledge that is being

shared between research teams all

with the aim of driving faster and

better research for better health

across the globe.

The Network Member Hubs are highly

connected open hubs where research consortia

are sharing data, knowledge, methods

and know-how within their programmes

and networks, and also with many others.

These are vibrant, multi-functioned and

personalised spaces where research teams

can work together whilst also sharing what

works to benefit their groups and others.

Groups are disseminating evidence, policies,

guidelines and methods for implementation

of research. This sharing of best practice,

and the tools to implement them, removes

duplication whilst raising standards and

quality. This is achieved because this is crosscutting

and ground-up and so is minimising

bottlenecks and delivering meaningful data

efficiently and to a high quality.

Integrated with these Member Hubs are

numerous mechanisms for delivering

research skills to build sustainable research

capacity. Some of these tools and training

courses guide research consortia on specific

topics within their programmes, to ensure

standardization and quality. The others are

not focusing on any one disease but instead

provide the general skills and knowledge

needed to set up high quality research

studies. Previous capacity building efforts

have focused on one disease or one protocol.

However, the elements researchers find

difficult do not differ between disease or even

the type of study. Therefore, solving the gaps

in skills and information to address this leaves

sustainable and adaptable capacity that can

last beyond a single study. The Global Health

Training Centre provides specifically designed

training courses delivering research skills and

know-how to healthcare workers.


Summary of The Global Health Network’s impact:

15 million

visits to


free online training courses taken by healthcare

workers across the globe

Another key barrier to research leadership in

low- and middle-income countries (LMICs)

is the ability for the whole research team

to develop careers and to be recognized

for their contribution to studies. To address

this, the WHO/TDR partnership Professional

Development Scheme for all roles of

research staff was set-up. Here, this scheme

is measuring research competencies to

show and track capacity development, and

this is working for individuals and also for

organisations and research platforms.

Working from, within and between global

regions is fundamental to The Global Health

Network and there are numerous countryled

initiatives that are increasing research

engagement, and providing practical support

and training. This local leadership and regional

ownership is aiming to empower healthcare

professionals in the world’s most vulnerable

regions to undertake locally led research.

Making Research Easier,

Faster and Better

Tens of thousands of research methods, protocols

and template documents downloaded, adapted

and used – making research vastly easier, faster

and better in the world’s poorest areas.

Disseminating Methods,

Tools and Know-How

Large research consortia and organisations such

as the World Health Organization (WHO) are using

The Network to disseminate their research outputs,

methods, tools and know-how.


A Digital Platform for Knowledge

Mobilisation in Global Health

The Platform Overview

The Global Health

Network as a platform

has evolved since its

conception, through

to the flourishing

community space it is

today, by providing a

number of useful tools

and resources tailored

to support community

interaction. Each

Member Hub is set up

for each partner to give

them their own highly

specific online working

space. Thus providing

high specification web

technology that gives

research consortia

highly affordable

and attainable

access to their own

bespoke mechanism

for sharing their

documents, processes

and repositories of

information. The aim

is to make information

discoverable through

tagging and linking

which gives prominence

to information that is

needed by researchers

in each specific field.

Some of the features

available include:

●●Dynamic homepages of curated and

automated content, social media feeds

and image reels

●●Standard pages of web content including

formatted text, images, video and maps

●●Community building tools including

member profiles, blogs, articles, social

bookmarking, and closed and open

discussion working group spaces

Member Hubs can also take advantage of

a number of cross-cutting tools, to provide

essential capacity development and support

for health researchers including:

●●SiteFinder – matching service for research

platforms to find suitable study partners

●●Process Map – step-by-step guidance

for planning a successful health research


●●The Global Health Training Centre –

encompassing high quality eLearning

and online training and a Professional

Development Scheme to build a

professional CV and track professional skills

training over a researcher’s career.

The downloadable tools and templates are

very resourceful. Also eLearning short-courses

are vital in getting knowledge and updates.

This should be encouraged to enable my entire

medical team to benefit”

Laboratory Staff Member, Kenya


A typical user’s journey

through The Global Health

Network and the tools

available, free to all health

researchers anywhere


By sharing resources, training teams,

and developing careers to drive more

and better evidence and translating

this into changes in practice that

improve health


Connect your study

or research site with

potential collaborators


Digital Platform for Knowledge Mobilisation

“I downloaded some microbiology standard

operating procedures which I found useful

indeed, furthermore I completed GCP,

GCLP, Introduction to Clinical Research and

Reviewing Genomic Data from Global Health

Field Worker, Uganda



Join The Network to create

a profile and connect with

other health researchers


Join a number of Member Hubs and find

out more about specialty research areas,

take part in discussions, post blogs and

submit articles

uExchanging methods,

tools, know-how and

outputs between

diseases, regions,

research areas and



Take part in eLearning and gain

certificates on successful completion



Sign up to the Professional Development Scheme -

build your research profile and track your professional

development over time


Use the Global Health Research Process

Map to plan your study


Platform Usage and Access


New members in 2018

The Global Health

Network platform

continues to experience

strong growth with

its user base and

readership year on

year. During this review

period almost 60,000

new memberships

were registered, adding

just fewer than 5,000

new members per

month. This drives

capacity development

in research and also

enriches the platform

with members’ input

from discussions and

article submissions

through to queries and

feedback concerning

the platform and tools


From the platform’s feedback survey for this

review period, more than 68% of visitors

specified that they come to the platform from

real-world recommendations – either by a

friend, colleague or at an organisational level.

Just under 25% reported hearing about the

platform via referrals, search or article links. This

shows very well how resources are passed on

to physical networks by word of mouth and

also highlights a useful area to focus on – better

use of search engine optimisation and digital





Link from









Other 12

Recommended by a

friend, colleague or




Digital Platform for Knowledge Mobilisation


Digital Development

The Global Health Network platform uses

cutting-edge, digital technology to drive

dissemination, visibility and engagement.

The digital platform is built on an open source

development framework called Django, which

is a high-level Python Web framework that

encourages rapid development and clean,

pragmatic design. This allows The Global

Health Network to benefit from Django’s many

advantages including high levels of security

and scalability, as well as leveraging a large

community of developers from across the

globe investing time in continuous long-term

development and support. It is used by many

global organisations and industry leaders in

business including some of the most widely

used social media networking platforms.

The platform also benefits from a number of

popular widely used plugins and third-party

software that enrich our users’ experience and

provide better access to great quality global

health research information.

Looking forward, The Network continues to grow and with that

growth comes new opportunities to expand on the proven concept

of the platform. The up-coming development roadmap will look to

cover some key items such as:

●●Developing a new look and feel for the platform to allow easier

navigation of content

●●Enhance the eLearning platform with new course structures, navigation

and dashboards providing a richer learning environment

●●Further develop the Professional Development Scheme to allow more

access to research groups from low- and middle-income countries (LMICs)

and implement better team reporting to research consortia wishing to track

their team’s development through projects and their research cycle

●●Continue to expand the number and breadth of Member Hubs and


●●Develop the existing Process Map tool and create custom maps

applicable for different research areas

Furthermore, The Network has set out to

make finding resources on the platform easier,

smarter and faster. The implementation of

a smart search and suggestion functionality

within the platform will be investigated so

that each user, from the moment they first

visit and complete their profile through to

active engagement on The Network, is able

to see the most relevant content that meets

their training and development needs. This

will create a smarter learning and capacity

development environment that successfully

meets the needs of healthcare workers across

the world to conduct high quality research. The

potential to utilise cloud services and associated

tooling, such as the intelligent search feature,

will also strengthen The Network’s capabilities

and future-proof the scaling-up of the platform,

providing an exciting prospect of collaboration

with technology partners in industry.

Finding new and novel ways to reach ‘nobandwidth’

areas or areas of extremely poor

connectivity is an area of great potential

for solutions such as implementing offline

apps and the production of a ‘platform on a

stick’ offline version of The Network. Piloting

such approaches in the field will provide an

opportunity to road test these concepts and

build tools that will better assist individuals

and teams in remote locations to conduct high

quality research.

In order to help broaden and strengthen

ownership of The Network and encourage

local champions, more multilingual content via

online tools and downloadable resources will

be made available through the platform. This

will improve accessibility of content to local

healthcare workers and researchers, widening

The Network’s reach.



Jan – Feb


Building Communities of Practice

Building Communities of Practice

in Global Health Research

A Community of Practice is a group of

practitioners (thus specialists in their fields)

who come together to share experiences and

knowledge, solve a shared problem, promote

best practice and develop professional skills. 1

The Global Health

Network has been

conceptualized and

implemented based

on the concept of

Communities of

Practice 1 , aiming at

creating an open,

trusted and neutral

platform to help

facilitate and promote

interactions and

knowledge sharing

between healthcare


researchers and

research consortia.

The innovative application of the Communities

of Practice concept to the field of global health

research and the use of cutting-edge digital

technology to build and link these online

communities has made The Global Health

Network platform a unique and valuable portal

for knowledge exchange. This highly interactive

digital ecosystem, with its many discussion

forums, blog posts and groups, has facilitated

the interaction between a multi-disciplinary

audience of users – coming from 195 countries

– and leveraged the sharing of practical

experience between healthcare professionals,

creating a self-sustaining platform whereby

each user contribution has helped to increase

the platform’s knowledge capital, and advance

the research processes across the regions.

Over the past 12 months, The Network has

become the “science park” for 36 research

consortia who have set up a Community of

Practice and has grown by 34% in comparison

to previous years. The Network received 5

million visits, adding to an historical 15 million

visits since its implementation in 2011.

Jun – Jul


Nov – Dec

15 Million

Frequency of visits to the

The Global Health Network – 2018

1 Wenger, E.C. and W.M. Snyder, Communities of Practice: The Organizational Frontier. Harvard Business Review, 2000. 78(1): p. 139-145.


Linking the

Member Hubs

into Functional



In membership terms, The Network has

experienced a soaring 44% increase in registered

members to its many Member Hubs with 60,000

members joining the platform in 2018, and adding

to a pool of 135,000 registered members. The most

popular communities were those where users

could have rapid and facilitated access to training

materials, and other downloadable resources such

as guidelines and protocols for health research

implementation (see table below).

The interconnected structure of the platform

has contributed to the development of fully

functional, independent and self-organising

Communities of Practice around seven

complimentary thematic areas, namely: social

sciences, ethics and community engagement;

maternal health/mother and child research;

laboratory, vectors and diagnostics; research

consortia and networks; non-communicable

diseases; research planning and methods; and

infection, immunity and resistance (see panel far

right). These thematic areas are non-exclusive

and borrow knowledge from each other and from

other hubs. This is beneficial to each Member Hub

as they will always host additional content from

other scientific areas, as well as beneficial to the

members that can access a very complete suite

of resources from within a single Member Hub.

Top-10 Member Hubs hosted on The Global Health Network in 2018.

*Cumulative non-exclusive memberships until December 2018.

Member Hub Historical Historical Memberships Webplatform

Views Sessions Ranking

Global Health Training Centre 10,414,330 774,225 104,507 1

Global Health Trials 1,969,404 535,855 24,855 2

INTERGROWTH-21 st 398,529 130,343 1,981 3

The Global Health Network 298,527 154,420 - 4

(landing page)

Research Nurses 129,343 38,790 2,905 5

SiteFinder 115,975 35,215 2,418 6

ISARIC 105,809 36,027 1,266 7

Bioethics Research Review 85,956 32,509 11,203 8

Laboratories 81,226 33,449 3,906 9

Mesh 77,041 26,850 1,277 10


Building Communities of Practice

Member Hubs Hosted

on The Global Health

Network in 2018

Member Hub Name

Thematic Area

A good example here is the Mesh Member

Hub, where a user can access various resources

around community engagement on health

research in low- and middle- income countries

(LMICs), whilst learning about the application

of ethics on health research implementation,

taking training on fundraising in ethics and

social sciences research, and furthering

their understanding on engagement around

epidemic response and preparedness. The

interconnectivity and complementary nature

of these hubs expose the members to a

much richer and multidisciplinary knowledge

environment, and contribute to more complete

capacity development in health research.


Research Consortia and Networks

Bioethics Research Review Social Science, Ethics and Communities

Brain Infections Global Research Consortia and Networks

Childhood Acute Illness and Research Consortia and Networks

Nutrition Network (CHAIN)


Research Consortia and Networks


Research Consortia and Networks

Data management Research Planning and Methods


Laboratory, Vectors and Diagnostics


Laboratory, Vectors and Diagnostics

EDCTP Knowledge Hub Research Planning and Methods

Elsi 2.0

Research Consortia and Networks


Research Consortia and Networks


Non-Communicable Disease

Global Birth Defects Mother and Child

Human Infection Studies Infection, Immunity and Resistance

INTERGROWTH-21 st Mother and Child


Research Consortia and Networks


Laboratory, Vectors and Diagnostics


Research Consortia and Networks

Mother Child Research Mother and Child


Non-Communicable Disease

Research Nurses

Research Consortia and Networks

Pharmacovigilance Laboratory, Vectors and Diagnostics


Mother and Child

Pregnancy CoLab

Mother and Child


Research Consortia and Networks

Research Methods Research Planning and Methods

Social Science

Social Science, Ethics and Communities

TDR Fellows

Research Consortia and Networks


Social Science, Ethics and Communities

Global Health Trials Laboratory, Vectors and Diagnostics


Research Consortia and Networks


Research Consortia and Networks

Zika Infection

Infection, Immunity and Resistance


Research Consortia and Networks


Research Consortia and Networks


Harnessing Online Resources

and Interactions to Promote

Change in Health Research

There have been

some extraordinary

examples of how the

interactive nature

of The Global Health

Network platform

has contributed

to advancing and

developing health

research capacity across

the regions.

A remarkable example came from Nigeria

during the latest Lassa fever outbreak in

early 2018. Dr Glory Ogunfowokan, Regional

Faculty Lead, used the blog post facility on the

Global Health Trials Member Hub to identify,

organise and coordinate a response team of

Nigerian healthcare professionals to fight the

outbreak. His initiative triggered an interesting

discussion session with the participation of

many healthcare professionals, including

a major funder contribution and offer to

support research capacity and work. Such

an example illustrates the power of these

forums to harness local leadership and

promote change-making collaborations that

otherwise would be challenging to manifest.

Another example is the use of The Global

Health Training Centre to support training

and knowledge standardisation prior to

the implementation of a study led by the

“Pregnancy Care Integrating translational

Science, Everywhere” (PRECISE) team on

pre-eclampsia and placenta displacement.

“Working with The Global Health Network has been a fantastic

opportunity to increase opportunities for developing the skills

and capacity of staff across The PRECISE Network through the

Professional Development Scheme and eLearning. We have had

fantastic feedback from our teams in Africa about these aspects

of The Global Health Network as well as using the private area

for uploading study protocols and operating procedures that can

be quickly and easily accessed by those working in the field. We

have only been members since October 2018 and are excited to

work with The Global Health Network to continue maximising the

potential of this brilliant platform for our network.”

Dr Meriel Flint-O’Kane

PRECISE Community Programme Manager


Building Communities of Practice

“Mesh now reaches an average of two or three thousand visits each month. This

is in large part due to its position embedded within the larger community of The

Global Health Network, enabling us to share resources with thousands of researchers

we would not otherwise reach, and the support of The Global Health Network team

in enhancing our social media presence and platform traffic. Being part of a greater

whole also enables us to collaborate with other disciplines and provide tools to enhance

research, for example, developing a specialist area on engagement and epidemics

to support The Global Health Network member hubs that focus on epidemic

preparedness and response.

A key example of where The Global Health Network team has added value to Mesh this

year is during a consultation we ran on a working document being produced by UNICEF.

The communications and operations teams at The Global Health Network advised us on

how to get this out to a wide audience and facilitated its sharing on other Member Hubs.

We also received personalised advice and feedback on how best to present and share a

new area of the platform making it more user friendly; an example of the value of their

web communications expertise. The Global Health Network team also provide support

on how we and our partners can develop high quality and widely used eLearning in the

future. Taken together, all this support means we can run Mesh effectively and enable

it to continually develop, building on the learning that The Global Health Network team

are uniquely situated to gather and share due to their helicopter view of the Member

Hubs, and building on their challenges and successes.”

Natalie Hunter

Mesh Coordinator, Wellcome


The Global Health

Training Centre

The Training Centre is extremely popular and is the

most accessed area of the whole platform, with a total of

over 10.5 million page views from over 785,000 sessions.

Individuals from 195 countries across the globe have

utilised The Training Centre.

The Global Health Network continues to operate

a free and open access Training Centre that

provides research staff and healthcare workers

of all roles, all regions and all disease areas

with the ‘how-to’ training materials, resources,

seminars, and toolkits required to safely conduct

high quality research in resource-limited

settings. The Training Centre is extremely

popular and is the most accessed area of the

whole platform, with a total of over 10.5 million

page views from over 785,000 sessions. In

2018, The Training Centre saw a 60% increase

in traffic with Africa still the continent accessing

it the most, with 31% of the overall traffic.

Individuals from 195 countries across the globe

have utilised The Training Centre.

Each course is developed from material donated

by respected organisations and institutions

such as the World Health Organization, the

Multi Regional Clinical Trials Center at Harvard

University, Nuffield Council of Bioethics, the

Geneva Foundation for Medical Education and

Research, and many more. All courses are peer

reviewed before launch, reviewed periodically

and accessible in slow-speed internet areas.

The online training courses continue to be

hugely popular with 2018 seeing over 260,000

modules taken by over 53,000 eLearners.

Compared to 2017, this was a 58% and 63%

increase, respectively, bringing the total overall

modules taken to 600,000 by 110,000 eLearners

with over 250,000 certificates awarded.

In order to understand how impactful The Global

Health Training Centre’s eLearning courses are to

the research staff and healthcare workers that

make up the overwhelming majority of the

memberships, each course has an online survey

incorporated. These surveys continue to provide

extremely positive feedback with 96% stating

they would recommend the eLearning courses

to a colleague. Once users have completed a

course they are asked how confident they are

at implementing a course-specific task, on a

scale of 1 to 10 (1 = not confident at all, 10 =

extremely confident). Across all of The Global

Health Network’s courses, 85% percent of users

rated their confidence of completing the coursespecific

tasks between 7 to 10.

In 2019, The Training Centre’s Virtual Learning

Environment will be upgraded to provide

eLearners with an improved learning experience

including a searchable table of courses, a

personal course dashboard, updated course

navigation, and much, much more. Several

exciting new courses are already in development

with multiple international organisations to

meet identified knowledge gaps and these will

be made available throughout the year.


The Global Health Training Centre

The Training

Centre currently

offers 30 open

access online

training courses

consisting of

80 individual

learning modules

including over

50 modules

translated into

a variety of

languages such as

French, Spanish

and Portuguese.


modules taken by over

53,000 eLearners

in 2018


of eLearners said they would

recommend the eLearning

courses to a colleague


of users rated their

confidence of completing

the course-specific

tasks between 7 to 10


Certificates awarded

The 5 most popular courses are:

1 ICH Good Clinical practice E6 (R2)

2 Research Ethics


Introduction to Clinical Research

4 Essential Elements of Ethics

5 Introduction to Good Clinical Laboratory Practice


“Very much helpful in a way that I know how

and why should clinical trials and research be


Nurse, Malawi

“It helped me a lot because I was able to get the

information I needed to advance my argument in

meetings and for references.”

Project manager, Ghana

“I have developed experience in

research proposal and report

writing. I have published articles

and even have got research grant

award in my institution currently

with topics related to sexual and

reproductive health.”

Nurse, Ethiopia

“It improved the standard how I do

things and the confidence how I

handle my work.”

Nurse, Kenya

“I was able to generate research

questions and conduct more

clinically relevant research.”

Doctor, Nigeria



“I was equipped with knowledge

on safety and quality for the

realization of reliable results.”

Laboratory Staff, Kenya

“I work in the neonatal unit and

the knowledge I acquired is

really helping me to know how

to measure and monitor their


Nurse, Nigeria

“It helped me to consciously

ensure accuracy and

completeness of any data am


Pharmacist, Nigeria

“It gives some credibility to the

training and quality control

performed onsite.”

Investigator, Thailand

These resources were very

helpful during the initial phases

of my transition from clinician

to researcher and I use them

mostly in my research role.”

Investigator, Gambia

“It helped me to review the

research proposals assigned

to me as a member in research

ethics committee in my faculty.”

Lecturer, Egypt

“I coordinate clinical

activities in a

fistula centre in my

country, it gave me a

broad appreciation

of the problem and

who the patients are

and the experiences

they have probably

before they visit our


Project manager, Ghana


Modules taken and eLearners per year




Modules Taken







Modules taken


2011 2012 2013 2014 2015 2016 2017 2018


The Global Health Training Centre

eLearning Courses Hosted on

The Global Health Training Centre



of Modules Translations

Acute Pneumococcal and Meningococcal Meningitis 1

Basic Malaria Microscopy 5

Children and Clinical Research 1 Spanish

Congential Cytomegalovirus 1

Data Safety Monitoring Boards for Clinical Trials 1 French

Essential Elements of Ethics 11

Ethics and best Practices in Data Sharing 1

Ethics in epidemics, emergencies and disasters: Research, 7

surveillance and patient care

Ethics of Ancillary Care in Research 1

Good Clinical Laboratory Practice 4

Herpes Simplex Virus Encephalitis 1

HIV Neuropathy 1

How to Conduct GCP Inspections/Audits at the Clinical 1

Investigator Site

ICH Good Clinical Practice E6 (R2) 1 French, Spanish, Russian, Portuguese, Vietnamese

INTERGROWTH-21 st course on maternal, fetal and 2 Spanish, Portuguese

newborn growth monitoring

Introduction to Clinical Research 1 French, Spanish, Portuguese, Mandarin, Vietnamese,


Introduction to Collecting and Reporting Adverse Events 1

Introduction to Data Management For Clinical 1

Research Studies

Introduction to GCLP 1 Spanish

Introduction to Informed Consent 1

Introduction to Reviewing Genomic Research 1 French, Spanish, Portuguese,

Maternal Infections 6

Neurological Infectious Diseases 17

Obstetric Fistula 4 French

Preterm infant feeding and growth monitoring: 3 Spanish, Portuguese, Russian, Italian

Implementation of the INTERGROWTH-21 st protocol

Research Ethics 14

The Research Question 1 French, Spanish, Mandarin, Vietnamese

The Study Protocol: Part one 1 French

The Study Protocol: Part two 1 French


Case Study



The INTERGROWTH-21 st Project



Tools Downloaded

from 195 Countries


Courses Taken





The International Fetal and Newborn Growth Consortium

for the 21 st Century (INTERGROWTH-21 st )

is a collaboration between 300 researchers and

clinicians from 27 institutions in 18 countries and

coordinated from the University of Oxford. The

objective is to improve perinatal health within a

global context, thus reducing preterm birth and

poor intrauterine growth.

The INTERGROWTH-21 st project aimed to extend

the established World Health Organization’s (WHO)

Child Growth Standards into the foetal and neonatal

period. Research findings from three populationbased

studies provided new ways of classifying

preterm and small for gestational age newborns.

Furthermore, the INTERGROWTH-21 st Consortium

have produced a new international equation for

estimating gestational age through ultrasound,

based on the first international crown-rump length


In addition to these tools and resources, an

accompanying course has been developed, and

is hosted on the Global Health Training Centre in

English, Spanish and Portuguese. The objective

of the course is to guide eLearners through the

methodology of maternal, foetal and newborn

growth monitoring, and the application of the

INTERGROWTH-21 st international growth standards.

At the end of 2018, this two-module course had

6,662 modules taken by 2,816 eLearners with 3,470

certificates awarded (certificates per module).


The Global Health Training Centre

Case Study



WHO Toolkit for research

and development of paediatric

antiretroviral drugs and


In 2018, The Global Health Training Centre

developed and launched the online

version of the WHO toolkit for research and

development of paediatric antiretroviral drugs

and formulations. Research and development

of antiretroviral drugs and formulations for

children has traditionally lagged behind that of

adult versions of the drugs. The toolkit consists

of ten modules and provides online access for

drug manufacturers, regulatory authorities,

and more widely by the global research

community, to help facilitate and accelerate the

development of HIV drugs for children.


Leadership from the

Regions to Drive Capacity

for Research

The Global Health

Network is involved

in two preparedness

initiatives. By working

to develop research

capacity, these networks

are encouraging and

building the skills of

clinical and laboratory


The Research Capacity Network, REDe –

established through a single work package

that is common and runs across three EUfunded

Zika consortia (ZIKAction, ZIKAlliance

and ZikaPLAN) in Latin America and the


This Project has received funding

from the European Union’s Horizon

2020 research and innovation

programme under grant agreement

No.s 734548, 734584, 734857

The African coaLition for Epidemic Research,

Response and Training (ALERRT) – a clinical research

and response network for epidemic infections in

sub-Saharan Africa.

This Network is supported by the European

& Developing Countries Clinical Trials

Partnership (EDCTP) 2 Programme under

the European Union - grant agreement

number RIA2016E-1612. Its initial focus is

on advancing rapid and coherent research

response in sub-Saharan Africa (SSA).

Case Study:

Setting up Platforms in Latin America

As the Zika consortia started to set up their various observational

and pregnancy cohort studies, REDe assisted by hosting a series

of webinars – one of which was the concept of conducting a study

walkthrough using the research platform.

This is a great way to explain the whole study to everyone

involved. The importance of involving all staff was emphasised

so that everyone can work through what happens to a

participant at each stage, what the tasks of a particular

member of staff would be, and how these tasks are

conducted. This task-specific approach means that

staff learns the study procedures by ‘doing’, rather

than simply reading the study manual. This

method is easy to do as the costs are low and

it helps flag any problems that may not have

been previously identified, e.g. a problem

could be anything from the logistics of getting

a participant from the examination room to

another part of the hospital to take consent, to

missing a check box on the case report form.


Driving Capacity for Research

REDe means ‘network’ in Spanish and

Portuguese, pronounced as the word

‘ready’ in English - for being prepared.

We think that this is quite apt for

creating a preparedness network in

Latin America and the Caribbean in the

event of outbreak.

So, researchers are READY to respond in

an outbreak situation, using the ZIKA

outbreak as a platform.

To meet this objective, The Network links

together experienced research groups, creating

and strengthening a cadre of experienced,

willing research staff, undertaking highquality

research, and ethical data capture. The

locally led alliance of partners coordinate and

contribute to the knowledge, research tools and

training; fostering links between experienced

and inexperienced research platforms, which

underpins the strength of these networks.

As a strong component of these networks, the

regional faculty programme runs extensive

training events in and around the world, based

on the perceived research capacity needs of

each target setting. Many research centres

have specifically chosen to run blended learning

programmes and open workshops focusing on

clinical research ethics or career development

for researchers, responding to demand in

these areas. To date, these Research Capacity

Networks, REDe and ALERRT, have run 40

workshops across 14 countries. The following

short excerpts briefly describe some of these

networks’ faculty activities:

INDIA: Clinical research workshops have

been conducted for healthcare workers,

laboratory staff and nurses, with the aim to

introduce the importance of research and the

opportunities it offers.

NIGERIA: Building research capacity

for clinical research professionals through

workshops, blended learning programmes,

networking initiatives, training opportunities,

and the creation of online toolkits. In July 2018, a

two-day workshop took place in Abuja with over

350 attendees.

HONDURAS: Platforms conducting

regulatory standard clinical trials most

commonly discuss difficulties with regulatory

processes; as this stage creates significant

barriers to conducting timely, and further

research, creating a need for increased and

standardised documentation such as Standard

Operating Procedures (SOPs). This Regional

Faculty works alongside ethical and regulatory

review boards to provide training to its members,

bringing together the local research community

through conferences, workshops and events.

SOUTH AFRICA: Pioneers of the

blended learning initiatives and trailblazers of a

‘twinning’ initiative in which one platform works

alongside a more experienced vaccine platform,

to learn about Phase I studies. This faculty has

also hosted numerous free workshops appealing

to research staff at all levels.



Case Study:

Response to the plague

outbreak – capacity

building workshop for

local research staff

“This platform will be of great

help for our training and

development in the field of

health, and will help us to be

more updated as it is a global,

interactive and dynamic


Doctor, Madagascar

The Global Health Network, ALERRT and

Institut Pasteur de Madagascar ran a

workshop to support research capacity

development in Madagascar in response to

the outbreak of the plague.

The aim was to:

• work with local research organisations

to describe the health research capacity

gaps in Madagascar,

• see if a shared goal could be found

where these organisations would like to

be in terms of research being led from

the country, and

• determine a set of short, medium and

longer-term mechanisms for addressing


There were several components to the

workshop including:

The next steps:

Access to shared training and capacity

development opportunities was a clear

finding – in response to this there are

several initiatives including setting up a

Health Research Network in Madagascar,

and establishing an exchange programme

around a Disease Surveillance System.

A Disease Surveillance System is the

fundamental starting point for health

research and addressing critical capacity

gaps. Unless there is an understanding of

the population, their access to healthcare,

what the healthcare structure is and what

diseases are affecting the population, it

is impossible to plan drug and vaccine


• preparation meetings with institutions

such as: MISA (Computer Science

Mathematics and Applied Statistics)/

University of Antananarivo; INSTAT

(National Institute of STATistics); IPM

(Institute Pasteur Madagascar) –

Epidemiology, Clinical Research Unit,

Plague Unit, Clinical Biology Center,

Mycobacteria Unit and Virology Unit;

LARTIC (Health Information system

laboratory); Hospital in Befelatanana

in Antananarivo; Faculty of Medicine,

University of Antananarivo,

• workshops with focus groups activities

– introducing a qualitative research


• debrief meetings.


Driving Capacity for Research

Case Study:

Data Sharing Workshop

With the “Open Science” revolution, researchers

are expected to provide open access to

information about their study’s methods,

analyses and results. Funders argue that data

sharing can enable faster evidence generation.

However, data sharing is a relatively new

phenomenon and considerable confusion still

exists around what it means to share data,

how it can be achieved, and how to overcome

potential barriers.

The Global Health Network ran a workshop

to bring together experts who shared their

experience on the issues and challenges of

data sharing. Professor Oumar Gaye, Université

Cheikh Anta Diop de Dakar, Senegal, along with

Professor Philippe Guérin, Infectious Diseases

Data Observatory (IDDO), University of Oxford,

United Kingdom and Professor Trudie Lang, The

Global Health Network, University of Oxford


Professor Oumar Gaye’s presentation specifically

honed in on malaria as a case study and as a

community that has embraced responsible,

collaborative data sharing, discussing the

pathway undertaken to establish the trust and

collaboration that now exists.

Professor Trudie Lang gave an overview of The

Network and explained their efforts to progress

capacity building initiatives. The Network

is currently collaborating with The European

Clinical Trials Partnership (EDCTP), to develop a

“Knowledge Hub” that will address the training

needs of EDCTP’s grantees with regards to

protocol development, data management and

data sharing.

Professor Philippe Guerin spoke of the

importance of data sharing, the challenges it

presents and the benefits to be gained, as well

as more broadly about the scope and objectives

of IDDO.



As part of the

interactive breakout

session, participants were

divided into three groups,

with each group assigned

a topic for discussion.

The topics included:


The perceived barriers

to data sharing


The potential

opportunities and

benefits of data sharing


The training and

resources required for

data sharing


Research Capacity

Activity, Honduras

The Nigerian

Regional Faculty

An induction meeting on The Global Health

Network and REDe platforms took place

in the computer laboratory of the Nursing

School with the participation from the

undergraduate students who are attending

the Rural Community Nursing class. This

class was part of the ‘Research Methodology

Module’ of the curriculum. Students take

theory classes for four weeks, and then

transfer to different hospitals and health

centres in the country. As part of the module,

the students are expected to conduct a

research study in the community.

The objective of the induction meeting was

to inform the students about The Network

and REDe resources and tools, to strengthen

their research capacity with emphasis on

research methodology and research

ethics courses (i.e. Introduction to

Clinical Research, The Research

Question, The Study Protocol:

part 1 and 2, and Good Clinical

Laboratory Practice). The

platform was explored

in real time and most

of the students

proceeded to their

registration using

the computers in

the laboratory.

The Nigerian

Regional Faculty

organised a free

clinical research

capacity building

workshop in

July 2018, which

was attended by

over 200 nurses,


laboratory and

social scientists.


Driving Capacity for Research

The opening speech was given by Mr Umar

Aliyu, Head of Department and Deputy Director

of Nursing Services at the National Hospital,

Abuja. Dr Saleh Garba, Head, Department of

Nursing Science, Ahmadu Bello University, Zaria

followed with a presentation on ‘Implementing

research results in clinical practice; the

experience of nursing professionals’.


Networking and sharing is very important in

building capacity in clinical research, as that is a

very typical way of improving and strengthening

the knowledge of local research, therefore enabling

and empowering them to do better clinical research,

comparable to the standards in other parts in the

world, and that is very important because as they

are now able to do research embedded in the local

context, solving real-life problems that enhances that

community or society.” Doctor, Nigeria

The presenter highlighted barriers to implementation

of clinical research findings by nurses in Nigeria

and made suggestions on ways to improve the

implementation of research results by nurses.

Further talks were conducted on Pharmacovigilance

in Clinical Research, where participants were

encouraged to get involved in research studies

while carrying out their routine clinical duties.

The role that clinicians and nurses (since they

are with the in-patients 24 hours a day) play in

pharmacovigilance was also discussed, such as the

importance of reporting adverse drug reactions and

documentation, e.g. photographic and documented

records of such incidents.


Developing Careers and Fostering

Team Capabilities

A mechanism for tracking professional

development and measuring changes in

capacity development

The Professional

Development Scheme

(PDS) was devised to give

health research staff a

mechanism to record

their research skills and

experience. Measuring

the acquisition of

research competencies

also generates

comprehensive data on

the impact of capacity

development initiatives.

Lack of recognition for working in research is

widely cited as an impediment to its conduct.

There is a lack of career structure for the many

roles involved in research (investigators, trial

managers, nurses, local healthcare workers),

and a lack of understanding of who does

what. Competency frameworks exist for some

individual job roles, but these are infrequent;

thus a global framework describing all of the

roles and responsibilities in a research team

was needed. The Global Health Network in

conjunction with the WHO Special Programme

for Research and Training in Tropical Diseases

(TDR) combined 28 frameworks created by

external groups, with information from 116 job

descriptions obtained from partners in clinical

trial units worldwide and from the web, to

create a widely encompassing framework

derived from 11 different roles. The resulting

framework presents 50 competencies required

throughout a study lifecycle, from assessment

of scientific literature to results dissemination

via project management, public engagement or

grant application. It is applicable to studies that

may differ in design, geographical location, and

disease and can be adapted to the particular

needs of specific projects or roles.

The research competency framework forms the

core component of the PDS; an innovative and

unique online tool providing researchers with a

reliable mechanism to record their skillset, track

their career development and identify gaps in

their knowledge.

“Ground-breaking tool to measure

the impact of capacity development “


Developing Careers

The PDS provides a step-by-step process for

all researchers to document their career thus

gathering further points as they gain experience

and vocational research skills. Members assess

their research competencies, are awarded a

membership level and are required every year

to go through a review process to update their

points and progress through the 25 levels of the

scheme. The PDS is an audited and highly robust

system that provides ongoing recognition for

research staff to support and guide their career

development and identify training and skills


By collecting and collating the data from all

members of a team this system enables

platforms or groups to showcase their

experience, and monitor and report their team’s

capacity development over time. This facility

provides a reporting system that measures

progress on the development of research

capabilities and allows study managers or

consortia to quickly and easily produce reports

for their specific programme or teams. This

scheme is entirely unique and very powerful

as it provides robust evidence that can be used

to seek investment and funding to address

capacity gaps. Research coordinators, funders

and sponsors can be given access to data on

large networks, individual platforms or specific

staff roles; thus measuring the impact of

capacity development initiatives.


Assessing Barriers and

Enablers to Research, and

Measuring the Impact of

the Platform

The research resources

available on The Global

Health Network have

been downloaded

and accessed many

hundreds of thousands

of times. To understand

how the information is

being used, The Network

is setting out to assess

the impact the resources

are making on research

and practice, starting

in the area of child


The Network has served as a mechanism

for disseminating growth and development

resources and training for a research consortium

called INTERGROWTH-21 st and these have

been downloaded by over 120,000 healthcare

workers and researchers in 195 countries. Due

to the popularity of the INTERGROWTH-21 st

resources on the platform, The Network, in

collaboration with the Nuffield Department of

Women’s & Reproductive Health, is undertaking

a comprehensive mixed methods study to

understand the impact of these resources.

The findings from the study will determine

where the gaps exist and help to understand

whether the resources benefited both practice

and research, and to guide The Network in

making even more resources available to take

advantage of areas of opportunity.

The strongest themes repeated throughout the survey responses were:

1 Ongoing availability of research staff in the clinic and the laboratory

2 Institutional mandate to engage in research

3 Career development and support for research work within clinical and

laboratory roles

4 Strategic use of funding to allow healthcare centres to build infrastructure:

rather than a ‘platform’ within a healthcare centre

Thus we believe these themes could be tackled by working at a healthcare

delivery level approach, which is exactly what we are doing with The

Global Health Network.


Barriers and Enablers to Research and Measuring Impact

The latest Ebola outbreak and rapid spread of

the Zika virus epidemic highlighted the lack of

research capacity in low-resource regions in both

the ability to undertake observational research

to describe the diseases and subsequently

to set up the regulatory standard clinical

trials to assess potential drugs and vaccines.

These outbreaks also made visible the lack

of research being done day to day to address

local healthcare needs of these communities.

We would argue that it is the lack of day-today

research that is the true problem, because

if that capacity were in place, these researchers

could respond to an outbreak.

In preparation for future epidemics, the

World Bank led a taskforce to establish an

understanding of what research capacity exists

at present across low- and middle-income

countries (LMICs) for conducting vaccine

research. The Network’s platform utilised its

resources to assess the research capacity in

LMICs. The uptake of the survey was very popular

with over 5,000 responses. The overwhelming

response from the survey demonstrates

how well The Network communicates with

researchers and healthcare workers in LMICs.

within those institutions. This has resulted in

situations where a state-of-the-art research

group within a hospital has their own laboratory

to work on one disease (e.g. HIV or malaria),

but are also just hundreds of metres away from

other clinical groups who have no experience in

producing high quality research.

The gaps and issues reported by the researchers

who responded to the survey shows that research

should be embedded in healthcare delivery,

and in order for this to happen, institutions and/

or governments need to recognise the value of

research. If research activities are limited to one

disease or protocol, then the ability for research

is not extended beyond that specific therapeutic

area. This is not conducive to long-term research

capacity, and furthermore, limits the ability to

effectively respond to outbreaks. Importantly,

we have shown that the skills, infrastructure,

regulatory ability and oversight do not differ

significantly between disease or research types.

As the skillset for conducting clinical research is

therefore largely similar, it would be possible

to make improvements in research capacity

by working with healthcare-providing facilities

instead of isolated groups.

We already knew that over the past twenty

years there has been a steady increase in the

amount of regulatory standard clinical trials

occurring in low-resource countries. These

studies have largely been led by publicprivate

partnerships and have assessed drugs

and vaccines for HIV, TB and Malaria. These

programmes have made a remarkable impact

and have left teams within research platforms

well equipped, trained and able to undertake

clinical research. Further, these studies can

largely be credited for the strong capacity that

does exist in limited resource settings. However,

whilst these externally sponsored programmes

have invested in specific teams within hospitals

and/or universities, we found that the skills and

abilities have not necessarily been transferred


What Next?

In 2013, the WHO said that unless

low- and middle-income countries

(LMICs) become the generators and

not the recipients of health research

data, then there will never be any real

improvement in the greatest burdens

to public health in these countries. Our

survey findings echoed this call and

produced unique evidence to show

why we need to strengthen research

awareness and capacity in low-income

countries with a high burden of disease.

If we can equip these regions with

the skills and resources to undertake

research on the everyday disease

burdens that cause such high levels

of early mortality, then interventions

and prevention approaches can be

identified and tested, which could bring

significant change in health outcomes.

Then, with this embedded ability to

undertake research, these vulnerable

regions would also be better placed to

lead and undertake their own research

response within outbreaks.


Strategic Development

The Strategic



Therefore, central to our strategic development

plan is to strengthen regional engagement

and leadership of The Global Health Network.

Here, the intent is that the concept, approach

and platform are taken up with partners in

the region who will lead regional hubs. These

hubs can coordinate the regional capacity

development network and use The Global

Health Network platform as the central vehicle

for connecting research organisations and

sharing expertise and skills locally, between

healthcare organisations, universities, health

charities and government health agencies. The

main focus, however, will be running the faceto-face

activities that work so well in engaging

frontline healthcare workers in research and

using evidence in practice. Here, we have

toolkits of activities that have proven to work

so well, such as supported learning sessions,

reciprocal monitoring and research quality

management, workshops and mentoring. The

mix of these ‘on the ground’ activities and the

resources, communities and training online

is a sustainable and long-term solution for

delivering real research capacity development

that supports more and better research in the

most underserved regions, and that works for

any disease and in any healthcare setting.

Our most exciting development that we are

currently working on is about discoverability

and information architecture. Our vision here

is to harness the technology that is used

commercially so widely to persuade us to book

a hotel or order a book. Our goal is to provide

researchers and healthcare workers in clinics

and laboratories with information that they

would not have known existed. So, for example,

if there was a researcher planning a study on

Leishmaniasis in Ghana they might have found

a protocol on this platform. What we want

to build in, using machine learning, is that

alongside the protocol, they would be offered

case report forms, standard outcome measures,

a consent template, and a guide for community

engagement; all focused on Leishmaniasis and

encompassing all that the team would need to

conduct a world-class study using standards and

practices that are out there, but were previously

unknown to this team. With this technology we

could allow researchers to discover resources,

tools, guidance and training that can enable

high quality research that generates fast and

better data that is ready to be shared.

In order to deliver the ability to share

information to enable world-class standard

research anywhere in the world, The Global

Health Network needs to apply the very best

digital technology. Here, we are focusing

on growing the scale and discoverability of

information. We need this platform to be

accessible everywhere and to run at optimum

speed, even in low-bandwidth regions. We are

exploring cloud technology and placing The

Global Health Network platform in strategic

hubs across the globe. All the resources and

content are designed to work on all devices and

on low-band width internet; we also continually

ensure the platform is fully compliant with all

data privacy laws and regulations.


The Global Health Network Collaborators

The Global Health Network Funders

Brain Infections Global

Brain Infections UK

Centre for Immunology and Vaccinology, Imperial College London

Childhood Acute Illness and Nutrition Network

Clinton Health Access Initiative

Collaborative Initiative for Paediatric HIV Education and Research

Columbia University Mailman School of Public Health


DF/NET Research

Drugs for Neglected Diseases Initiative

East African Consortium for Clinical Research

Elizabeth Glaser Pediatric AIDs Foundation


Epidemic Diseases Research Group Oxford


Faculty for Capacity Development

Geneva Foundation for Medical Education and Research

Global Alliance for Musculoskeletal Health

Global Health Clinical Consortium

Industry Liason Forum

Infectious Diseases Data Observatory

Infectious Diseases Research Institute

Institute of Infections and Global Health, University of Liverpool


International AIDS Vaccine Initiative

International Committee for Congenital Anomaly Surveillance Tools

International Maternal Pediatric Adolescent AIDS Clinical Trials Network

International Partnership for Microbicides

International Severe Acute Respiratory and Emerging Infection Consortium

International Vaccine Institute



Kings College London

KWTRP KEMRI Wellcome Trust Research Programme

Liverpool School of Tropical Medicine

London School of Hygeine and Tropical Medicine

Magee Women's Research Insitute

Maternal Health Task Force

Medicines for Malaria Venture

Medicines Patent Pool

MORU Mahidol Oxford Tropical Medicine Research Unit

Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal

Sciences, University of Oxford

NurioID e-Learning

OUCRU Oxford University Clinical Research Unit

Oxford Maternal & Perinatal Health Institute

Paediatric European Network for Treatment of AIDS


Pregnancy Care Integrating translational Science, Everywhere Network

TB Alliance

TDR, the Special Programme for Research and Training in Tropical Disease

The Aga Khan University

The Global Pregnancy Collaboration

The Mutli-Regional Clinical Trials Center if Brigham and Women’s Hospital Harvard

The Royal Liverpool and Broadgreen University Hospitals

The Synergist

The United States President’s Emergency Plan for AIDS Relief

The Walton Centre NHS Foundation Trust

The Worldwide Prison Health Research & Engagement Network

TRICLINIUM Clinical Development (Pty) Ltd



World Health Organisation

WorldWide Antimalarial Resistance Network




European Union Horizon

2020 Research and

Innovation Programme

©The Global Health Network 2019


The Strategic Development Plan


The Global Health Network

Nuffield Department of Medicine Research Building (NDMRB)

University of Oxford

Old Road Campus

Roosevelt Drive



Professor Trudie Lang, Director:

Liam Boggs, Senior Operations Manager: