Professor Trudie Lang

Professor Trudie Lang
Globale Gesundheitsforschung und Leiterin des Global Health Network, Universität Oxford, über LactaHub – A Resource for Evidence-Based Breastfeeding Intelligence

Sie arbeiten mit vielen Fachgruppen zusammen. Was sind deren Bedürfnisse und warum ist LactaHub, die erste Online-Plattform für evidenzbasiertes Stillwissen über Stillen und Muttermilch, eine gute Lösung?

The Global Health Network unterstützt die Gesundheitsforschung in Ländern mit niedrigem bis mittlerem Einkommen, wo es an Daten und Fakten fehlt. Stillforschung ist ein stark vernachlässigtes Thema. Es macht Sinn, LactaHub in das Netzwerk (das inzwischen über 65 Wissenszentren umfasst) einzubinden, um es verschiedenen Fachgruppen leicht zugänglich zu machen.

Was wünschen Sie sich als nächste Entwicklung für LactaHub?

Ziel des Global Health Networks ist es, Experten aus der Gesundheitsforschung, und denen, die solche Forschung koordinieren, leiten und von ihren Erkenntnissen profitieren, einen gleichberechtigten Zugang zu Wissen zu ermöglichen. Dies gilt insbesondere für die Themen Gesundheit von Müttern und Entwicklung von Neugeborenen. Viele der Prozesse, die wir in Gang setzen, zielen darauf ab, Chancengleichheit unter den Forschenden zu schaffen. Wir planen ein spannendes Projekt, bei dem wir versuchen, 1’000 von Krankenschwestern und Hebammen betreute Studien zu unterstützen. Es wäre grossartig, wenn Stillforschungsexperten an forschungsfördernden Aktivitäten teilnehmen oder Schulungsprogramme anbieten würden. Wir haben viel über die ersten 1’000 Lebenstage gesprochen und darüber, wie andere Initiativen rund um die Themen Ernährung oder Unterstützung von Müttern damit verbunden werden sollten. Ich denke, LactaHub ist dafür beispielhaft. Die Möglichkeit, den riesigen Wissensfundus auf der Plattform verfügbar zu machen und über persönliche Kontakte in den Regionen praktisch anzuwenden, wäre ein fruchtbarer nächster Schritt. 

Was ist der Wert des Global Health Network für das Wissensmanagement, und wie hat sich die Zusammenarbeit mit der Stiftung auf Ihre Arbeit ausgewirkt? 

Die Stiftung ist einzigartig. Entscheidend ist, dass sie krankheitsneutral ist, ganzheitliche Forschung ermöglicht und als Vermittlerin für die Weitergabe von Wissen agiert. In diesen Punkten decken sich unsere Einstellungen. Das Global Health Network operiert bereichsübergreifend und unterstützt alle Arten von Forschung weltweit.

Dass LactaHub genau diesen Ansatz für die Stillforschung verfolgt, ist perfekt. Die Förderung von LactaHub ist grossartig, und wir haben viel von der Stiftung gelernt. Es war toll, all die Jahre mit der Stiftung zusammenzuarbeiten, in denen sie in den Aufbau von LactaHub investierte, was uns dessen Wachstum ermöglichte.

Extended interview, in English

You interact with many communities of practice. What are their primary needs and why is LactaHub, the first knowledge hub focused on breastfeeding and lactation, a good fit for the Global Health Network? 

The Global Health Network exists to support health research in low-middle-income countries, everywhere evidence is missing. So the work of the LactaHub knowledge hub is crucial because maternal and child health is one of the key areas that we're all interested in supporting across so many of the knowledge communities we work in.

Breastfeeding research is a really neglected area. This is why it works to have LactaHub on the network (now over 65 knowledge hubs) because it’s a very niche, specialized subject which is underserved, yet much better off connected up with other communities of practice, maybe those focused more broadly on maternal health outcomes say, or on supporting neonates. 

It works as that perfect synergistic relationship of providing a platform where people can find LactaHub and access this information they didn't even know existed to support breastfeeding and lactation, but also, I hope to support research generation and evidence generation in places where it is missing. And obviously this is such an important area. I think that’s where we've always really aligned with the Foundation because it’s an enabling force. 

How does LactaHub address equity in access to knowledge, to bring research into practice for better health outcomes?

One of the things we talk about all the time is that The Global Health Network aims to bring equity in access to who undertakes health research, who coordinates it, who leads it, and of course who benefits from the evidence. This couldn’t be truer in this context of maternal health outcomes and neonatal development. But also, in those first 1,000 days of life, we’re still in that situation where 90% of the world's research is led from the Global North – everybody knows the statistics – and even research that happens in the South is often still attributed to those in the North, or maybe the questions are set elsewhere.

This often pragmatic research that can help understand perceptions, behaviors, and training mechanisms, and of course interventions, or understanding health benefits by doing observational surveillance work, is a perfect topic to take to breastfeeding. So lots of the processes we’re enacting are around bringing equity to who undertakes that research.

We’ve got an exciting program coming up, trying to support 1,000 nurse and midwife led studies. This is one opportunity that we can use to enact research into practice and equity and who gathers scientific knowledge. That is something we will be talking about with the foundation over the next few months.

What would you like to see in the next evolution of LactaHub?

I would love to see LactaHub evolve in the same way that The Global Health Network is evolving. And here, we’re pushing for this flat, decentralized franchise organization across the whole of The Global Health Network. Whilst of course it’s a digital platform which hosts all this remarkable information, what we're doing now as well is creating that activity, face-to-face, in the regions by having a whole network of knowledge coordinators in the Global South. I would love to see the next evolution of LactaHub involved with that possibility and leveraging what we’ve done already. 

It would be amazing to have breastfeeding research experts taking part in some of the research enabling activities or running training programs. We’ve talked a lot in the past about the first 1,000 days of life and how this should link up with other initiatives around wider nutrition, or supporting mothers, and I think this work fits in beautifully. The opportunities for having that vast bank of knowledge available on the platform, and really enacting it by connecting up in person in the regions, would be an exciting next step.

This has begun to happen on an initial level with the LactaWebinars, where breastfeeding and breastmilk experts from different regions are coming together and bringing their expertise to practitioners in other regions. It's that wider engagement, and the potential for that, where we've only scratched the surface.

We’re doing a lot more work with midwives and community health workers. The Global Health Network is now a WHO Community of Practice, and I think the opportunity is there for tying up some of these initiatives. We have often talked about how we can integrate this with connecting excellence in other areas. You've got that whole, systematic approach of supporting those early years of life and optimizing feeding. Understanding the role of breastfeeding in that, and gathering that evidence, is so vital. This never happens in isolation, with all the other things that mothers and healthcare workers in their environment have got going on. That could be infectious disease threats, it could be poverty, it could be displacement, all those other competing factors could be looked at alongside these first 1,000 days, by having those regional contextual opportunities and being able to actively work in the regions in person.

What makes The Global Health Network such a beautiful innovation in knowledge management, that sits outside the business sector? 

It’s definitely unique. It never ceases to amaze me, actually, that it is unique. In the past, all the initiatives that have tried to address lack of research capacity and activity in low resource settings were focused on one disease, or they have taught centers to gather data for somebody else, which then gets taken back overseas to that 90% we talked about earlier. And the initiatives were very short term and didn't leave lasting capable teams.

What turned out to be the magic factor for The Global Health Network is that the elements that make research difficult don’t vary, whatever disease you’re working on or whatever health area. The basic building blocks are the same. So having this facility that is completely disease agnostic and all around research-enabling – not doing our own primary research, but simply acting as that convener to move knowledge around – has worked remarkably as this neutral broker in enabling knowledge translation across different specialties.  

Also, if you're in a health center, the patients that come to you don't have just one problem. There’s mothers trying to breastfeed, there’s people with infections, there’s orthopedics, so research has to come from that community basis. That’s why it works, there’s nothing else like it. 

What sparked the collaboration with the Foundation, and how has it benefitted your work? 

Even in the early discussions we had, many years ago now, we saw that real shared alignment of being a convener and seeing that disconnect is what holds back progress. That is where we and the Foundation share the exact same outlook. 

The partnership works perfectly because The Global Health Network serves very deliberately to be entirely cross-cutting to support all types of research for every disease across the globe. We call it the research ecosystem. With LactaHub having that precise focus on breastfeeding research, it's perfect because we’re trying to connect up all those specialist niche areas within that holistic arena that there needs to be.

The support for LactaHub is wonderful. It's been a really useful, consistent partnership, and we've learned so much from the Foundation as well. It was a formative time for The Global Health Network, because we were expanding when we first worked with the Foundation. It's been excellent to work alongside the Foundation for all these years, having that constant partnership where the Foundation is invested in the LactaHub facility,  which we've enabled to grow.

It would be excellent looking forward if the Foundation could contribute to the wider growth of The Global Health Network and contribute to the hardest parts to support, the pieces that bring the community in, the provisions that we do for training and learning for researchers and running resources in the regions. That would be a great thing to look to do in the future. 

In our aim to try and connect up the most unusual pieces, it’s just been great. So congratulations to LactaHub and of course the Foundation for 10 years’ worth of work.