Areas of expertise in the Maternal Health Team include the measurement of maternal morbidity and mortality, clinical audits of near-miss cases and maternal deaths, other quality of care improvement approaches, evaluation of complex interventions, definition and measurement of unsafe abortion, signal functions for health facilities, long term consequences of maternal deaths and complications, the relationship between HIV and maternal mortality, and healthcare-associated infections at birth.
The Maternal and Newborn Health Group is a multi-disciplinary research team at the London School of Hygiene and Tropical Medicine within the Department of Infectious Diseases and Epidemiology and Faculty of Epidemiology and Population Health.
The Maternal and Newborn Health Group carries out research to contribute to the international debate and key policy, measurement and evaluation issues related to the health of mothers and newborns, including the prevention of stillbirths.
Improving the health and survival of women and their newborns during and after pregnancy has long been a research priority globally, and one to which LSHTM has contributed to since its inception over a 120 years ago. During this long period, the topics and geography of focus as well as the research methods have shifted and evolved enormously, and the current MNHG in IDE reflects this process – both in its composition and its aspirations for the next decade and beyond. From a small nucleus created in the late 1980s, the Group has expanded well beyond its initial focus on the epidemiology of maternal health, particularly metrics to assess levels, trends and differentials, and there is now also a strong programme of research on newborn health and on stillbirths.
The multidisciplinary research team is made up of epidemiologists, anthropologists, statisticians, economists, demographers, and clinicians such as medical doctors, midwives, and nurses. Research by the Group is conducted with collaborative partners in the UK and overseas who have established reputations in the field. We also publish actively in both peer-review publications and global guidance in partnership with for example the World Health Organization, UNFPA and UNICEF.
Areas of expertise in maternal health include the measurement of maternal morbidity and mortality, clinical audits of near-miss cases and maternal deaths, other quality of care improvement approaches, evaluation of complex interventions, definition and measurement of unsafe abortion, signal functions for health facilities, long term consequences of maternal deaths and complications, the relationship between HIV and maternal mortality, and healthcare-associated infections at birth.
In newborn health expertise focuses on high impact research and partnerships for next generation leadership, notably through the ‘Every Newborn Action Plan’. We work to reduce stillbirths and neonatal deaths, perinatal infections notably Group B Strep, later disability and to promote child development. Specific expertise includes: improving data and routine information systems for impact indicators (LBW, preterm birth, stillbirths, neonatal cause of death, maternal and perinatal death surveillance and response), coverage/quality of care, tools to assess service readiness for maternal/newborn care, as well as measurement for early child development; large observational studies and cohorts; RCTs; large scale evaluation of complex interventions and national progress tracking and case studies.
The current Head of the MNH Group is Professor Wendy J Graham, and the Deputies are Dr Louise T. Day and Dr Enny Cruz.
Focus on High Burden Countries to address SDG Targets 3.1 & 3.2
Current global health efforts focus on the Sustainable Development Goal (SDG) targets, of which the first two for SDG 3 are on reducing maternal and newborn mortality.
- SDG Target 3.1: Reduce the global maternal mortality ratio to less than 70 per 100,000 live births
The high number of maternal deaths in some areas of the world reflects inequalities in access to quality health services and highlights the gap between rich and poor. The MMR in low income countries in 2017 is 462 per 100 000 live births versus 11 per 100 000 live births in high income countries.
- SDG Target 3.2 | Newborn and child mortality: By 2030, end preventable deaths of newborns and children under 5 years of age, with all countries aiming to reduce neonatal mortality and under‑5 mortality
Globally 2.4 million children died in the first month of life in 2019. There are approximately 7 000 newborn deaths every day, amounting to 47% of all child deaths under the age of 5-years, up from 40% in 1990. Sub-Saharan Africa had the highest neonatal mortality rate in 2019 at 27 deaths per 1,000 live births, followed by Central and Southern Asia with 24 deaths per 1,000 live births. A child born in sub-Saharan Africa or in Southern Asia is 10 times more likely to die in the first month than a child born in a high-income country.
MNH Group members lead research and teaching to address where maternal mortality, and newborn mortality stillbirth are highest. Many studies are multi-country and efforts are intentionally global in reach. We partner with fellow academic institutions, multi-lateral and non-governmental organizations across both high income and low-and-middle income countries, with an aim to decolonize global health and engage in two-way learning and capacity building through equal and sensitive engagement.
Collaboration with the MARCH Centre
Many of the MNH Group members also are active members of the LSHTM Maternal, Adolescent, Reproductive and Child Health Centre (MARCH). Centres at LSHTM are cross-faculty, multi-disciplinary, cross-institution networks of academics collaborating and innovating to address global health challenges. MARCH brings together over 400 researchers at the London School of Hygiene & Tropical Medicine to improve the health of women, children & adolescents worldwide. The Centre has a range of expertise across 50 disciplines, from anthropology to zoonoses, clinical care, lab, and social sciences and works around the world in 100 countries, from Afghanistan to Zimbabwe.
Maternal and newborn health is a research priority across LSHTM, and so teams working in this area can be found in all three Faculties and in many departments.
These webpages focus on the MNH group in the Department of Infectious Disease Epidemiology, in the Faculty of Epidemiology and Population Health. Having said this, defining precisely the composition of the Group is challenging, in part owing to the frequent changes – with new staff joining and others leaving, and in part due to the variations in affiliation practices across LSHTM.
From an administrative point of view, the membership of the Group is defined by IDE affiliation and line-management, and currently comprises 40 academic and professional support staff. This framing, does not include those in other Departments and Faculties who undertake collaborative work with the IDE-based MNH group, currently comprising 17 academics. Finally, and importantly, the Group has the benefit of six honorary academic members of staff who play important roles in promoting our work and in making important connections to key actors in the MNH space.
The table below lists the leadership team and the members of the IDE-based MNH group, and provides links to their LSHTM profiles where you can read about their specialist interests, current projects and recent publications.
First name |
Position |
|
Hannah |
Associate Professor |
|
Ellen |
Bradley |
Research Fellow |
Oona |
Professor of Epidemiology and Reproductive Health |
|
Jaya |
Chandna |
Research Fellow in Child Development |
James |
Research Fellow |
|
Enny |
Assistant Professor & Deputy MNH Group |
|
Claudia |
Professional Support Personnel (PSP): Project Manager |
|
Louise Tina |
Deputy Head MNH Group |
|
Veronique |
Professor of Maternal Health and Epidemiology |
|
David |
Assistant Professor |
|
Giorgia |
Assistant Professor in Epidemiology |
|
Wendy |
Professor of Obstetric Epidemiology, & Head MNH Group |
|
Zoe |
Knowledge Management & Communications Officer NEST360 |
|
Ralph |
Hale |
PSP |
Debra |
Professor, Takeda Chair in Global Child Health |
|
Jess |
Research Fellow |
|
Meghan |
Assistant Professor |
|
Joy |
Professor, Director of MARCH Centre |
|
Lucas |
Malla |
Assistant Professor |
Sylvia |
PSP: Programme Manager |
|
Melissa |
Medvedev |
Clinical Assistant Professor |
Sarah |
Assistant Professor |
|
Christian |
Ochieng |
Research Assistant |
Eric |
Associate Professor |
|
Yemi |
Assistant Professor |
|
Shefali |
Research Fellow |
|
Proma |
Research Fellow in Epidemiology |
|
Loveday |
Penn-Kekana |
Assistant Professor |
Rebecca |
Research Assistant |
|
Kimberly |
Research Fellow |
|
Emma |
Research Fellow |
|
Carine |
Professor of Epidemiology |
|
Harriet |
Research Fellow |
|
Sophie |
Sarassat |
Assistant Professor of Epidemiology |
Rosie |
Assistant Professor |
|
Cally |
Associate Professor in Global Newborn Health & Early Child Development |
|
Alice |
Tarus |
Research Assistant |
Zeenat |
PSP: Research Programmes Assistant |
|
Judith |
Research Fellow |
Our seven honorary academic members are:
LSHTM title |
Current/former affiliation |
|
Honorary Associate Professor |
Institute of Tropical Medicine, Antwerp |
|
Honorary Professor |
Institute of Public Health, Heidelberg |
|
Honorary Assistant Professor |
NHS Consultant, Guy’s and St Thomas’s Hospital, London |
|
Honorary Associate Professor |
Centre for Development and Environment, University of Oslo |
|
Liz Mason |
Honorary Professor |
Former head of Dept of MNCAH, WHO |
Özge Tunçalp |
Honorary Professor |
Dept of Reproductive Health, WHO |
Honorary Professor |
Division of Family Health, WHO |
Overview
The Maternal and Newborn Health Group is currently working on the evidence base from epidemiology through intervention on all continents. We partner with multilaterals, national governments, research and professional organisations as well as NGOs. There are a number of cross cutting themes that the various research projects address:
- Measuring the burden of diseases associated with pregnancy, obstetric, stillbirth and neonatal complications, as well as their risk factor and socio-economic costs;
- Improving our understanding of barriers to safe and appropriate obstetric and newborn care in low and middle income countries;
- Strengthening the evidence base for large scale evaluation of complex interventions targeted at women with wanted or unwanted pregnancies, randomised control trials, and modelling;
- Promoting the use of evidence to strengthen policy making.
The individual projects are described in the research pages for further in depth reading of the current work being carried out by the Maternal and Newborn Health Group.
The Maternal and Newborn Health Group works alongside many partners both in the UK and overseas. Below is the list of some of our main past and present partner organisations and institutions.
AfricSanté, Burkina Faso
Bandim Health Project, Guinea-Bissau
Centre Muraz, Burkina Faso
CERRHUD (Centre of Research for Human Reproduction and Demographics), Benin
CHERG (Child Health Epidemiology Reference Group)
Dabat Research Centre, Ethiopia
Dhulikhel Hospital Kathmandu University Hospital, Nepal
Guttmacher Institute, USA
ENSP (National School of Public Health), Morocco
Fundación Infant, Argentina
International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Bangladesh
Ifakara Health Institute, Tanzania
Iganga Mayuge HDSS, MUCHAP, Uganda
Institute of Tropical Medicine, Belgium
ISGLOBAL, Spain
KEMRI|Wellcome Trust, Kilifi
King’s College London , UK
Kintampo Health Research Centre, Ghana
Kwame Nkrumah University of Science and Technology, Ghana
Makerere University School of Public Health, Uganda
Manhiҫa Health Research Center, Mozambique
Muhimbili University of Health and Allied Sciences, Tanzania
National Institute for Public Health and the Environment (RIVM), Netherlands
Options, UK
Peking University, School of Public Health, China
Pokhara Academy of Health Sciences, Nepal
Population Council, USA, Zambia, India
Public Health Foundation of India
Sichuan University, China
The Soapbox Collaborative, UK
UCL Great Ormond Street Institute of Child Health
University of Aberdeen, Scotland
University of Amsterdam, Netherlands
University of East Anglia, UK
University of Gondor, Ethiopia
University of Oslo, Norway
University of Southern Denmark/Odense University Hospital, Denmark
University of Witwatersrand, South Africa
World Health Organization, Switzerland
Members of the Maternal and Newborn Health Group teach on a number of cross-cutting MSc modules at LSHTM, including among others Basic Epidemiology, Extended Epidemiology, Foundations in Reproductive Health, and Current Issues in Maternal and Perinatal Health.
The ‘Foundations in Reproductive Health’ module aims to give students an understanding of the main themes in reproductive health research including: what the different medical, social, political and gender perspectives are in which reproductive health is constructed; how these perspectives influence research and practice; which demographic and epidemiological methods are used in reproductive health research; and which approaches are used for interventions, programmes and policies through the lifecycle, taking contextual challenges into consideration. This is a core module for students enrolled in the Reproductive and Sexual Health Research MSc, and takes place face-to-face in London from October to December.
The module ‘Current Issues in Maternal and Perinatal Health’ focuses on low and middle income countries and addresses the following public health questions: what is the burden of mortality and morbidity for women and their young babies; what are the determinants and causes of this burden; what are the available evidence-based interventions and strategies; what are their relative effectiveness; what are current topical or unresolved issues in maternal and perinatal health. The module includes lectures on common ground material and problem-based activities on unresolved or topical programmatic issues. It is attended every year by 40 students, including external students, and takes place from the end of February to the end of March.
In addition to teaching MSc students, academic staff supervise research degree students (PhD, DrPH) from different countries in their specialist areas. Please contact any member of the team if you would like to do a research degree on maternal or newborn health with us.
Our teaching also includes MOOCs, including the highly successful Lancet Maternal Health Series MOOC dealing with maternal health care quality, its current state worldwide and the future of maternal health. Another popular MOOC is the MARCH Centre MOOC (to be launched later this year). It equips participants with knowledge on maternal, newborn, child and adolescent health in different areas of the globe using the most recent data available, explains current policies and programmes, and facilitates debates among all participants. LSHTM staff have developed the teaching materials for both MOOC in collaboration with external experts.
Events
The MNHG Seminars usually take place on the first Thursday of the month during lunch times (1.00 pm - 2.00 pm). This seminar is an informal space to talk about your current projects in Maternal and Newborn Health. The event takes place in a hybrid format through Zoom and in a university teaching room. No events are recorded, we are always looking for members of staff to present so if you wish to take part in or attend a seminar, please contact either Sarah Moxon, (Sarah.Moxon@lshtm.ac.uk) or Proma Paul (Proma.Paul@lshtm.ac.uk).