Centre for Maternal, Adolescent, Reproductive, and Child Health

Thirty years and counting: LSHTM’s maternal health group turns 30

In January 1989, a new research group was launched at the London School of Hygiene & Tropical Medicine, created formally by virtue of a grant award from the Ford Foundation and the MacArthur Foundation. Loosely-called the “maternal health research group” and comprising just three individuals – now all Professors: Oona Campbell, Veronique Filippi and Wendy Graham – a journey began. The initial grant was to develop methodologies for measuring maternal health. This focus has remained a strong one since 1989, but today at LSHTM many other disciplines, perspectives and focal areas contribute towards a common aim – high quality research to improve the health and well-being of mothers and newborns. Across 2019, the 30 year anniversary will be celebrated through a series of events, marking not only the contribution made by academics at the School but also the many country collaborative partners and alumni. Watch this space for more details on these events and on how to take part. Here we kick-start the year with the voices of the three original musketeers – seen “before and after” in these photos.

Image: The Measuring Maternal Health Workshop participants meet at LSHTM in 1989. The group includes Veronique Filippi & Wendy Graham (front row, 3rd & 4th from the left). Oona Campbell (back row, 2nd from left).

Prof Wendy J Graham: “My memory of 1989 as our launch year is one of excitement and in trepidation – a sense of privilege that we were so new but entrusted with the challenge to improve understanding on the definition of “maternal health” and the options for measuring levels, determinants and consequences. This was at a time when the definition was, in practice, seen essentially as equivalent to “maternal mortality.” Although we had already developed The Sisterhood Method to give low-income countries an opportunity to gain some estimate of the magnitude of deaths, we were now charged to look also at the much broader field of maternal morbidity. We launched into this minefield with a unique set of colleagues from six countries. Thirty years on, the sense of responsibility but also the invitation to think outside the usual measurement box and be innovative has had a lasting impact on me.”

Prof Veronique Filippi: “In 1989, I was incredibly lucky to be hired by Wendy as a research assistant/fellow to work on measurement issues related to maternal health together with Oona. This is when I started learning my trade, particularly with respect to the measurement of maternal morbidity which became my specialty. The funding context was probably as competitive in 1989.  Granted, very few groups such as ours were working in maternal public health.  On the other hand, research funders were not making huge financial commitments. Although some USA-based private foundations, such as Ford Foundation and MacArthur Foundation, financed research in maternal health in low income settings, the Gates Foundation, Buffet Foundation and CIFF – who  are so important today in shaping the research agenda- did not exist. 1989 was a time when there was little reliable information coming from countries. There was an agreement that there was a need for better measurement tools, such as the sisterhood method developed by Wendy and Prof Bill Brass, and better programmatic responses beyond primary health care and community-based intervention, which were better suited to child health or family planning. Although poor quality of care was sometimes documented in maternity units back in the late 1980’s, efforts around its measurement, including outcomes such as near-miss and components such as respectful care and accountability, were minimal.  The challenge today is to demonstrate that a sustained focus on maternal wellbeing is essential for sustainable development and from a human right perspective.”

30 years on, the founders of the Maternal Health Group: Veronique Filippi, Oona Campbell, and Wendy Graham.

Prof Oona Campbell: “I knew I was coming to live in London about a year before I’d finished my PhD. On a visit, I walked past LSHTM , hoping it might be a place I would find work.  It was a dull November Sunday, and I made the mistake of thinking the Gower Street side was the main entrance.  All was steely-gray and firmly shut, with a barren sidewalk, speeding traffic and the strange pits leading to what I later learned were the underground vaults. There was no sign of life. It seemed unwelcoming and daunting.

Coming in the front entrance in January 1989 to a new job, in a new unit, with new colleagues was an immense contrast – full of excitement and anticipation. We focused on a new challenge- one which I think we never really cracked- of capturing maternal morbidity through household surveys. We set off an early trip to US institutions setting out our vision, which was received with enthusiasm, and we came back with a very early version of a laptop that had no memory and weighed a ton! Most exciting of all was a trip with Wendy to Assiut University in Egypt to meet the first ever colleagues that responded to our call for collaboration.  We arrived in Cairo, and we called Assiut from the Guest House where we were staying.  As I spoke to them in Arabic to clarify that I was Dr Campbell, I then realized they were expecting me to be a man.  They then asked rather plaintively “and Dr Wendy, HE is here?” The adventure of designing new research and data collection as a woman-only team had begun………..“

Watch this website for further details on how 2019 will be as, if not more, exciting than 1989!

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