By Dr Paul Lokubal, MSc candidate in Public Health for Development
To learn more about thirty years of progress and challenges in maternal and newborn health research, please join us on 30 April for a lecture and panel discussion and to hear more from Dr. Paul Lokubal.
How does one feel before interviewing a global Maternal and Child Health veteran, programmer, leader, academician, trailblazer and an icon in the fight against maternal and child health morbidity and mortality? Excited? Perhaps nervous and uncertain about how the “whole thing” will turn out? I felt a whole range of emotions, trying to figure out how to interview someone whose experience and interest in a field I’m so passionate about spans more than four decades.
As part of events to mark 30 years of ground-breaking research, innovation and teaching by the Maternal and Newborn Health Group (MNHG), I was honoured to interview alumnus of the group: Dr Vincent Fauveau, now a retired Maternal and Child Health expert, and one of those lucky few who was present at the group’s infancy.
So, who exactly is Vincent Fauveau? He is a former UNFPA country representative for Cambodia, Morocco and Djibouti, and for 9 years was the international MNH adviser based at Geneva, Switzerland. He has worked in over 18 countries with international and research agencies including Save the Children and International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B). A medical doctor specialised in neonatology, Dr Fauveau received a PhD in Public Health from the University of Nancy and boasts 35+ years’ experience in sexual and reproductive health, maternal and child health, and family planning.
It was while at LSHTM as a senior research fellow (1990-1991) that he encountered the Maternal and Newborn Health Group, comprising a team of young and enthusiastic professionals who were passionate about improving maternal mortality, then considered, “a fact of life”, and not a disease or an issue to be tackled.
“The group was small from the beginning but very much focused and dedicated on measuring and improving maternal health. Together, we discovered that maternal health was a social disease and needed epidemiological studies to measure it and monitor its changes.… The beginning [of maternal health research group] was extremely interesting and forward going.”
But it was not easy at the beginning. Measuring and classifying maternal deaths was problematic because there were no maternal death registrations in most countries, making it difficult to design effective intervention programmes. MNHG co-founder Prof Wendy Graham created the Sisterhood Method, a form of population-based survey in which women were asked if they had lost a sister or had a friend who had lost a sister to a maternal death, to fill the gap. The events surrounding the woman’s death would then be retrieved retrospectively through interviews with family members to find out how and when she died. These epidemiological studies allowed the group to classify causes of maternal death into direct and indirect factors and, importantly, identify the main direct causes of maternal deaths. Once the measurements and causal categorisations had been defined, it was important to, “translate research and measurements into intervention programmes”, and so Dr Fauveau left academia and re-joined programmes. He focused the rest of his career on promoting the role of midwives.
On the major challenges facing maternal health in the years to come, Dr Fauveau cites donor fatigue and rapidly changing political dynamics as potential derailing events. He implores maternal health researchers to invest time and resources on impact studies to be able to tell the donors, “Look! This is what has happened with your contribution!” He also urges continued lobbying and advocating for maternal and child health.
Dr Fauveau cites young and enthusiastic professionals as having the opportunity to do even more since the problems of, and solutions to, maternal health are now well defined, and belong to governments. He urges public health institutions, such as LSHTM, to attract and nurture young professionals to prepare them adequately to address maternal and child health issues. He further urges the School to advocate at the international level, and to continue to be a leader in research, innovation and teaching of public health disciplines, while ensuring these are accessible to students from all backgrounds.
For young professionals who are just joining the field of public health research and programmes, Fauveau has 3 main messages:
“First, go for higher studies – do masters and doctoral studies – because it gives you recognition, knowledge and confidence. It gives you opportunities and gives you more important roles in the future….
Secondly, think of programmes at a large scale. Don’t stay at the level of small or local NGOs which, although they are doing a very good job, won’t impact so much at country level.
Finally, go for impact studies. …they’re very important to convince donors that they [donors] are in the right direction to continue funding maternal health programs.”
And should you hit a snag and get lost in the vast oceans of an unforgiving world, don’t worry. Fauveau is, “ready to listen to young people and hear what their concerns are and give my modest advice if I can!”
Dr Paul Lokubal is a Ugandan medical doctor currently pursuing a Master’s in Public Health for Development, on Chevening Scholarship, at LSHTM. This is a summary of an interview he had with Dr Vincent Fauveau, former UNFPA country representative and MNH international adviser, and one of the alumni of the Maternal and Newborn Health Group.