UCL CENTRE FOR INTERNATIONAL HEALTH & DEVELOPMENT
WHO WE ARE AND WHAT WE DO
Design 2eFINAL.indd 2 26/9/07 10:04:22 Our purpose The UCL Centre for International Health & Development
The UCL Centre for International Health & Development (CIHD) is an interdisciplinary collaboration of leading academics based at UCL and the UCL Institute of Child Health working on health and development in a global context. Our mission is to promote the health, nutrition and welfare of children and their families in less-developed countries.
Our research themes include maternal and newborn health, nutrition and livelihoods, children in difficult circumstances, child development and disability, HIV prevention and treatment, and the evaluation of community interventions for policy and practice. We aim to develop the scientific basis for improvement in clinical practice and public health using robust epidemiological, laboratory and social-science methodologies.
We collaborate with a number of centres of excellence – especially in Africa and Asia – and share results of research widely so that they can contribute to the improvement of the health, nutrition and development of people in poor communities. We are committed with our partner organisations in developing countries to capacity-build and disseminate our work as widely as possible. We also work with a range of international agencies and NGOs promoting the use of evidence-based good practice.
In October 2006 the UCL Centre for International Child Health, the UCL International Perinatal Care Unit and the UCL International Health & Medical Education Centre united to become the UCL CIHD. We continue the innovative work begun by Professor David Morley in the Tropical Child Health Unit in the 1970s and 80s and Professor Andrew Tomkins thereafter.
Design 2eFINAL.indd 3 26/9/07 10:04:23 UCL CIHD 1 Our purpose Contents 2 Foreword
4 Our research
Maternal and newborn health 4
Disability and children in difficult circumstances 8
Nutrition and livelihoods 12
Early child development 16
18 Our teaching
Taught postgraduate programmes 18
Research degree programmes 19
Undergraduate activities 21
The Infant Feeding Consortium 21
22 Our partner institutions
24 Our people
Women & Children First 30
31 Our recent publications
36 The UCL Institute for Global Health
37 London’s global university
Left: Members of the UCL CIHD On the cover: A Malawi women’s group with whom the UCL CIHD works
Design 2eFINAL.indd 4 26/9/07 10:04:23 2 UCL CIHD Foreword
The UCL Centre for International Health & Development (CIHD), based at the UCL Institute of Child Health, gives us a tremendous opportunity to become one of Europe’s leading academic centres for global health and development. In all our work we emphasise the importance of research findings informing policy and practice, so many staff have close links with national governments and leading international agencies.
One of the most exciting aspects of the new UCL CIHD is the opportunity to expand our links with UCL’s superb academic staff in other departments, including economics, anthropology, infectious disease, HIV and sexual health, urban planning and social policy. The President and Provost of UCL, Professor Malcolm Grant, has made international health one of his key priorities within the university, and the UCL CIHD will be a core component of the new UCL Institute for Global Health.
The combination of undergraduate and postgraduate teaching brings synergies of ideas and experience to our new centre. Last year we welcomed the BSc in International Health undergraduates who now mix day-to-day with our postgraduates studying for masters and short courses in international maternal and child health and disability studies. In the future, we hope that many of the BSc alumni will come back as postgraduates.
We are in our third year of offering a European MSc in International health, a joint degree with seven European partners. Students are awarded prestigious Erasmus Mundus scholarships by the European Commission. Our participation in the tropEd European Network for International Health continues with
Design 2eFINAL.indd 5 26/9/07 10:04:24 UCL CIHD 3
sharing of MSc courses and quality assurance development. We hope that our new MSc in Global Health & Development will open doors for new partnerships.
Our teaching and research draws on a wealth of experience gained with our overseas partners in countries such as Bangladesh, China, India, Kenya, Malawi, Mexico, Nepal, South Africa and Zambia. The UCL CIHD has established population surveillance systems covering almost two and a half million people, which gives us an unrivalled opportunity to evaluate interventions, analyse health outcomes, study equity issues and ensure that our findings inform policy and practice. I hope these partnerships for research and policy will expand, allowing us to improve the health of families living in the world’s poorest countries.
We believe strongly in advocacy. In accordance with our mission, the UCL CIHD supports undergraduate and graduate networks, such as Medsin and Alma Mata, campaigning for wider recognition of global-health issues. We organised the inaugural annual UCL/Lancet lecture given in 2006 by the Prime Minister of Norway, Mr Jens Stoltenberg. In 2007 we held a conference to launch a Lancet series on early child development, and an international nutrition conference.
Our vision is for this new centre to rank with the world’s best academic centres for international health, combining academic excellence with the UCL tradition of independent and radical thought. Our academic endeavour is not the world of ‘ivory towers’, but rather to influence global policy and make a difference to the lives of millions of people in the developing world.
Anthony Costello Professor of International Child Health and Director of the UCL CIHD October 2007
Please do keep abreast of our developments through our website (www.cihd.ich.ucl.ac.uk) or by email ([email protected])
Left: Professor Anthony Costello Above: The Towards 4+5 Research Programme Consortium to reduce maternal and child mortality, was hosted by Dr Charles Mwansambo in Malawi in 2006, and attended by members of the UCL CIHD
Design 2eFINAL.indd 6 26/9/07 10:04:24 4 UCL CIHD Our research Maternal and newborn health
Towards 4+5 – Strategic Research to Achieve Ghana, Nepal, Malawi and Bangladesh with the Millennium Development Goals for Mothers and purpose of improving maternal and infant survival in Infants poor countries, by integrating disparate evidence, Partners: London School of Hygiene & Tropical generating new knowledge in key areas and Medicine; Centre MURAZ, Burkino Faso; Diabetic communicating research findings effectively. Association of Bangladesh; Kintampo Health Research Centre, Ghana; MaiMwana, Malawi; Mother Improving Essential Maternal and Newborn Care in & Infant Research Activities, Nepal Poor Rural Communities What we are doing: This DFID-funded research Location: Mchinji District, Malawi programme consortium focuses on working towards Partner: Kamuzu Central Hospital achieving MDGs 4 and 5, using strategic research to The challenge: In rural Malawi primary and develop the evidence base for policy for mother and secondary care for mothers and their infants is poor infant care at facility and community level. because of variable service quality, high turnover of The objectives of the consortium are: service providers, lack of drugs and supplies, and • to provide evidence on interventions to improve lack of ownership of health programmes by local the survival of women and infants through communities. According to the DHS survey report for (i) community interventions and (ii) health services 2005, maternal mortality is 984 per 100,000 live births. delivery Neonatal mortality accounts for almost half of all infant • completion by 2010 of a communication strategy deaths. that supports policy and management What we are doing: The MaiMwana project is the decision-making on large-scale programmes for first in this programme to take place in Africa, where maternal and infant mortality reduction health issues such as HIV/AIDS and malaria have • increased capacity in partner countries for an impact on maternal and child health. Community knowledge generation and policy influence. mobilisation is provided by trained female facilitators, The consortium manages projects in Burkina Faso, who are identified by the local communities. In
Design 2eFINAL.indd 7 26/9/07 10:04:25 UCL CIHD 5
addition, volunteer counsellors are trained in nutrition change. Therefore we work with the community and breastfeeding counselling. They provide advice groups to encourage improved diets and eating habits, and support on breastfeeding, family planning, especially during pregnancy and periods of exclusive prevention of mother-to-child transmission of HIV and breastfeeding. birth-preparedness. They also support women when Following on from the success of work by Bang they have problems with breastfeeding. Women are and colleagues in India and the Morang Innovative also supported and counselled about when to start Neonatal Initiative (MINI) project in Nepal, Mother & mixed feeding, and which foods are most nutritious. Infant Research Activities Dhanusha is also testing a system for community-based management of neonatal Trial of Community-Based Interventions for Perinatal sepsis through female community-health volunteers. Health and Nutrition These women will visit all newborns, check for signs Location: Dhanusha, Nepal of possible serious bacterial infection, administer The challenge: Infant mortality in Nepal is 68 per antibiotics as necessary and refer complicated cases 100 live births. Deaths in the first month amount to 39 to the nearest health facility for antibiotic injections. per 1,000 live births. Estimates of maternal mortality in the plains of Nepal indicate levels remain high. The City Initiative for Newborn Health What we are doing: This project aims to adapt Location: Mumbai, India the intervention in two important ways. Partners: City Initiative for Newborn Health; First, to model scale-up and potential sustainability, Society for Nutrition, Education & Health Action for we work with female community-health volunteers, an Women & Children; ICICI Bank existing group of volunteers in the government system, The challenge: Of the 26 million babies born in as facilitators for the women’s group intervention. India every year, 1.2 million die in the first four weeks Second, given the success of the intervention newborn of life, a figure that accounts for a quarter of global survival, we think that participatory community neonatal deaths. mobilisation could also affect dietary behaviour What we are doing: The City Initiative for Newborn Health (CINH) works with urban slum communities in Mumbai, the most populous city in Left: Women’s groups – such as this one in Bhimphedi, Nepal – are India with more than 16.4 million citizens and with an effective way of empowering families to improve the health of the public-health system to improve maternal and mothers and children neonatal health services at primary, secondary and Above: A women’s group meeting in Mchinji District, Malawi tertiary levels. In addition, we work with community
Design 2eFINAL.indd 8 26/9/07 10:04:26 6 UCL CIHD
members in slum areas to improve care practices partly to the funding crisis in healthcare provision and care-seeking. The CINH uses a process of on the part of international agencies and national Appreciative Inquiry, a philosophy which looks at the governments, and partly to the failure of existing strengths and potential of individuals in an health-education programmes and healthcare to organisation or community. deliver substantial benefits to those in most need. Outcomes: Each programme component will centre What we are doing: The original study, carried on the formation and activities of groups, which may out in Makwanpur district, Nepal, arose from the belief be institutional or community-based, that communities themselves could be a route to and have a range of structures that allow for improving health. Impressed by the findings of a cross-disciplinary discussion and the involvement of study from Bolivia, which suggested that key stakeholders. The process is participatory and community-based women’s groups could develop democratic, and encourages ownership. strategies to increase the survival of their own children, we decided to test the idea in Nepal. Effect of Participatory Interventions with Women’s Makwanpur district is a poor, hilly, predominantly rural Groups on Birth Outcomes: An International area in central Nepal, with limited transport and health Programme facilities. Location: Makwanpur, Nepal Working with Professor Dharma Manandhar and his Partner: Mother & Infant Research Activities team in MIRA, we strengthened district-health services (MIRA), Nepal with training and equipment across the whole district, The challenge: Neonatal deaths in developing and then tested the community programme. To do countries make the largest contribution to global this, we selected 24 areas in the district at random, mortality in children younger than five years; 90% of matched them into 12 comparable pairs, ran our deliveries in the poorest quintile of households happen programme in one area from each pair and compared at home. The opportunity: This programme comprises evaluations of community-based participatory Above: Community health involves links with traditional healers, interventions with the aim of reducing maternal and such as this Nepalese shaman neonatal mortality. There is a growing interest in Right: A group meeting in Jharkhand, India, where maternal and community participation in healthcare as a response newborn mortality rates remain high
Design 2eFINAL.indd 9 26/9/07 10:04:26 UCL CIHD 7
it with its partner. The programme involved a local women will give birth with the help of a family member woman in each area who worked with women’s groups or a traditional birth attendant, and just under half to identify their major maternal and newborn problems will receive antenatal care from a trained health and develop community-driven strategies to address professional. them. What we are doing: The UCL CIHD is providing Outcomes: We saw a 30% fall in newborn deaths technical support on a project aiming to replicate, on and an 80% fall in maternal deaths. The extraordinary a wider scale in poorer communities, primary-care success of the programme has generated international and community-based interventions. The project is discussion and set us on a path to refine, adapt and mobilising local communities, training healthcare staff retest the model. We are now conducting cluster in safe motherhood and essential newborn care, and randomised controlled trials in five additional sites, improving birth registration systems and data on all each of which allows us to modify the model and adapt births. it for a different situation. Each site also allows us to measure a novel aspect of maternal and/or newborn Improving Maternal and Newborn Health in health. Deprived Rural Areas through the Empowerment of Tribal Communities Training Traditional Birth Attendants in Poor, Rural Locations: Jharkhand and Orissa, India Districts to Prevent and Manage Birth Asphyxia at Partner: Ekjut Community Level The challenge: In India, tribal societies are widely Locations: Bogra, Faridpur and Moulavibazar, recognised as marginalised and exploited members of Bangladesh society who face social and economic discrimination. Partner: Diabetic Association of Bangladesh The health conditions of these tribal populations are The opportunity: Resuscitation with room air is aggravated by widespread poverty, illiteracy and as effective as resuscitation with oxygen. A multicentre malnutrition. There is an urgent need to improve trial has demonstrated the effectiveness of the mouth- health outcomes for mothers and newborns in these to-mask method of resuscitation in an institutional rural populations. setting which provides a more What we are doing: This project aims to reduce practical and cost-effective technical option for a maternal and newborn mortality and illness in rural community-based intervention trial. tribal communities in Jharkhand and Orissa using What we are doing: Working in Bogra, Faridpur three different approaches: and Moulavibazar, Bangladesh, the project aims to • working with women’s groups to develop strategies identify whether training traditional birth attendants for effective health promotion during pregnancy, in the prevention of birth asphyxia and neonatal delivery and the post-partum period resuscitation is a feasible and cost-effective means of • strengthening links between the community and improving newborn health and survival at community primary healthcare providers to increase use of level. services • promoting good governance and policy change in Perinatal Care Project order to improve health service delivery. Location: Bangladesh outcomes: We hope this will strengthen links Partners: Women & Children First; Diabetic between the community and primary-healthcare Association of Bangladesh providers by improving health-service delivery the challenge: Over 90% of women in and increasing the use of these services for Bangladesh will give birth at home. Nine out of ten routine care.
Design 2eFINAL.indd 10 26/9/07 10:04:28 8 UCL CIHD Our research Disability and children in difficult circumstances
Evaluation of the Impact of a Community-Based the treatment gap, reduce the economic burden Intervention to Improve the Treatment of People with and reduce the individual burden of disease, all of Epilepsy which should improve the quality of life of people with Locations: Kilifi and Muranga Districts, Kenya epilepsy. Partners: Kenya Medical Research Institute; Wellcome Trust (Kilifi) Health Consequences of Internal Migration The challenge: Although anti-epileptic drug (AED) Location: Zhejiang Province, Eastern China treatment is very effective in controlling seizures, up Partners: Zhejiang Centre for Disease Control; to 90% of people with epilepsy in developing countries Zhejiang University do not receive appropriate treatment. This ‘epilepsy- The challenge: There are approximately 120 treatment gap’ is influenced by lack of access to AED million rural-to-urban migrants in China. They make treatment, financial restrictions, stigma and poor a major contribution to China’s impressive and communication between providers and service users. consistent economic growth. However, migrants What we are doing: This study aims to evaluate are frequently marginalised in urban communities, an intervention that has community involvement are targets of discrimination, and are blamed in planning and implementation. The intervention for social disorder and rising urban crime rates. comprises educational programme and treatment Crowded housing conditions, limited access to provision. A qualitative investigation of attitudes and clean water and sanitation, movement away from beliefs about epilepsy has informed the intervention. a stable community leading to risky behaviours, We will measure the effectiveness of the intervention dangerous working conditions and poor access to in four ways: drug levels in the blood; frequency of healthcare are risk factors for poor health in migrant seizures; quality of life of people with epilepsy; and populations. However, evidence for the actual health knowledge, beliefs and attitudes about epilepsy. consequences of migration is sparse. Outcomes: If effective, the intervention will diminish What we are doing: This project aims to explore living and working conditions, health status and healthcare access in Chinese rural-to-urban migrants, and to compare these with permanent rural and urban residents. We are conducting a cross-sectional survey, anthropometric measurements and collecting blood samples for HIV and syphilis.
Effects of Pesticide Exposure on Working Children Location: Nayarit State, Mexico Partner: University of Nayarit, Mexico The challenge: Young children and adults of reproductive age are particularly at risk of the chronic effects of organophosphate pesticide exposure. Effects include neurological damage and developmental delay, neural-tube defects and cancers. Each year thousands of Huichol Indians migrate to the coastal area of Nayarit State, northwest Mexico, to work on the tobacco plantations. There they are exposed to potentially harmful levels of pesticide. Although neurological testing and measurement
Left: China is a development success story, but there has been massive migration from rural to urban areas and the UCL CIHD is studying the health consequences Above right: Huichol Indians migrate to work on the tobacco plantations of northwest Mexico, where they are exposed to potentially harmful levels of pesticide
Design 2eFINAL.indd 11 26/9/07 10:04:28 UCL CIHD 9
of cholinesterase activity have been conducted Kenya, we are evaluating the outcome of separately, they have not been directly linked through community-based cash transfer in rural areas of measurement at the time of exposure. Kenya with a high rate of orphanhood. This includes What we are doing: Working in collaboration with an assessment of what cash is being used for, who the University of Guadalajara, the Mexican National is involved in the decision-making and how many Programme for the Attention of Migrant Agricultural children benefit. Workers and the National Institute of Public Health we are developing research to measure the physiological Giving Young People who Use Augmentative and neurological effects of occupational exposure to & Alternative Communication a Voice: An children. Ethnographic Study of Identity in Young People with Outcomes: The study is urgently needed for Severe Physical and Communication Impairments the protection of migrant families and will serve Location: United Kingdom as an important advocacy tool for prohibiting Partner: Department of Anthropology, University of organophosphate and carbamic pesticide use on crop Sheffield production or where children are at risk of exposure. The challenge: Children and young people with neuro-developmental impairments that affect their Cash Transfer for Support of Orphans ability to move easily and to speak often use a Location: Kenya combination of low- and high-tech support systems Partner: Government of Kenya (AAC) to communicate. However, children using AAC The challenge: In recent years a number of are in a potentially difficult situation if communication governments in less-developed countries have started is recognised as a key contributor in the construction cash-transfer schemes to support poor families. Most of identity. Although previous studies have provided have depended on conditionality, including regular some insight into parents’ and teachers’ views of attendance at clinics and schools. The HIV epidemic these young people’s worlds, very little work has in Africa has produced a larger number of orphans, explored the participants’ own views in depth. Current many of whom are poor and not attending school. government initiatives to improve services for all A key question is how to support such children in a children and young people, as enshrined in the green sustainable way. paper ‘Every Child Matters’ (2003) and the Children What we are doing: In association with the Act (2004), are evidence that taking note of young Department of Social Services, Government of people’s views is a live and current issue in health,
Design 2eFINAL.indd 12 26/9/07 10:04:29 10 UCL CIHD
social and educational policy and practice. What we are doing: This project aims to identify What we are doing: This UK-based study uses risk factors for the uptake of injecting drug use in order qualitative methods such as participant observation in to inform recommendations for preventive strategies. their schools and homes, and extended interviews, to gain the participants’ perceptions of themselves and The Effectiveness of a Low-Tech Approach to the their lives. This project is unique in researching young Management of Feeding Difficulties in Children with people with severe disabilities over a long period of Cerebral Palsy time, and in using innovative qualitative methods Location: Dhaka, Bangladesh specially adapted for the participants. Partner: Shishu (Children’s) Hospital, Dhaka, Outcomes: The study will enrich the anthropology Bangladesh of disability, and explore identity, selfhood and The challenge: Feeding difficulties are a common personhood in children and young adults. consequence of cerebral palsy and have far-reaching effects on the children and their caregivers. Feeding An Exploration of Motivations and Risk Behaviours difficulties cause severe malnutrition, with pneumonia of Young Injecting Drug Users being the most common cause of death. Feeding Locations: Wa State, Myanmar, and Yunnan difficulties also result in caregiver frustration, upset Province, China and stress, which often leads to aggressive feeding Partner: Yunnan Bureau of Public Health practices and distressing mealtimes for the child. The challenge: There are many injecting drug What we are doing: We designed a training users in Yunnan Province (bordering Myanmar and programme for caregivers living in a low-income the neighbouring Wa State of Myanmar), which fuels environment, where alternative feeding options such the HIV epidemic. The Chinese government employs punitive measures in drug control and injecting drug users are subject to compulsory detoxification. There Above: In Malawi – and many other sub-Saharan countries – more is some evidence that increasing numbers of young than one in 100 pregnancies will end in the death of the mother people are starting to use drugs and there is growing Right: Many of the poorest countries, like Angola, are ravaged by interest in the reasons why this is occurring. conflict. Mothers and children are always the most vulnerable
Design 2eFINAL.indd 13 26/9/07 10:04:30 UCL CIHD 11
as gastrostomy-tube feeding are not available. We What we are doing: Working with partner aimed to maximise oral feeding for children with agencies in Bangalore we are exploring the views and cerebral palsy by teaching caregivers feeding methods aspirations of young people with cerebral palsy, their that would improve nutritional intake, reduce the risks non-disabled peers and some parents. of aspiration during feeding and make mealtimes more Outcomes: Using qualitative and quantitative enjoyable and less stressful. methodologies we will be able to ascertain differences Outcomes: Preliminary results show 60–70% and similarities between the views of these three achievement in the attainment of individual caregiver groups. Our partners are interested in our results to training goals, including changes in diet provided to assist their planning. their children and the caregivers’ feeding manner. Caregivers report a marked decrease in the number Continuing Work on Low-Cost Screening for of chest infections in their children since attending the Children with Disabilities training, mirrored by a significant decrease in signs Location: Sri Lanka of aspiration. Stress levels have decreased by 76.5% Partner: Disability Studies Unit, University of and children’s observed distress during feeding has Kelaniya been reduced by 66.75%. We work with policyholders What we are doing: There is a series of projects in Bangladesh to lobby for the integration of children examining how to conduct low-cost screening with disabilities into health and nutrition programmes. including generic screening by community health workers. Asia Pacific Certificate Course: Community Outcomes: This training is now conducted by the Initiatives in Inclusion Disability Studies Unit. Partner: Spastics Society of India What we are doing: Together with colleagues Low-Cost Screening for Neonatal Deafness in Bandra, Mumbai, we have developed a four-month Location: Lagos certificate course for professionals from health, Partner: Department of Audiology, University of education and social sectors. This course explores Lagos ways in which services for children with disabilities can What we are doing: We are looking at low-cost be integrated into community activities. screening by community health workers and nursing Outcomes: The course has run annually for the assistants to screen for neonatal deafness in Lagos, past four years with participants from India, Pakistan, Nigeria. Bangladesh, Mongolia, Viet Nam, Indonesia and China. Some course participants have gone on to Mumbai Parents’ Perceptions of Disability become ERASMUS scholars and attended the UCL Location: Mumbai, India CIHD as part of our postgraduate programme. Partner: Unmed Child Development Centre, Mumbai, India Adolescents’ Views of Disability What we are doing: A small project looked Location: Bangalore, India at parents’ perceptions and experiences, using Partners: Action Aid India; Leonard Cheshire qualitative methods such as narrative interviews and International; Spastics Society of India participant observation. The challenge: There is little consultation with Outcomes: This work will inform the organisation’s older children with disabilities about the services they work and may lead to changes in working practice in feel they need. early intervention for disabled children in other Mumbai-based organisations as Unmed has a training and dissemination role.
Reproductive Health Education for Migrant Workers Location: Hangzhou City, Zhejiang Province, China Partners: Zhejiang Bureau of Public Health; Zhejiang University The challenge: Our work on internal migration has indicated that rural-to-urban migrant workers in Hangzhou City have low levels of health knowledge, are prone to risk behaviours and are less likely to access health services, including reproductive and family-planning services. What we are doing: This project aims to determine the effectiveness of a peer-education approach to health education for migrant workers in Hangzhou City.
Design 2eFINAL.indd 14 26/9/07 10:04:30 12 UCL CIHD Our research Nutrition and livelihoods
The Efficacy of a Probiotic/Prebiotic-Enhanced one factor that might have significant positive benefits. Ready-to-Use Therapeutic Food in the Treatment of In this study, the therapeutic food will be enhanced Severe Acute Childhood Malnutrition by the addition of a probiotics/prebiotic mixture called Location: Blantyre, Malawi “Synbiotic” (Synbiotic 2000 forteA8 ~ Medipharm AB, Partners: Queen Elizabeth Hospital, Blantyre; K8Cger9Ad, Sweden). Valid International Outcomes: This approach has potential for treating The challenge: The incidence of severe acute critically ill patients in intensive care and other malnutrition in Africa remains a significant developed-country settings. The study hypothesis is public-health challenge. Evidence from studies in that it will also be beneficial to both HIV positive and developed countries suggests that the inclusion of negative severely malnourished people. probiotic bacteria in therapeutic feeds may reduce the incidence and severity of diarrhoea and other HIV and Management of Severe Malnutrition infections, and improve the rate of recovery. Locations: Zambia and Malawi What we are doing: This study investigates the Partners: Action Against Hunger (Malawi); efficacy of a Ready-to-Use Therapeutic Food (RUTF), Department of Paediatrics, Lusaka University enhanced by the addition of a mixture of probiotic Teaching Hospital bacteria for severely malnourished children (including The challenge: HIV/AIDS causes nutritional HIV-positive children) admitted to ‘Moyo’ Therapeutic problems in children, increases the mortality rates, and Feeding Programme (TFP) at Queen Elizabeth Central reduces the growth rates of severely malnourished Hospital, Blantyre, Malawi, where malnutrition-related children. The mechanisms and the best form of mortality and morbidity is high. Improving the food is management are not established. What we are doing: In association with the Department of Paediatrics in the Lusaka University Teaching Hospital, Zambia, we are doing clinical studies on the immunology and clinical response to nutritional rehabilitation in HIV-infected and uninfected children. In association with Action Against Hunger in Malawi we are studying the outcome of the management of severe malnutrition in nutrition centres and at home among HIV-infected and uninfected children to assess the best form of treatment, including when to start anti-retroviral therapy.
Effects of Antenatal Multiple Micronutrient Supplementation on Birth Weight and Gestational Duration Location: Nepal Partner: Mother & Infant Research Activities The challenge: A third of all deaths happen in children younger than five years, mostly in the first weeks after birth. Low birthweight (<2.5 kg) causes many of these deaths. 25 million low-birthweight infants are born every year. Antenatal multivitamin and mineral supplements could increase infant birthweight and prevent some of these deaths. What we are doing: This project compared the
Left: Ready-to-use therapeutic foods can dramatically reduce childhood deaths from severe malnutrition Above right: Improving the quality and user-friendliness of health services is a key issue
Design 2eFINAL.indd 15 26/9/07 10:04:31 UCL CIHD 13
impact of micronutrient supplements on pregnancy techniques has only recently been introduced for outcome with outcome in women who only took folic human nutrition. The approach assists decisions on acid and iron. The test pill contains a combination of how to allocate limited resources (eg food stocks) to the recommended daily allowances of ten vitamins achieve an optimal outcome (eg dietary quality) while and five minerals. Supplementation begins at about minimising costs. These techniques might improve the four months’ gestation and lasts until delivery. Results design of food products, to analyse the best possible indicate that average birthweight was 77 grams diet obtainable at a given price and to optimise the higher in the test group than the control group, while design of food aid rations. the proportion of low birthweight babies was 25 What we are doing: This project builds on percent lower. We found no difference between the our previous work in developing the spreadsheet two groups in terms of the duration of pregnancy, application NutVal 2006. The World Food Programme illness or problems during pregnancy. Many women (WFP) supplies food to about 23 million people and in both rich and poor countries take iron and folic is working to improve the nutritional impact of its acid supplements during pregnancy and only small programmes. Food-aid rations frequently fail to meet policy changes would be needed to change this to minimum standards for nutrient content and outbreaks a multivitamin and mineral supplement. However, of micronutrient malnutrition in food-aid-dependent analysis of our data in conjunction with another populations have resulted. supplementation study in Nepal has raised the Outcomes: Design of a user-friendly software possibility that, in addition to the beneficial impact on application to facilitate planning for food-aid rations birthweight, there may also be unexpected effects on that ensures that minimum standards are met, perinatal mortality. while at the same time minimising costs, will provide a Outcomes: Results from a number of international valuable tool for improving the performance of studies are currently being looked at together food-aid operations. We are working in close to assess the overall risk/benefit of this type of collaboration with colleagues in WFP in Rome. intervention. Our results from the trail children at two years show persisting effects of supplementation on Providing Effective Nutritional Support During Drug child growth. Treatment of HIV/AIDS Location: Kenya NutVal 2006: Implementation of Optimisation Partner: Valid International Algorithms in the Planning of Food-Aid Rations The challenge: There is growing evidence that Location: London effective treatment of HIV/AIDS with antiretroviral Partner: World Food Programme drugs depends on co-therapy with food supplements. The challenge: The application of linear Providing nutritional support treats the acute programming and other mathematical optimisation malnutrition often associated with AIDS and helps to
Design 2eFINAL.indd 16 26/9/07 10:04:31 14 UCL CIHD
optimise the control of secondary infections. uptake of prevention of mother-to-child transmission What we are doing: The use of ready-to-use services are being monitored. This project is being foods has been demonstrated as an effective means run in association with the LSHTM’s Chilenje Infant of treating malnutrition in AIDS patients in Africa. Growth, Nutrition & Infection Study and the UCL However, the cost of these foods is relatively high and Institute for Child Health, supported by the Gates the products used are often based on formulations Foundation. designed for the treatment of acute child malnutrition. Outcomes: Indicators of uptake of services and Outcomes: We are working on the formulation of qualitative research on reasons for uptake/non-uptake lower-cost therapeutic feeding products designed of services. specifically for use with HIV-positive adults suffering from acute malnutrition and undergoing treatment Poverty, Nutrition and Non-Communicable Disease with antiretroviral drugs. The therapeutic feeds will be Locations: Brazil; India; The Netherlands manufactured in Africa using local commodities and Partners: Federal University of Pelotas, Brazil; tested in a randomised controlled trial. King Edward Memorial Diabetes Unit, India The challenge: Diabetes, hypertension and Support of Community Groups for Counseling of coronary heart disease have a high prevalence in HIV-Infected Mothers in the Infant Feeding and HIV south Asian and African-Caribbean migrants to the UK Project in Lusaka, Zambia and other industrialised countries. There is also a high Location: Chilenje, Lusaka, Zambia prevalence of these conditions in urban populations Partners: Department of Obstetrics, Gynaecology in much of the developing world. Data suggest that & Paediatrics, Lusaka University Teaching Hospital; a change from a traditional to a more energy-dense Hestia Foundation; Gates Foundation; London School and refined diet is accompanied by a greater degree of Hygiene & Tropical Medicine (LSHTM) of metabolic and vascular disequilibrium than is The challenge: Women attending Chilenje found in people who have been used to such diets antenatal clinic have a high prevalence of HIV (around from childhood. There is some overlap with the 30%) but despite availability of HIV testing, CD4 observations of Barker and colleagues, ascribing a testing and ARVs, the number of women taking tests particular risk to postnatal, or post-infant weight gain has been low. There is a high level of stigma in subjects of low birthweight. This may be related to and low level of knowledge of how to prevent different distribution of adipose and other tissue in mother-to-child transmission in the community. The subjects with dietary energy excess or deficiency at challenge is to increase the rate of testing and uptake different phases of their life. of ARVs as appropriate. What we are doing: We are collaborating with What we are doing: A Community Support colleagues at the King Edward Memorial Diabetes Group has been formed for HIV-positive and Unit, Pune, India, on a series of studies comparing HIV-negative women and partners of women anthropometry and a range of clinical variables in attending the antenatal clinic in Chilenje. Community rural, urban slum dwellers and urban middle-class meetings, income-generating activities and social subjects in and near Pune. They have proposed the action have been started. Monitoring of these activities concept of the ‘thin-fat baby’ and have described the and their association with change in the rates of ‘Y-Y Paradox’ of high body-fat content in south Asian
Design 2eFINAL.indd 17 26/9/07 10:04:33 UCL CIHD 15
subjects with normal body mass index. burden and equity, and because even management Outcomes: Ongoing studies in Pune and of infectious diseases such as AIDS and TB raise Amsterdam exploring vascular and metabolic parallel problems. consequences of low birthweight, and a new What we are doing: The IIF was established collaboration in Pelotas, Brazil, may help to define as a charitable foundation to tackle the issues of the potential benefits and risks of postnatal food diabetes management in resource-poor countries. supplementation on adult disease risk. As well as acting as an advocacy group, the IIF has supported the work of David Beran in conducting Evaluation of a Community-Based Approach to the rapid assessment protocols in three countries in Africa Treatment of Severe Acute Malnutrition (Mozambique, Zambia and Mali) and one in Latin Location: Malawi America (Nicaragua), producing reports which have Partner: Valid International become the basis of national diabetes programs, or The challenge: Community Therapeutic Feeding even of programs for non-communicable disease as (CTC) is an approach to the treatment of severe acute a whole. With support from Diabetes UK, David is malnutrition. By appropriate triaging and the use of working to take forward the development of a ready-to-use therapeutic food (RUTF), most cases services for patients with diabetes and other of severe malnutrition can be successfully treated at non-communicable diseases in Mozambique. home, thereby reducing the costs for the carer and Outcomes: David has also recently completed and improving programme coverage. launched a major report on Implementing Diabetes WHAT WE ARE DOING: The potential for increasing Programs in sub-Saharan Africa. programme coverage and effectiveness is being assessed in a number of CTC programmes Nutrition and HIV launched in response to nutritional emergencies. Location: Lusaka, Zambia Programme performance is being evaluated against Partners: Bill and Melinda Gates Foundation; international humanitarian standards and the potential Lusaka University Teaching Hospital; London School of this approach for reducing the global burden of of Hygiene & Tropical Medicine (LSHTM) malnutrition-related child mortality is being reviewed. The challenge: Without intervention, about 30% of children born to HIV-infected mothers acquire the Health Services for People who Have Chronic virus from them. The infection rates are affected by Disease infant-feeding practice and maternal health. While the Location: Mozambique benefits of exclusive breastfeeding for prevention of Partner: The International Insulin Foundation mother-to-child transmission are clear, the optimal (IIF); Ministry of Health, Mozambique; the Diabetes infant-feeding regime for mothers once they can no Association, Mozambique longer breastfeed exclusively is not known. Various The challenge: Health services in many locally produced (industrial and domestic) foods resource-poor countries are badly equipped to may provide nutrients to those infants who are no manage patients with chronic disease. The prevalence longer breastfed. The impact on child health, growth, of insulin-requiring diabetes in much of sub-Saharan nutritional status and development is unknown. Africa is an order of magnitude lower than in What we are doing: In association with industrialised countries, in large part because the colleagues, we have developed new fortified foods for life expectancy of people who develop this condition older infants for evaluation in community studies of is as low as one year. While the cost of insulin infants of HIV infected mothers in Lusaka, Zambia. contributes to this problem, diabetes is a condition where drug availability at affordable cost is only one of several components of an effective healthcare system needed to ensure survival – educated healthcare staff, monitoring equipment and a referral system for complex cases are also vital. While non- communicable disease is accorded low priority in countries with a high prevalence of HIV and other communicable diseases, attention to improving health systems is important both for reasons of disease
Above left: Persuading women and their partners to take HIV tests and treating HIV-positive individuals with antiretroviral drugs is one of Africa’s major health challenges Right: Drugs and medical supplies are critical for the success of primary care
Design 2eFINAL.indd 18 26/9/07 10:04:34 16 UCL CIHD Our research Early child development
Efficacy of Community-Based Follow-Up, Food The Effects of Early Childhood Stimulation on Supplementation and Psychosocial Stimulation Economic, Cognitive and Social Outcomes in a in the Home Management of Young Severely Cohort of Stunted Jamaican Children Malnourished Bangladeshi Children: A Randomised Location: Jamaica Intervention Trial Partners: University of the West Indies; World Location: Bangladesh Bank Partner: International Centre for Diarrhoeal The challenge: To design suitable instruments Disease Research, Bangladesh to measure economic productivity and social The challenge: Controlling the quality of the development; to track down the subjects who have intervention. emigrated. What we are doing: Called the MINIMat study, What we are doing: We are following up children this is a cohort of 500 malnourished children who have who were enrolled into stimulation studies at 24 years been randomised to five groups standard of age to assess their educational attainment, social follow-up (SF): development and economic productivity. • SF at hospital • SF in the community The Long-Term Follow-Up of a Cohort of 2,000 • SF+ food supplementation in the community Bangladeshi Children to Determine the Effect • stimulation at community clinics + SF of Arsenic Exposure in the Drinking Water and • food supplementation + stimulation at community Nutritional Status on their Development clinics + SF. Location: Bangladesh Outcomes: Improvement in mental and motor Partners: International Centre for Diarrhoeal development assessed on the Bayley scale. Disease Research, Bangladesh; Institute of Environmental Medicine, Division of Metal & Health, Evaluation of a UNICEF Inventory to Assess Karolinska Institute; International Maternal & Child Stimulation in the Home Health Unit, Uppsala University, Sweden Location: Bangladesh The challenge: Developing culturally appropriate Partner: International Centre for Diarrhoeal assessment tools and maintaining quality of testing Disease Research, Bangladesh such large numbers. Tracking down children. The challenge: Assessing the mothers’ What we are doing: A wide-range assessment understanding of the items. of approximately 2,400 children at five years of age What we are doing: We have evaluated the whose mothers were followed from pregnancy. Family Care Inventory developed by UNICEF to assess stimulation in the home with 800 mothers from Long-Term Follow-Up of the Development of a the MINIMat sample. Language-Assessment Tool for 12- and 18-Month-Old Outcomes: The test is reliable and valid. We Bangladeshi Children identified items that needed changing. Location: Bangladesh Partner: International Centre for Diarrhoeal Disease Research, Bangladesh The challenge: The need for careful piloting. What we are doing: We developed a language assessment test for Bangladeshi children using the mothers’ report. It was based on the constructs of the MacArthur Test. We evaluated its use on the MINIMat
Left: Despite low use of hospitals for delivery in Bangladesh, maternal mortality rates have fallen sharply, due in part to better education, nutrition, access to antibiotics and safe abortion Above right: The 2006 UCL CIHD International Child Survival Symposium, at which the Bill and Melinda Gates Foundation announced a $35 million contribution to the new partnership for maternal, newborn and child health
Design 2eFINAL.indd 19 26/9/07 10:04:34 UCL CIHD 17
sample, a group of children enrolled into a food were enrolled in early pregnancy. Urinary arsenic supplementation study. will be assessed. We will examine the relationship Outcomes: The test is reliable and valid. It is related between child development and (i) arsenic exposure to children’s development measured on the Bayley prenatally and postnatally, (ii) maternal depression, Scales and home stimulation and socio-economic (iii) socio-economic environment including stimulation status. in the home and (iv) nutrition in pregnancy and early childhood. Low-Birthweight Term Babies at Six Years of Age The challenge: Developing culturally appropriate Location: Jamaica assessment tools and maintaining quality of testing Partner: University of the West Indies such large numbers. Tracking down children. The challenge: Locating the children and Outcomes: Small benefits to development at adapting instruments to be suitable for the children. seven months from early Vs late food supplementation What we are doing: A cohort of 100 and from micronutrient supplementation. No effect of low-birthweight term babies have been followed prenatal arsenic exposure detected at seven since birth. We have just completed assessing their months of age. Assessment at five years is just development at six years of age. beginning. Outcomes: Cognitive, language and motor development, behaviour and growth. Data is being The Effect of Stimulation on Iron-Deficient analysed. Anaemic and Non-Anaemic Iron Sufficient Infants’ Development The Long-Term Follow-Up of the Development of Location: Bangladesh a Cohort of 2,400 Bangladeshi Children Whose Partners: International Centre for Diarrhoeal Mothers Received Nutritional Supplementation in Disease Research, Bangladesh; Purdue University Pregnancy and Factors Affecting Development The challenge: Logistics of working in so many Partners: International Centre for Diarrhoeal villages. Designing appropriate curriculum for the age Disease Research, Bangladesh; Institute of group. Environmental Medicine, Division of Mental Health, What we are doing: A cluster randomised Karolinska Institute, Sweden; International Maternal & trial with 432 infants aged 6–12 months (216 Child Health Unit, Uppsala University, Sweden iron-deficient anaemic and 216 non-anaemic iron What we are doing: A wide range assessment of sufficient) in 40 villages to assess the cognitive and approximately 2,400 children at five years of age who motor development and behaviour before and after have been followed from birth and whose mothers intervention.
Design 2eFINAL.indd 20 26/9/07 10:04:35 18 UCL CIHD Our teaching Taught postgraduate programmes
Our taught postgraduate programmes are: to teaching, research and policy developments in their • Global Health & Development, with the option of a respective fields. disability studies pathway • International Child Health (MSc, PG Diploma and Our graduates include students from more than 70 PG Certificate), with option of a mother and child countries worldwide and from a variety of professional health pathway backgrounds including community healthworkers, • MSc in International Health (tropEd) health managers, medical doctors, nurses, • European MSc in International Health. researchers and NGO workers. This increases the capacity for students to benefit from learning about We aim to equip health professionals, managers and each other’s skills, experiences and perspectives. policymakers with the appropriate skills, knowledge and attitudes to manage effective community-based Students may study full-time or enrol on our flexible programmes in developing countries. Participants learning programme. A full-time MSc takes one year, develop skills which allow them to contribute positively while a part-time MSc takes two to five years.
Postgraduate Certificate Postgraduate diploma MSc Student successfully In addition to the core In addition to the core completes all core modules the student and optional modules, modules from September selects and successfully the student submits a to December in order to completes further optional dissertation in the summer receive the postgraduate modules from January to and if successfully certificate award June in order to receive the completed, is awarded with postgraduate diploma the MSc
Design 2eFINAL.indd 21 26/9/07 10:04:35 UCL CIHD 19 Research degree programmes
The MPhil/PhD in Child Health It runs a weekly seminar programme which provides an opportunity for our research community to The MPhil/PhD in Child Health programme at the UCL meet and share experiences and ideas through CIHD aims to provide an interesting, challenging and presentations. academically sound training for exceptional students, so that they may successfully pursue careers in At a broader level, through the UCL Graduate School research, training, medicine, child health or public and the UCL Institute of Child Health, students health. partaking in the MPhil/PhD programme are also able to pursue a wide range of academic and professional Students are initially registered for an MPhil, skills training courses. upgrading to a PhD, subject to satisfactory academic progress. MPhil/PhD research normally has an MSc in International Health (tropEd) international dimension, often with fieldwork carried out abroad. It lasts three years if taken full-time, or five For more than a decade we have been a member of years if part-time. tropEd, a network of 28 European partner institutions for higher education in international health. tropEd Students, with help from their supervisory committees, collaborates closely with institutions in Asia, Africa and finalise their research proposal during the first year. the Americas in providing postgraduate education and This may require travel to the study site to collect training opportunities, with an emphasis on student preliminary data, pilot questionnaires etc. and scholar mobility and exchange. Students include doctors, nurses, social scientists and health educators. The UCL CIHD takes an interdisciplinary approach and involves a closely connected MPhil/PhD and wider The MSc in International Health is a modular degree research network, which are kept in communication which is available for full- or part-time study and will through weekly seminars, electronic forums and the take a minimum of one year (full time) to a maximum support staff, both academic and administrative. of five years (part time) to complete.
Past and present MPhil/PhD in Child Health theses titles include:
• The management of feeding difficulties in children with cerebral palsy in Bangladesh’
• ‘Build the cradle later: An examination of perinatal care and mortality in village Nepal’
• ‘Effect of an improved complementary food on nutrition of Zambian infants’
• ‘Infant hearing screening models for the early detection of permanent childhood hearing loss in Nigeria’
• ‘Pesticides and birth outcomes: A case study of Huichol tobacco workers’
• ‘Early growth in infancy and body composition in adult life’
• ‘Design and evaluation of a low-cost, easy-to-eat, nutrient-dense food, for severely malnourished Kenyan adults living with HIV: Impact on nutritional status, compliance, and the effectiveness of antiretroviral therapy’
• ‘How does community mobilisation reduce neonatal and maternal mortality?: MaiMwana women’s groups in rural Malawi’
• ‘Maternal and neonatal deaths in rural Malawi: How many lives could be saved with more effective use of existing interventions?’
• ‘Participation of adolescents with disabilities in social, education, and health systems: Experiences from South India’
Design 2eFINAL.indd 22 26/9/07 10:04:35 20 UCL CIHD Our teaching
More than 200 modules are offered consisting of • Child Health public-health-related topics including nutrition, biology, • Health-Research Methods environmental health, epidemiology and statistics, • Health in Emergencies. infectious diseases, disability, health management and population sciences. Modules are offered across Highly qualified students who apply for the European a wide range of participating tropEd institutions, and MSc in International Health are also encouraged to participants are required to study at a minimum of two apply for the Erasmus Mundus Scholarship funded of these in different countries, providing an excellent by the European Commission. This is subject to opportunity to experience the diverse expertise that availability. each tropEd institution has to offer. Additionally, the Erasmus Mundus Scholarship is Students develop their critical thinking and analytical available for visiting academic scholars to contribute skills and the ability to draw implications for practice to teaching and research in consortium institutes. with regards to major endemic diseases, health policy, The UCL CIHD has hosted three visiting academics health-systems research, management of health from Brazil, South Africa and Australia with Erasmus services and health economics. Mundus scholarship awards.
As one of the tropEd home institutions, we offer a core Academic Foundation Year 2 Post in International course from September to December through the UCL Public Health CIHD MSc in International Child Health. We also offer a variety of advanced optional modules to be taken The growing interest in international health among from January to May as well as thesis supervision for medical students has led to a campaign to expand those students on our core course. career opportunities in international public health. Unfortunately funding for postgraduate training comes European MSc in International Health (Erasmus from UK Deaneries who generally do not recognise Mundus Programme) international training.
The MSc in International Health is also offered This has led UCL CIHD to establish an Academic under the Erasmus Mundus Programme. This is Foundation Year 2 Post in International Health. The a prestigious one-year full-time degree, the first post has proven very popular with the first three Erasmus Mundus degree to be offered at UCL. cohorts of doctors doing academic training at UCL, with 20% selecting it as their first choice. The posts This highly competitive degree attracts students of a rotate to the academic attachment for four months, high calibre and gives them the opportunity to study at but participate in a project and in generic academic up to three of the eight European institutions involved training for the entire year. in awarding the degree. Taster courses and short courses The programme aims to raise awareness of current global issues. Successful participants learn to identify We offer postgraduate modules as taster and short and critically analyse key factors influencing the health courses for several years. Our short courses are and wellbeing of low- and middle-income countries. aimed at candidates seeking non-credited professional development for which they receive a certificate Six study tracks are available to choose from, of attendance, upon successful completion of the each beginning with a three-month core course module(s). from September–December in one of the awarding institutions. Advanced modules are then taken from Several of our most prominent MSc students began at January–June at another member institution. Students the UCL CIHD with the taster programme, an excellent also carry out a research project within their study method of extending access to higher education on a track and submit it as a thesis, with supervision from a global level. It provides participants with an opportunity third participating institution. to take part on individual postgraduate modules before deciding to fully enrol on a postgraduate degree. Study tracks include: • Health Systems Successful participants earn UCL credits which can • Health Policy & Management then be transferred to a UCL CIHD MSc, PG Diploma • Sexual & Reproductive Health or PG Certificate.
Design 2eFINAL.indd 23 26/9/07 10:04:36 UCL CIHD 21 Undergraduate activities
In 2006 the UCL International Health & Medical policy to the practice of medicine both in the UK Education Centre (IHMEC) became part of the and abroad. UCL CIHD, under the new directorship of Professor Anthony Costello. The centre’s activities continue Our teaching comprises: unchanged and we anticipate that the uniting of the • BSc (intercalated) in International Health departments will create many new opportunities for • 5th-year Student Selected Component (SSC) and global health undergraduate education across a range Elective Exchange Programme in International of disciplines. Public Health • 2nd-Year SSC Introduction to International Health We aim to: Issues • provide undergraduate students with understanding • collaboration with UK and overseas institutions and knowledge of international health, and involved in developing taught course and online opportunities to gain experience and develop their teaching material for international health teaching. interests in the field The directors of the Breastfeeding: Practice & • challenge concepts of health and ideas of healthcare provision by studying different health problems and systems globally, and help to produce doctors who are flexible and responsive to patients from a wide variety of backgrounds • produce resources for teaching medical students about international health and provide support to other institutions • raise awareness of the importance of training doctors with a global, multicultural perspective on healthcare • provide an opportunity for qualified doctors to explore issues in international health and to understand the relevance of international health
The Infant Feeding Consortium
Policy course have formed the Infant Feeding breastfeeding coordinators. The course has been Consortium (IFC) to provide specialists in training, successfully piloted in South Africa with partners curricula development, formative research, health UNICEF and the Nutrition Directorate of South Africa, information and writing, programme review and policy and in Malaysia with Partners World Alliance for development on infant and young-child feeding. Breastfeeding Action.
IFC consultants have complementary backgrounds We are also: and expertise, but all have many years experience of • developing and testing the Essential Newborn Care teaching and training. course for World Health Organization (WHO) • conducting in-service training of trainers on A key component of the work of the IFC is Breastfeeding Counselling in Indonesia, Oman and capacity-building in accordance with the WHO/ India UNICEF Global Strategy on IYCF. IFC delivers a • developing short training modules on Infant range of flexible training modules, workshops and Feeding in Emergencies with the Emergency conference sessions tailored to suit the needs of Nutrition Network for use in humanitarian particular groups of participants. emergencies • continuing our long-established Breastfeeding: In response to requests from ministries of health Practice & Policy course, held in London in around the world to make the Breastfeeding: collaboration with WHO’s Child & Adolescent Practice & Policy course accessible and affordable, Health Department and UNICEF (Nutrition), run we have developed an outreach Breastfeeding: annually in June/July and attracting senior health Advocacy & Practice course. This is a two-week professionals from all over the world. training programme in partnership with host-country
Design 2eFINAL.indd 24 26/9/07 10:04:36 22 UCL CIHD Our partner institutions
Bangladesh Ireland BIRDEM Hospital Concern Diabetic Association of Bangladesh Italy Ibrahim Memorial Medical School Clinica di Malattie Infettive e Tropicali, Universita degli International Centre for Diarrhoeal Disease Research Studi di Brescia * Shishu (Children’s) Hospital World Food Programme Belgium Jamaica Prince Leopold Institute for Tropical Medicine * Epidemiology Research Unit, University of the West Brazil Indies Federal University of Pelotas Kenya Burkino Faso Government of Kenya Centre MURAZ Kenya Medical Research Institute China Wellcome Trust (Kilifi) Tongji Medical College, Huazhong University of Malawi Science and Technology * Action Against Hunger Yunnan Bureau of Public Health Kamuzu Central Hospital Zhejiang Centre for Disease Control LATH Malawi Zhejiang University MaiMwana Cuba Queen Elizabeth Hospital Instituto Superior de Ciencias Medicas de La Valid International Habana Mozambique Denmark Ministry of Health Department of International Health, Kobenhavns Diabetes Association Universitet * Mexico Ecuador University of Nayarit Facultad de Ciencias Medicas, Universidad de Nepal Cuenca Mother & Infant Research Activities France Ministry of Health National Safer Motherhood Centre de Formation et de Recherche en Medecine et Programme Sante Tropicales, Universite de Aix-Marseille II * The Netherlands Centre Rene Labusquiere, Universite Victor Segalen *, Koninklijk Instituut voor de Tropen * Bordeaux Nigeria Institut de Medecine Tropical du Service de sante des Department of Audiology, University of Lagos Armees * Norway Germany Centre for International Health, University of Charite Universitatsmedizin Berlin, Humboldt Bergen * University and Free University Berlin * Centre for International Health, University of Tromso InWent Internationale Weiterbildung und Entwicklung * Pakistan Department of Tropical Hygiene & Public Health, Aga Khan University Ruprecht-Karls-Universitat Heidelberg * Peru Ghana Universidad Peruana Cayetano Heredia, Lima Kintampo Health Research Centre Portugal India Instituto de Higiene e Medicina Tropical, Universidade City Initiative for Newborn Health, Society for Nutrition, Nova de Lisboa * Education & Health Action for Women & Children South Africa Ekjut, Chakhradapur, Jharkhand Nutrition Directorate of South Africa ICICI Bank Spain King Edward Memorial Hospital and Research Centre Departamento de Parasitologa, Facultad de Mobility India Farmacia, Universidad de Valencia * National Centre for Inclusion Escuela Nacional de Sanidad *, Madrid Spastics Society of India Facultat de Medicina, Universitat de Barcelona * Unmed Child Development Centre Universitat Autonoma de Barcelona *
Design 2eFINAL.indd 25 26/9/07 10:04:36 UCL CIHD 23
Sri Lanka The Institute for International Health & Development, Disability Studies Unit, University of Kelaniya Queen Margaret University College *, Edinburgh Sweden The International Insulin Foundation Department of Public Health Sciences, Karolinska King’s College London Institutet * ‘The Lancet’ Switzerland Leonard Cheshire Centre of Conflict Recovery Institut de Medecine Sociale et Preventive, Universite Leonard Cheshire International de Geneve * Liverpool Associates for Tropical Health Institut Universitaire de Medcine Sociale et London School of Hygiene & Tropical Medicine * Preventive *, Lausanne National Perinatal Epidemiology Unit, Oxford International Labour Organisation Nuffield Centre for International Health & Schweizerisches Tropeninstitut * Development, Institute of Health Science and Public UNHCR, the UN Refugee Agency Health Research, Nutrition Works UNICEF Open University UN Standing Committee on Nutrition Options World Health Organisation Royal Society of Tropical Medicine & Hygiene Tanzania Save the Children Fund Muhimbili University College of Health Sciences Source Thailand Teaching Aids at Low Cost Department of Public Health, Khon Kaen University * UNICEF Uganda University of Leeds * Community-Based Rehabilitation African Network The Wellcome Trust UK Wellcome Trust Bloomsbury Centre for Clinical Child to Child Programme Tropical Medicine Department of Anthropology, University of Sheffield Women and Children First UK Department for International Development USA Emergency Nutrition Network The Bill and Melinda Gates Foundation Exchange Saving Newborn Lives Handicap International Zambia The Health Foundation Lusaka University Teaching Hospital Hestia Foundation Valid International Healthlink Worldwide Infant Feeding Consortium * tropEd partner
Design 2eFINAL.indd 26 26/9/07 10:04:40 24 UCL CIHD Our people
A more detailed staff list may be found at www.cihd.ich.ucl.ac.uk.
Mel Adams BA Hons PGDipCCS MRCSLT MHPC, 4+5 Research Programme Consortium and a number of Research Fellow other research projects. She previously worked at the Special interests: neurodisability in relation to University of Southampton as a research assistant and feeding and nutrition; inclusive health; education for as an administration assistant on a DFID Knowledge health workers and health policy Programme. Mel qualified as a speech and language therapist in 1988. She has worked with a Bangladeshi community in the East Sarah Barnett PhD, Lecturer in Maternal Health End of London and done voluntary work at a rehabilitation Special interests: maternal and newborn health; centre in Bangladesh. She returned to Bangladesh to set sexual and reproductive health; cluster-randomised up a speech- and language-therapy degree course and controlled trials and quantitative-data analysis conducted fieldwork for her PhD into the effectiveness Sarah has worked in Soweto, South Africa, and China. of a low-tech approach to the management of feeding She is now working: on maternal and child health difficulties in children with cerebral palsy. research projects with Ekjut in predominantly tribal areas in Jharkhand and Orrisa, India; with the Society Nwanne Amadi BSc, Teaching Programme for Nutrition, Education & Health Action for Women & Administrator Assistant Children in the urban slums of Mumbai; and with the Nwanne provides support for the European Masters in Diabetic Association of Bangladesh. She did her PhD International Health. She also deals with admissions at Southampton using multilevel modelling and GIS to and student support for TropEd, taster- and explore inequalities in health. short-course students, provides support for the UCL CIHD Alumni Network and is responsible for the Adrita Bhattacharya BA, Postgraduate content and maintenance of the web-based learning Administrator environment, WebCT, used by academic staff and Adrita graduated in India in sociology and moved to the postgraduate students. Nwanne graduated from Brunel UK in 2004. Since then she has been working in the University with a joint degree in economics and law, NHS managing waiting times and targets. and is studying written and spoken Arabic and Spanish within the University of London. David Beran MSc, Project Coordinator, International Insulin Foundation Sarah Ball BSc MCMI, Research Administrator Special interests: diabetes, chronic diseases and Sarah is responsible for coordinating the DFID Towards health systems in developing countries
Design 2eFINAL.indd 27 26/9/07 10:04:41 UCL CIHD 25
David holds a BSc in Management with an Emphasis public-health provision; infectious diseases of the in Marketing. Following his first degree, he worked for majority world a leading Swiss Biotech Company in health policy, Tim completed an MSc in Control of Infectious government relations and public relations, and took an Diseases from the London School of Hygiene & MSc in Public Health at the London School of Hygiene Tropical Medicine in 2004. He then worked at ICH in & Tropical Medicine, with his dissertation based at the the Paediatric Epidemiology department on an NHS WHO looking at designing a model for the prevention Health Technology Assessment commissioned project of Type 2 diabetes in children. Since 2002 David has modeling the natural history of GBS and other neonatal been the Project Coordinator for the International sepsis in the UK (which included a systematic review) Insulin Foundation, where he has designed a Rapid and assessing strategies for its prevention. Tim joined Assessment Protocol, which assesses access to CIHD in February and since then has been based in diabetes care and insulin in resource-poor countries, Malawi, alongside Bejoy Nambiar on the evaluation now implemented in Mali, Mozambique, Nicaragua and of a project, funded by the Health Foundation, that Zambia. seeks to reduce maternal and neonatal mortality via community empowerment (women’s groups) and quality Julie Carter MSc PhD, Lecturer in International improvement of maternity care. Child Health Special interests: impact of poor health, Steve Collins MB BS MBE MD, Honorary Research malnutrition and disease (especially infectious Fellow diseases affecting the brain) on child development; Special interests: community therapeutic feeding; consequences of orphanhood on child health and malnutrition in famines wellbeing, in particular psychosocial status; design and Steve formed Valid International with Dr Alistair Hallam evaluation of interventions to address the problems as a means to bring about change in humanitarian faced by orphans, particularly those associated with practice. He is a specialist in nutrition who has HIV/AIDS worked on adult malnutrition in famines. Worried that Julie completed initial clinical training in speech humanitarian agencies were rarely able to reflect pathology and therapy, then took her MSc and PhD on their experience or to take a lead in developing in Neurosciences at the University of Manchester and improved approaches, they formed an organisation that UCL. She lived and worked in coastal Kenya for three would explore and disseminate evidence about what years, carrying out her doctoral work at the Wellcome works and what does not. Valid now has an excellent Trust/Kenya Medical Research Institute, investigating reputation based upon the numerous evaluations of the prevalence of neurological impairment following large-scale emergency relief programmes that it has severe malaria in children. Julie continues her work carried out for multilateral and bilateral organisations. in Kenya and has also been involved in: research Community-based Therapeutic Care (CTC) initially and consultancy work in Tanzania and Vietnam faced many challenges in being brought to fruition but looking at the impact of malaria on child development; by using a rigorous evidence-based approach, Valid the occurrence of autistic spectrum impairments in has been able to show that the approach worked child survivors of malaria; and community-based and WHO has adopted the principles of CTC as interventions to improve the medical treatment and recommendations for responding to nutritional crises. quality of life of children with epilepsy. Anthony Costello MA MB BChir FRCP FRCPCH, Prue Chalker MSc, Honorary Research Fellow Professor of International Child Health and Director of Special interests: community-based rehabilitation UCL Centre for International Health & Development and inclusive education; Child to Child Special interests: maternal and newborn health Prue runs our modules on Current Issues in Inclusive Anthony trained as a paediatrician and conducted Education and Disability & Development. She has research in neonatology at University College Hospital, worked with Sheila Wirz and colleagues in India London, before working in western Nepal with Save to develop a new international course for trainers the Children Fund. Since 1992 he has collaborated and planners of community-based rehabilitation closely with Mother & Infant Research Activities, a programmes, to which she and Sheila continue to research organisation in Nepal, and currently runs large contribute. She has also worked in Vietnam, Tajikistan epidemiological field sites and randomised controlled and Romania. She is the part-time independent chair trials in Makwanpur and Dhanusha districts in Nepal, of a neighbourhood development project in an area of monitoring pregnancies and neonatal outcomes in multiple deprivation in Plymouth, UK, where, among rural populations. This work led to collaboration on other initiatives, she and Jo Eliot are working together projects in Malawi (Maimwana), Bangladesh (DAB) and on training courses aimed at empowering women. India (with SNEHA in Mumbai and Ekjut in Jharkhand, Orissa) and also with Women & Children First, an NGO Tim Colbourn BSc MSc, Research Fellow he established in 2001 to promote the health of mothers Special interests: quantitative and qualitative and infants. epidemiology; maternal and neonatal health; health inequalities; information technology in health; Lorraine Dardis BA, MSc, PG Cert ALPD, community empowerment; community-based Postgraduate Teaching Coordinator/Tutor Lorraine manages the UCL CIHD’s postgraduate teaching and course development and has a Left: Picture cards of health problems stimulate debate in women’s background in community NGOs, European languages groups so they can develop their own healthcare strategies and translation. Lorraine completed an MSc in Public
Design 2eFINAL.indd 28 26/9/07 10:04:41 26 UCL CIHD Our people
Policy (focusing on refugee policy, health policy and in adolescent and reproductive health which have human rights) and a Postgraduate Certificate in Adult explored the epidemiology of hepatitis B and C, STIs Education & Professional Development. She represents and HIV, the vertical transmission of infection and the the UCL CIHD in the tropEd European international impact of population policy on the health of women and health education network general assembly and the children in China. tropEd Erasmus Mundus consortium. Zelee Hill MA MSc PhD, Lecturer in International Jennie Gamlin MA MSc, Teaching Fellow Child Health Special interests: public-health issues for children Special interests: community-based in difficult health circumstances in developing countries interventions; formative research; neonatal and child and non-western medical systems, with particular focus health on working and migrant children; social and cultural Zelee has over 10 years of research experience determinants; qualitative and participatory research including work in Ghana, Brazil and Tanzania working methods for working with children; the ethics of mainly in maternal and child health with a focus on research with children in developing countries; cultural (i) community interventions to reduce maternal and and social aspects of reproductive health and maternal newborn mortality, (ii) care seeking for childhood mortality illnesses and (iii) HIV/AIDS. She is principal investigator Jennie is a graduate in development studies with on a cluster randomised trial to evaluate the impact of masters degrees in Latin American studies from a behaviour change intervention delivered at home to the National Autonomous University of Mexico and rural mothers to improve newborn care. demography and health from the London School of Hygiene & Tropical Medicine. Her specific focus has Sandra Lang MPhil RM RGN Dip Ed Cert Ed, been on the health effects of child work, the health Course Director of the MSc infant-feeding modules and and psychosocial impacts of child labour in agriculture annual Breastfeeding: Practice & Policy course and the health effects of childhood occupational Sandra was a Senior Lecturer in Midwifery Studies at exposure to pesticides. Jennie has lived, worked and the University of Central Lancashire and is author of studied in Mexico, where she developed and pursued the book ‘Breastfeeding Special-Care Babies’. She research interests in critical theory, Meso-American recently completed writing and field testing (Philippines, cosmologies and their application to contemporary Mongolia and Zambia) the Essential Newborn Care western lifestyles. course for WHO (Geneva) as part of the Pregnancy, Childbirth, Postnatal & Newborn Care project aimed Paloma Garcia-Paredes MPPM, Undergraduate at helping to meet international millennium goals in Administrator maternal and neonatal care. She is involved in the Paloma graduated from the Graduate School of Public regional and national training of master trainers to and International Affairs at the University of Pittsburgh. implement this course. Sandra has been a She worked for five years there as an undergraduate consultant on infant-feeding projects for WHO and adviser and programme manager and has worked with UNICEF. the Hispanic Scholarship Fund as programme officer. Joy Lawn MB BCH MSC, Research Fellow Madeleine Green, UCL CIHD Administrator and Special interest: neonatal health Anthony Costello’s PA Having completed postgraduate training in paediatrics, Madeleine has worked in UCL CIHD for 17 years and Joy worked as a Lecturer in Child Health in a teaching previously was the Department Administrator for Human hospital in Ghana (1993–1997) where she managed the Nutrition at the London School of Hygiene & Tropical neonatal nurseries, promoted newborn health including Medicine. resuscitation training and exclusive breastfeeding, and taught medical students and postgraduate doctors. Therese Hesketh MBChB MSc MRCPCH MFPHM She was a fellow at the WHO Collaborating Center in PhD, Senior Lecturer in International Child Health Reproductive Health at the CDC Atlanta (1998–2001), Special interests: the impact of difficult and completed a Masters of Public Health at Emory circumstances on the health and psychosocial wellbeing University, Atlanta. She is a co-author of ‘The Healthy of children; reproductive health, demographic change Newborn: A reference guide for program managers’, and health systems in China a joint CDC-CARE international publication, and Therese trained in paediatrics in Bristol and London, produced the global statistics for ‘The State of the and has worked with NGOs and UN organisations in World’s Newborns’, a report by Saving Newborn Lives China, Indonesia, Cambodia and Laos as a clinical and Women & Children First. She is currently working teacher and manager of health programmes. These on a number of newborn care clinical manuals. Joy has included the development of the first Neonatal & served as a consultant or on advisory groups for WHO, Paediatric Intensive Care Unit in China and the first neonatal outreach programme for the training of doctors and nurses. Since joining the UCL CIHD she Right: Antinatal care in Nepal remains the exception rather than the has developed a number of research projects in China rule for most women in pregnancy
Design 2eFINAL.indd 29 26/9/07 10:04:41 UCL CIHD 27
CDC, the Institute of Medicine and NGOs such as David McCoy BMed MPhil DrPH MFPHA, Senior CARE and Save the Children. Research Fellow SPECIAL INTERESTS: Maternal and child health, Sonia Lewycka BSc MSc, Research Fellow health systems and global health governance Special interests: equity, equality and access David’s experience in international health began with to healthcare for rural populations; socio-economic two and half years spent as a district medical officer determinants of health in developing countries; and medical superintendent in northern Kwazulu, development of population-based surveillance systems South Africa. He then spent eight years working on for mother-and-child health outcomes; epidemiology health policy and systems research, PHC programme of mother-and-newborn health in rural African settings; implementation and health-systems development in community-based strategies to reduce mother-to-child South Africa with the University of Cape Town and the transmission of HIV Health Systems Trust. Over the last four years, he has With an undergraduate degree and masters in Natural been working in the NHS as a specialist registrar in Sciences, and a masters degree in epidemiology, Sonia public health. He is also a co-managing editor of the volunteered in India for an organisation rehabilitating Global Health Watch, an alternative world health report. people with addictions and for a school for street children. She is now involved in developing research Sally McGregor MB BS MD DPH FRCP, Emeritus and teaching collaborations in sub-Saharan Africa. She Professor of International Child Health lives in Malawi working as a Technical Advisor to the Special interests: early child development and MaiMwana Project – a community-based maternal and nutrition neonatal survival project, teaches quantitative research Sally worked at the Tropical Metabolism Research Unit methods at CIHD and is studying for a PhD on the at the University of the West Indies from 1974 until epidemiology of mother and newborn health in Mchinji joining the UCL CIHD in 1995. She is the Chair of the District, Malawi. Steering Committee for the recently published ‘Lancet’ series on Child Development in Developing Countries Sophie Martin MSc, Teaching Fellow and has published more than 150 peer-reviewed Sophie completed her Bachelor of Nursing at the articles and written many book chapters. She is an University of Nottingham, qualifying as a paediatric adviser to the UK Government and the Royal College of nurse. Since then – after staffing in a variety of settings Paediatrics & Child Health. and inspired by experience of voluntary work in Guyana and the Cook Islands – she has gone on to complete Joanna Morrison MSc, Research Fellow an MSc Econ in International Development with Special interests: testing effectiveness of distinction, specialising in International Health, at the interventions to reduce maternal and neonatal University of Wales, Swansea. Her masters research mortality in developing countries; qualitative research analysed the appropriateness of using policy generated as an evaluation methodology, and as a formative by international organisations to tackle the needs of methodology; the role of men in maternal and neonatal AIDS orphans in national and local settings. Sophie health in rural Nepal; investigating how to meet the coordinates all of the undergraduate teaching and perinatal health concerns of the most marginalised advocacy activities within the UCL CIHD and is a tutor populations on the International Health Policy module of the BSc. Jo has an MSc in Public Policy and has worked in
Design 2eFINAL.indd 30 26/9/07 10:04:42 28 UCL CIHD Our people
Honduras with Feed the Children where her work David Osrin MRCPCH DTMH PhD, Senior Research focused on supporting rural women to make their local Fellow feeding centres more sustainable and help them set Special interests: the possibilities for rigorous up local children’s clubs. She has also worked in East evaluation of public-health interventions as they unfold London and the City Health Authority’s Department of in the real world and low birthweight in developing Public Health, evaluating its maternity services. She is countries; perinatal and neonatal care and outcomes advising Mother & Infant Research Activities Nepal on in poor communities; cause-specific neonatal mortality; the development and evaluation of a women’s-group nutritional interventions to improve birthweight and intervention that has succeeded in significantly reducing neonatal mortality; community mobilisation through maternal and neonatal mortality, advises UCL CIHD participatory interventions; health-service interventions Partners in Bangladesh and India, and is completing to improve the quality and outcomes of maternal and her PhD. neonatal care; field surveillance systems for pregnancy, neonatal and infant outcomes; large-scale evaluation of Bejoy P Nambiar MBBS MHA MSc public-health interventions Special interests: working closely with people David trained in medicine, paediatrics and tropical and communities in identifying and finding solutions to medicine in the UK, Australia and Thailand, and their health priorities; developing, strengthening and joined the UCL CIHD in 1997 as part of a team that sustaining health systems tests interventions to improve newborn survival. His After having completed a degree in medicine, Bejoy earlier work concentrated on low birthweight, with worked with an NGO providing clinical care to the a particular interest in the practicalities of collecting geriatric population in the slums of Mumbai. He information in places where registration is limited. obtained a Masters in Health Administration and Subsequently he was involved in testing nutritional worked on a HIV intervention project working with interventions to improve birthweight and survival. sex workers in the slum areas of Delhi with a mobile Testing community-driven interventions to improve population such as truck drivers, before conducting women’s and infant’s survival, the integration of public health research on hypertension, and developing supply and demand, and maternal and neonatal the local research capacity. After his MSc in Health interventions are a huge challenge. David has expertise Services Research from London School of Hygiene in community enumeration, tracking, questionnaire & Tropical Medicine, he is working on an evaluation design, management of field teams, database design proposal for a scale-up development project in Malawi, and implementation, and the logistics of surveillance at funded by the Health Foundation, and is based in scale. Lilongwe, Malawi. Audrey Prost BSc MSc, Lecturer in International Child Health Special interests: South Asia; Himalayan communities; HIV; sexual-health interventions; participatory research methods Audrey is a medical anthropologist. She carried out doctoral fieldwork among Tibetan refugees in India focusing on health-seeking behaviour and the social significance of traditional Tibetan medicine among newly arrived refugees. She then worked as a lecturer in UCL Medical Anthropology before taking up a research fellowship with the MRC where she has been involved in the development of HIV prevention interventions for African communities in the UK.
Mikey Rosato MSc, Research Fellow Special interests: peace, freedom and rights; health and wellbeing of children, young people, mothers and communities in difficult circumstances; community mobilisation and participatory approaches to improving health and wellbeing; and research with participants, mixed qualitative and quantitative methods, integrated process evaluation of interventions and experimental ethnography Mikey has a masters in Archaeology & Anthropology,
Left: The UCL CIHD works in partnership with Mother & Infant Research Activities in Makwanpur, Nepal
Design 2eFINAL.indd 31 26/9/07 10:04:44 UCL CIHD 29
specialising in Biological Anthropology, and a masters micronutrient deficiencies in vulnerable populations; in Educational Psychology. He has worked for the the use of food fortification as a tool for improving the Department of Psychology & Special Needs, the Social nutritional status of populations; the use of GIS for the Science Research Unit at the Institute of Education and analysis of access to programmes and their coverage for Save the Children UK on projects predominantly and cost-effectiveness; nutritional support and therapy with children and young people, exploring such in severe acute malnutrition and HIV-associated issues as play and relationships, teenage pregnancy, malnutrition; the use of spreadsheet modelling and children’s rights and refugees. Mikey lives in Malawi optimisation in public-health programmes working on MaiMwana Project, a maternal and neonatal Having started his scientific career in laboratory survival project, as a technical advisor, teaches a research, Andrew then trained in public-health nutrition qualitative-research methods module at CIHD and is and now works on nutritional problems in populations working on a doctorate exploring the psycho-social affected by nutritional emergencies or HIV/AIDS. His mechanisms through which women’s groups reduce recent projects have been funded by the World Food mortality. Programme, the Micronutrient Initiative, Save the Children UK, UNHCR and Valid international and he Mike Rowson MSc, Teaching Fellow has worked in many African countries, Bangladesh and Special interests: international health, poverty eastern Europe. and development issues Mike is a teaching fellow on the undergraduate Andrew Tomkins OBE MBBS FRCP FRCPCH programme at the UCL CIHD. He is also a freelance FFPHM FMedSci, Professor of International Child writer on international health issues and previously was Health the Director of MEDACT, an international NGO. Special interests: nutrition and HIV; management of severe malnutrition Felicity Savage BM BCh FRCP MFPHM FIAP, Andrew trained in nutrition at the London School of Honorary Senior Lecturer in International Child Health Hygiene & Tropical Medicine and worked with the and Course Director of the MSc infant feeding Medical Research Council in Nigeria and the Gambia. modules and annual Breastfeeding: Practice & Policy He has long-developed research experience in course nutrition-infection interactions with collaborations Special interests: breastfeeding and other in Tanzania, Zambia, South Africa, Kenya and aspects of infant and young-child feeding, from a Bangladesh. He researches the impact of different public-health and community perspective support mechanisms for orphaned children, and heads Felicity has worked in Zambia, Indonesia and Kenya, the International Health Training Project – jointly developing teaching aids and health manuals, between the Royal Society of Tropical Medicine & and training healthworkers on immunisation and Hygiene, the Wellcome Trust and the Royal College of breastfeeding. She has been a consultant to WHO and Paediatrics & Child Health. UNICEF for the Baby-Friendly Hospital Initiative and is He retired as head of the UCL Centre for International a founding director of the UCL CIHD’s Breastfeeding: Child Health in 2006 and is now a trustee of UNICEF Practice & Policy course. From 1993–2001 she was a UK and Tearfund. He chairs various UN committees, medical officer at WHO responsible for breastfeeding including the SCN Working Group on Nutrition & HIV. and HIV, and infant-feeding training and policy development. She continues to be a consultant to Mary Wickenden BmedSci MSc, Research Fellow WHO, UNICEF and the Emergency Nutrition Network in Disability Studies Core Group on Infant Feeding in Emergencies, and is Special interests: cultural aspects of disability; a member of the UK Baby-Friendly Initiative Steering parents’ perceptions of disability; community-based Committee and the World Alliance for Breastfeeding rehabilitation; curriculum and training issues Action. Mary originally trained as a speech and language therapist and worked in the UK with young children Naomi Saville PhD, Research Fellow with severe disabilities. Since then she has pursued Special interests: community development; her interest in disability and development, working women’s health; gender issues; nutrition and livelihoods in two different programmes in India, and from Naomi studied natural sciences at Cambridge, 1998–2002 at the Disability Studies Unit, University specialising in zoology and ecology, and took her PhD of Kelaniya, Sri Lanka. She has also undertaken on the ecology of bees and conservation management curriculum development and training projects in Iran, of farm woodland habitats. Naomi has 13 years’ Dubai, Uganda and Bangladesh, and a project looking experience in rural development and livelihood at parents’ perceptions of disability in India. She is diversification from Nepal, Somaliland, India, Trinidad & currently studying for a PhD in the Anthropology of Tobago, Sierra Leone and Kenya. She has developed a Disability, based in the Centre for the Study of Children strong affiliation and integration into Nepali society, and & Youth at Sheffield University, funded by an ESRC/ is now applying her skills in participatory approaches, MRC studentship. overseas development and Nepal-specific cultural knowledge in the maternal and child-health context with Jolene Skordis MComm PhD, Lecturer in Health the UCL CIHD. Economics SPECIAL INTERESTS: The demand-side of Andrew Seal MSc PhD, Lecturer in International economics, ie the way that patients interact with health Nutrition services and the implications for this for health equity Special interests: the epidemiology of and efficient service delivery; developing new theory
Design 2eFINAL.indd 32 26/9/07 10:04:44 30 UCL CIHD Our people
as well as pursuing the empirical application of that Sheila has much experience on issues relating to theory community disability services and collaborations. She Jolene trained in commerce and economics at the has developed a range of courses both in the UK Universities of Cape Town and carried out her PhD at and with colleagues in Sri Lanka, India (Chennai and the London School of Hygiene & Tropical Medicine on Mumbai) and Takjikistan. She is Director of Teaching & understanding the demand for health services in Cape Learning at the UCL Institute of Child Health and in that Town: implications for health equity and effective TB role manages the smooth running of the nine degree care delivery. She has worked with an ICRC programmes, the short-courses programme and liaison delegation in Serbia advising on health-financing with the education section of Great Ormond Street mechanisms, survey methodology and data-analysis Hospital. techniques. John S Yudkin MD FRCP, Emeritus Professor of Carol Williams MSc, Course Director of the MSc Medicine, former Director of the UCL International infant feeding modules and annual Breastfeeding: Health & Medical Education Centre and Bijzonder Practice & Policy course Hoogleraar (Visiting Professor) in Vascular Special interests: breastfeeding practice and Complications of Metabolic Diseases, Vrije Universiteit policy Amsterdam Carol is a member of the Infant Feeding Consortium Special interests: medical education; health and a regular conference speaker on starting solids and services in resource-poor settings; capacity-building; the differences between breast milk and infant formula. pharmaceutical policy; diabetes and cardiovascular risk; She also leads MSc modules in nutrition policy at the obesity, inflammation and low birthweight London School of Hygiene & Tropical Medicine and the John’s interest in health and healthcare in the University of Westminster, and has carried out policy developing world was sparked by working in Tanzania development and health promotion for the European for VSO from 1968–1969 and in the University of Dar Heart Network, the Food & Agriculture Organisation, es Salaam from 1975–1977. He was appointed as the UK Department of Health, UNHCR, the World Senior Lecturer at UCL in 1980 and as Professor of Cancer Research Fund and WHO. Carol has worked Medicine in 1992, where his biomedical research has as a consultant for UNICEF on HIV and infant-feeding been largely related to cardiovascular risk, obesity, projects in Myanmar, Vietnam and South Africa, and inflammation and the metabolic syndrome, with an for the Food Standards Agency UK on complementary interest in ethnic differences in risks of diabetes and feeding, and has previously lived and worked in Sudan, vascular disease, and the impact of low birthweight Somalia and Kenya. on these differences. John established the UCL International Health & Medical Education Centre in Sheila Wirz MEd FCST PhD, Professor of Disability 2000 and has worked with UNCTAD and with WHO on & International Development pharmaceutical planning, and more recently has been Special interests: provision of appropriate involved in advocacy regarding the provision of services services for and with persons with disability in the for patients with insulin requiring diabetes in resource- community; higher-education design and management poor countries.
Women and Children First
Women and Children First (WCF) is a UK-registered Health and Director of Latin America Programmes charity, currently based in the UCL CIHD, working to for Marie-Stopes International. She has managed develop and share best healthcare practices to improve programmes across Asia, Africa and Latin America and maternal and newborn health in poor communities, is an experienced advocate. with a particular focus on pregnancy and the first 28 days of life. WCF currently manages programmes Rosemary McDonald MSc in Bangladesh and Malawi, all of which focus on Rosemary is a Programme Officer based at the UCL community mobilisation and healthcare strengthening. CIHD and completed a masters degree in public health at the London School of Hygiene & Tropical Ros Davies MA Medicine in 2006. She has six years’ experience of Ros has over 20 years senior management experience managing international development programmes for in not-for-profit settings and 18 years in the sexual various donors including DFID, the Big Lottery and and reproductive health (SRH) field of international UNAIDS. She has worked in Ukraine, Macedonia and development. Her previous roles include being CEO at Poland helping local organisations establish Citizens’ Interact Worldwide, a UK based SRH and rights NGO, Advice Bureaus, and spent three months in India consultant for USAIDs, Consultancy Services Director undertaking research for her undergraduate geography & External Relations Director at International Family dissertation.
Design 2eFINAL.indd 33 26/9/07 10:04:44 UCL CIHD 31 Our recent publications
Baker-Henningham H, Powell C, Walker S, Carter JA, Ross AJ, Neville BG, Obiero E, Katana Grantham-McGregor S (2005) The effect of early K, Mung’ala-Odera V, Lees JA, Newton CR (2005) stimulation on maternal depression: A cluster Developmental impairments following severe randomised controlled trial Arch Dis Child 90: 1230–4 falciparum malaria in children Trop Med Int Health 10: 3–10 Beran D, Yudkin JS and de Courten M. Access to care for patients with insulin-requiring diabetes in Casas JP, Shah T, Cooper J, Hawe E, McMahon AD, developing countries. Case studies of Gaffney D, Packard CJ, O’Reilly DS, Juhan-Vague Mozambique and Zambia Diabetes Care (2005) 28: I, Yudkin JS, Tremoli E, Margaglione M, Di Minno 2136–40 G, Hamsten A, Kooistra T, Stephens JW, Hurel SJ, Livingstone S, Colhoun HM, Miller GJ, Bautista LE, Beran D and Yudkin JS A theme issue by, for, and Meade T, Sattar N, Humphries SE and Hingorani about Africa: tackling the challenge of diabetes BMJ AD Insight into the nature of the CRP-coronary (2005) 331: 779–780 event association using Mendelian randomisation International Journal of Epidemiology. (2006) 35: Beran D, Yudkin JS and de Courten M Assessing 922–931 health systems for type 1 diabetes in sub-Saharan Africa: developing a ‘Rapid Assessment Protocol Chisenga M, Kasonka L, Makasa M, Sinkala M, Chintu for Insulin Access’ BMC Health Services Research C, Kaseba C, Kasolo F, Tomkins A, Murray S, Filteau (2006) 6: 17 S (2005) Factors affecting the duration of exclusive breastfeeding among HIV-infected and uninfected Beran D and Yudkin JS Diabetes care in sub-Saharan women in Lusaka, Zambia J Hum Lact 21: 266–75 Africa Lancet (2006) 368: 1689–1695 Chitty LS, Greene ND, Burren K, Hesketh T, Copp A Bhat DS, Yajnik CS, Sayyad MG, Raut KN, Lubree HG, (2006) OC126: The PONTI (Prevention of neural tube Rege SS, Chougule SD, Shetty PS, Yudkin JS and defects by inositol) clinical trial Ultrasound Obstet Kurpad AV Body fat measurement in Indian men: Gynecol 28 (4): 395 Comparison of three methods based on a two-compartment model Int J Obesity (2005) Christian P, Osrin D, Manandhar DS, Khatry SK, 29: 842–848 de L Costello AM, West KP Jr (2005) Antenatal micronutrient supplements in Nepal Lancet 366 Borghi J, Thapa B, Osrin D, Jan S, Morrison J, Tamang (9487): 711–2 S, Shrestha BP, Wade A, Manandhar DS, Costello AM (2005) Economic assessment of a women’s group intervention to improve birth outcomes in rural Nepal Lancet 366 (9500): 1882–4
Carter JA, Lees JA, Gona JK, Murira G, Rimba K, Neville BG, Newton CR (2006) Severe falciparum malaria and acquired childhood language disorder Dev Med Child Neurol 48: 51–7
Carter JA, Lees JA, Murira GM, Gona J, Neville BG, Newton CR (2005) Issues in the development of cross-cultural assessments of speech and language for children Int J Lang Commun Disord 40: 385–401
Carter JA, Mung’ala-Odera V, Neville BG, Murira G, Mturi N, Musumba C, Newton CR (2005) Persistent neurocognitive impairments associated with severe falciparum malaria in Kenyan children J Neurol Neurosurg Psychiatry 76: 476–81
Right: Studying the long-term effects of interventions in pregnancy involves monitoring the growth and health of children over many years
Design 2eFINAL.indd 34 26/9/07 10:04:45 32 UCL CIHD
Collins S, Sadler K, Dent N, Khara T, Guerrero S, impaired capillary recruitment in healthy individuals Myatt M et al. Key issues in the success of J Clin Endocrinol Metab (2006) 91: 5100–5106 community-based management of severe malnutrition Food Nutr.Bull. 2006;27(3):S49–S82 Ding QJ, Hesketh T (2006) Family size, fertility preferences, and sex ratio in China in the era of the Collins S, Dent N, Binns P, Bahwere P, Sadler K, one child family policy: results from national family Hallam A Management of severe acute malnutrition planning and reproductive health survey BMJ 333 in children Lancet 2006;368(9551):1992–2000 (7564): 371–3
Collins S, Sadler K, Bahwere P, Hallam A (2007) Ellis M, Manandhar D, Hunt L, Barnett S, Azad K (2006) Management of severe acute malnutrition in Touch detection of neonatal hypothermia in Nepal children – Authors’ reply Lancet 369 (9563): 741 Arch Dis Child Fetal Neonatal Ed 91 (5): F367–8
Colllins S. Treating severe acute malnutrition Emond A M, Lira PI, Lima M C, Grantham-McGregor seriously Lancet 2007;92:453–461 SM, Ashworth A Development of low birth weight term infants at 8 years in northeast Brazil: a longitudinal Costello A, Azad K, Barnett S (2006) An alternative study Acta Pediat 2006 Oct;95(10):1249–57 strategy to reduce maternal mortality Lancet 368 (9546): 1477–9 Engle P, Black M, Behrman JR, Cabral de Mello M, Gertler PJ, Kapiriri L, Martorell R, Young ME, Costello A, Osrin D (2005) The case for a new Global and the International Child Development Steering Fund for maternal, neonatal, and child survival Group (Grantham-McGregor S, Meeks Gardner J, Lancet 366 (9485): 603–5 Lozoff B, Wachs T, Walker S) Child development in developing countries 3. Strategies to avoid the loss Costello A, Osrin D (2005) Epidemiological transition, of developmental potential among more than 200 medicalisation of childbirth, and neonatal mortality: million children in the developing world Lancet 2007 three Brazilian birth-cohorts Lancet 365: 825–6 369: 229–242
Costello A, Filippo V, Kubba T, Horton R. Research Fernandez A, Osrin D (2006) The City Initiative for challenges to improve maternal and child survival Newborn Health PLoS Med 3 (9): e339 Lancet 2007;369:1240–1243 Filippi V, Ronsmans C, Campbell OM, Graham WJ, Creeke PI, Seal AJ (2005) Quantitation of the niacin Mills A, Borghi J, Koblinsky M, Osrin D (2006) Maternal metabolites 1-methylnicotinamide and health in poor countries: the broader context and a l-methyl-2-pyridone-5-carboxamide in random spot call for action Lancet 368 (9546): 1535–41 urine samples, by ion-pairing reverse-phase HPLC with UV detection, and the implications for the use Gamlin J, Romo PD, Hesketh T Exposure of young of spot urine samples in the assessment of niacin children working on Mexican tobacco plantations status J Chromatogr B Analyt Technol Biomed Life Sci to organophosphorous and carbamic pesticides 817: 247–53 indicated by cholinesterase depression Child Care Health Dev 2007;33:246–248 de Jongh RT, Ijzerman RG, Sern8E EH, Voordouw JJ, Yudkin JS, Delemarre-van der Waal HA, Stehouwer Gardner JM, Powell CA, Baker-Henningham H, Walker CDA and van Weissenbruch MM Visceral and truncal SP, Cole TJ, Grantham-McGregor SM (2005) Zinc subcutaneous adipose tissue are associated with supplementation and psychosocial stimulation: effects on the development of undernourished Jamaican children Am J Clin Nutr 82: 399–405
Gitau R, Makasa M, Kasonka L, Sinkala M, Chintu C, Tomkins A, Filteau S (2005) Maternal micronutrient status and decreased growth of Zambian infants born during and after the maize price increases resulting from the southern African drought of 2001–2002 Public Health Nutr 8: 837–43
Grantham-McGregor S, Baker-Henningham H Review of the evidence linking protein and energy to mental development Public Health Nutr. 2005 Oct;8(7A):1191–201
Grantham-McGregor S (2005) Can the provision of breakfast benefit school performance? Food Nutr Bull 26: S144–58
Left: UCL CIHD research has examined human rights in China
Design 2eFINAL.indd 35 26/9/07 10:04:46 UCL CIHD 33
Grantham-McGregor S, Baker-Henningham H (2005) Hesketh T, Li L, Ye X, Wang H, Jiang M, Tomkins Review of the evidence linking protein and energy to A (2006) HIV and syphilis in migrant workers in mental development Public Health Nutr 8: 1191–201 eastern China Sex Transm Infect 82 (1): 11–4
Grantham-McGregor SM, Olney D (2006). School Hesketh T, Xing ZW (2006) Abnormal sex ratios in feeding, cognition and school achievement Clinical human populations: Causes and consequences Nutrition 15:1–7 Proc Natl Acad Sci U S A 103 (36): 13271–5
Grantham-McGregor SM, Cheung YB, Cueto S, Hesketh T, Lu L, Jun YX, Mei WH Smoking, cessation Glewwe P, Richter L, Strupp B and International and expenditure in low income Chinese: cross Child Development Steering Group (Engle P, Black sectional survey BMC Public 2007;7:29 M, Meeks Gardner J, Lozoff B, Wachs T, Walker S) Child development in developing countries 1. Hesketh T HIV/AIDS in China: the numbers problem Developmental potential in the first five years for Lancet 2007;369:621–623 children in developing countries Lancet 2007 369: 60–70 Hindle LJ, Gitau R, Filteau SM, Newens KJ, Osrin D, Costello AM, Tomkins AM, Vaidya A, Mahato RK, Grantham-McGregor S Early child development in Yadav B, Manandhar DS (2006) Effect of multiple developing countries Lancet 2007;369:824 micronutrient supplementation during pregnancy on inflammatory markers in Nepalese women Am J Hamadani J D, Huda S N, Khatun F, Clin Nutr 84 (5): 1086–92 Grantham-McGregor SM Psychosocial stimulation improves the development of malnourished Idro R, Carter JA, Fegan G, Neville BGR, Newton CRJC children in rural Bangladesh J Nutr. 2006;136 (2006) Risk factors for persisting neurological and 2645–2652 cognitive impairments following cerebral malaria Arch Dis Child 91: 142–8 Hesketh T, Lu L, Xing ZW (2005) The effect of China’s one-child family policy after 25 years Ireland H, Konstantoulas CJ, Cooper JA, Hawe E, N Engl J Med 353: 1171–6 Humphries SE, Mather H, Goodall AH, Hogwood J, Juhan-Vague I, Yudkin JS, di Minno G, Margaglione M, Hesketh T, Tang F, Wang ZB, Huang XM, Williams D, Hamsten A, Miller GJ, Bauer KA, Kim YT, Cubitt DW, Tomkins AM (2005) HIV and syphilis in Stearns-Kurosawa DJ and Kurosawa S EPCR young Chinese adults: implications for spread Int J Ser219Gly: Elevated sEPCR, prothrombin F1+2, STD AIDS 16: 262–6 risk for coronary heart disease, and increased sEPCR shedding in vitro Atherosclerosis. (2005) 183: Hesketh G, Qu JD (2005) Psychological morbidity 283–292 in Chinese adolescents Psychological Reports 96: 435–444 Kasonka L, Makasa M, Marshall T, Chisenga M, Sinkala M, Chintu C, Kaseba C, Kasolo F, Gitau R, Tomkins A, Hesketh T (2005) The 10/90 report on health Murray S, Filteau S (2006) Risk factors for subclinical research Transactions of the Royal Society of Tropical mastitis among HIV-infected and uninfected women Medicine and Hygiene 99: 638–640 in Lusaka, Zambia Paediatr Perinat Epidemiol 20 (5): 379–91 Hesketh T, Ding QJ (2005) Anxiety and depression in adolescents in urban and rural China Psychol Rep Kihara M, Carter JA, Newton CRJC (2006) The 96: 435–44 effect of Plasmodium falciparum on cognition: a systematic review Trop Med Int Health 11(4): 386–97 Hesketh T, Duo L, Li H, Tomkins AM (2005) Attitudes to HIV and HIV testing in high prevalence areas Knippenberg R, Lawn JE, Darmstadt GL, Begkoyian of China: informing the introduction of voluntary G, Fogstad H, Walelign N, Paul VK, Lancet Neonatal counselling and testing programmes Sex Transm Survival Steering Team (2005) Systematic scaling up Infect 81: 108–12 of neonatal care in countries Lancet 365: 1087–98
Hesketh T, Zhu WX, Zhang J (2005) Mother to child Lawn J, Shibuya K, Stein C (2005) No cry at birth: transmission of HIV in China: Chinese HIV sentinel global estimates of intrapartum stillbirths and surveillance data were used incorrectly BMJ 331: intrapartum-related neonatal deaths Bull World 162; author reply 162 Health Organ 83: 409–17
Hesketh TM, Lu L (2005) HIV and syphilis in Chinese Lawn JE, Cousens S, Zupan J, Lancet Neonatal internal migrants AIDS 19: 1550 Survival Steering Team (2005) 4 million neonatal deaths: when? Where? Why? Lancet 365: 891–900 Hesketh T, Gamlin J, Woodhead M (2006) Policy in child labour Arch Dis Child 91 (9): 721–3 Lawn JE, Costello A, Mwansambo C, Osrin D (2007) Countdown to 2015: will the Millennium Hesketh T, Xing ZW (2006) Human rights in China Development Goal for child survival be met? Arch Lancet 368 (9529): 27 Dis Child 92 (6) 551–6
Design 2eFINAL.indd 36 26/9/07 10:04:46 34 UCL CIHD
Lietz G, Mulokozi G, Henry JC, Tomkins AM (2006) of selective feeding programs Bulletin of the World Xanthophyll and Hydrocarbon Carotenoid Patterns Health Organization 2005;83(1):20–6 Differ in Plasma and Breast Milk of Women Supplemented with Red Palm Oil during Pregnancy Natali A, Toschi E, Baldeweg S, Casolaro A, Baldi S, and Lactation J Nutr 136 (7): 1821–7 Sironi AM, Yudkin JS and Ferrannini E Haematocrit, type 2 diabetes, and endothelium-dependent Ijzerman RG, Voordouw JJ, van Weissenbruch MM, vasodilatation of resistance vessels Eur Heart J. Yudkin JS, Serne EH, Delemarre-van de Waal HA and (2005) 26:464–71 Stehouwer CD TNF-alpha levels are associated with skin capillary recruitment in humans: a potential Newens K, Filteau S, Tomkins A (2006) Plasma explanation for the relationship between 25-hydroxyvitamin D does not vary over the course TNF-alpha and insulin resistance Clin Sci (2006) 110: of a malarial infection Trans R Soc Trop Med Hyg 361–368 100: 41–44.
Lu L, Xing ZW, Jun Z, Hesketh T (2005) Reform of Osrin D, Vaidya A, Shrestha Y, Baniya RB, Manandhar primary care in China Lancet 366: 120 DS, Adhikari RK, Filteau S, Tomkins A, Costello AM (2005) Effects of antenatal multiple micronutrient Martines J, Paul VK, Bhutta ZA, Koblinsky M, Soucat supplementation on birthweight and gestational A, Walker N, Bahl R, Fogstad H, Costello A, Lancet duration in Nepal: double-blind, randomised Neonatal Survival Steering Team (2005) Neonatal controlled trial Lancet 365: 955–62 survival: a call for action Lancet 365: 1189–97 Phiri W, Kasonka L, Collin S, Makasa M, Sinkala M, Makasa M, Kasonka L, Chisenga M, Sinkala M, Chintu Chintu C, Kasolo F, Kaseba C, Tomkins AM, Filteau C, Tomkins A, Filteau S Early growth of infants of SM (2006) Factors influencing breast milk HIV RNA HIV-infected and uninfected Zambian women Trop viral load among Zambian women AIDS Res Hum Med Int Health 2007;12:594–602 Retroviruses 22 (7): 607–14
McNally LM, Jeena PM, Gajee K, Sturm AW, Tomkins Rochat TJ, Richter LM, Doll HA, Buthelezi NP, Tomkins AM, Coovadia HM, Goldblatt D (2006) Lack of A, Stein A (2006) Depression among pregnant rural Association between the Nasopharyngeal Carriage South African women undergoing HIV testing JAMA of Streptococcus pneumoniae and Staphylococcus 295 (12): 1376–8 aureus in HIV-1-Infected South African Children J Infect Dis 194 (3): 385–90 Rondo PH, Tomkins A (2005) Maternal overweight/obesity and birthweight of newborn McNally LM, Jeena PM, Gajee K, Thula SA, Sturm AW, babies J Trop Pediatr 51: 125–6 Tomkins AM, Coovadia HM, Goldblatt D Effect of age, polymicrobial disease, and maternal HHIV status on Rosa H, Goldani MZ, Scanlon T, da Silva AA, Giugliani treatment response and cause of severe pneumonia EJ, Agranonik M, Tomkins A (2006) Barriers for HIV in South African children: a prospective descriptive testing during pregnancy in Southern Brazil Rev study Lancet 2007;369:1440–1451 Saude Publica 40 (2): 220–5
Millward H, Ojwang VP, Carter JA, Hartley S (2005) Rosato M, Mwansambo CW, Kazembe PN, Phiri T, International guidelines and the inclusion of Soko QS, Lewycka S, Kunyenge BE, Vergnano S, disabled people: The Ugandan Story Disability and Osrin D, Newell ML, Costello AM (2006) Women’s Society 20: 153–169 groups’ perceptions of maternal health issues in rural Malawi Lancet 368 (9542): 1180–8 Miranda JJ, Yudkin JS and Willott C International Health Electives: four years of experience Travel Roy SK, Tomkins AM, Ara G, Jolly SP, Khatun W, Medicine and Infectious Disease (2005) 3: 133–141 Chowdhury R, Chakrabarty B (2006) Impact of zinc deficiency on vibrio cholerae enterotoxin-stimulated Morange PE, Saut N, Alessi MC, Frere C, Hawe E, water and electrolyte transport in animal model Yudkin JS, Tremoli E, Margaglione M, Di Minno G, J Health Popul Nutr 24 (1): 42–7 Hamsten A, Humphries SE, Juhan-Vague I, on behalf of the HIFMECH Study Group Interaction between Sadler K, Bahwere P, Guerrero S, Collins S the C-260T polymorphism of the CD14 gene the Community-based therapeutic care in HIV affected plasma IL-6 concentration on the risk of myocardial populations Trans.R.Soc.Trop.Med Hyg. 2006;100 infarction: The HIFMECH study Atherosclerosis (1):6–9 (2005) 179: 317–323 Sadler K, Myatt M, Feleke T, Collins S A comparison Morrison J, Tamang S, Mesko N, Osrin D, Shrestha B, of the programme coverage of two therapeutic Manandhar M, Manandhar D, Standing H, Costello A feeding interventions implemented in neighbouring (2005) Women’s health groups to improve perinatal districts of Malawi Public Health Nutr 2007;1–7 care in rural Nepal BMC Pregnancy Childbirth 5: 6 Sauvey S, Osrin D, Manandhar DS, Costello AM, Wirz Myatt M, Feleke T, Collins S, Sadler K A field trial S (2005) Prevalence of Childhood and Adolescent of a survey method for estimating the coverage Disabilities in Rural Nepal Indian Pediatr 42: 697–702
Design 2eFINAL.indd 37 26/9/07 10:04:46 UCL CIHD 35
Seal AJ, Creeke PI, Mirghani Z, Abdalla F, McBurney Walker SP, Chang SM, Powell CA, Grantham-McGregor RP, Pratt LS, Brookes D, Ruth LJ, Marchand E (2005) SM (2005) Effects of early childhood psychosocial Iron and vitamin A deficiency in long-term African stimulation and nutritional supplementation refugees J Nutr 135: 808–13 on cognition and education in growth-stunted Jamaican children: prospective cohort study Lancet Seal AJ, Creeke PI, Gnat D, Abdalla F, Mirghani Z 366: 1804–7 (2006) Excess dietary iodine intake in long-term African refugees Public Health Nutr 9 (1): 35–9 Walker SP, Chang SM, Powell CA, Simonoff E, Grantham-McGregor SM (2006) Effects Seal, A J, Creeke, PI, Dibari, F, Cheung, E, Kyroussis, of psychosocial stimulation and dietary E, Semedo, P, & van den, B T (2007) Low and supplementation in early childhood on deficient niacin status and pellagra are endemic in psychosocial functioning in late adolescence: postwar Angola Am J Clin Nutr. 85: 218–224 follow-up of randomised controlled trial BMJ 333 (7566): 472 Seal, A & Kerac, M (2007) Operational implications of using 2006 World Health Organization growth Walker SP, Wachs T, Meeks Gardner J, Lozoff B, standards in nutrition programmes: secondary data Wasserman GA, Pollitt E, Carter JA, International Child analysis BMJ;334:733 Development Steering Group (Grantham-McGregor S, Engle P, Black M) Child development in developing Stein A, Krebs G, Richter L, Tomkins A, Rochat T, countries 2. Child development: Risk factors for Bennish ML (2005) Babies of a pandemic Arch Dis adverse outcomes in developing countries Lancet Child 90: 116–8 2007 369: 145–157
Tomkins A (2005) UNICEF: suggestions for change Wirz S, Edwards K, Flower J, Yousafzai A (2005) Lancet 365: 289–90 Field testing of the ACCESS materials: a portfolio of materials to assist health workers to identify Tomkins A (2006) Measuring obesity in children: children with disabilities and offer simple advice to what standards to use? J Pediatr (Rio J) 82 (4): mothers Int J Rehabil Res 28: 293–302 246–248 Yudkin JS, Eringa E and Stehouwer CDA Vasocrine Wade A, Osrin D, Shrestha BP, Sen A, Morrison J, signalling from perivascular fat – a mechanism Tumbahangphe KM, Manandhar DS, de L Costello AM linking insulin resistance and vascular disease (2006) Behaviour change in perinatal care practices Lancet (2005) 365: 1817–1820 among rural women exposed to a women’s group intervention in Nepal [ISRCTN31137309] BMC Yudkin JS Prospective value of admission plasma Pregnancy Childbirth 6: 20 glucose and HbA1c in acute myocardial infarction Diabetic Medicine (2005) 22: 209–210
Yudkin JS and Freemantle N PROactive Study Lancet (2006) 367: 24–25
Yudkin JS The relationship between dysglycaemia and cardiovascular and renal risk in diabetic and non-diabetic participants in the HOPE study: a prospective epidemiological analysis – comment Diabetologia (2006) 49: 611–612
Yudkin JS Insulin for the world’s poorest countries Vintage Papers from the Lancet, Ed R Richardson, pp 430–432. Elsevier, Edinburgh, 2006
Yudkin JS Post-prandial hyperglycaemia and prevention of cardiovascular diseases – comment Diabetic Medicine – Continuing Education (2006) 23 (Suppl 1): 24–25
Yudkin JS Confounders in chronic stress at work and metabolic syndrome BMJ (2006) 332: 1153–1154
Yudkin JS The DREAM Trial Lancet (2006) 368: 2049–2050
Left: Women’s groups are highly effective at mobilising communities to expedite transport to hospital when an emergency occurs
Design 2eFINAL.indd 38 26/9/07 10:04:47 36 UCL CIHD The UCL Institute for Global Health
The UCL Centre for International Health & Development (CIHD) is a key contributor to and participant in the new UCL Institute for Global Health (IGH), which will create a dynamic and coherent programme of excellent research, education, advocacy and partnerships for global health.
UCL’s world-leading biomedical activity is undertaken within a multifaculty university with an international reputation for excellence in economics, anthropology, climatology, law, human rights, the built environment and urban planning.
UCL has a wealth of teaching expertise related to global health at both undergraduate and postgraduate levels, which will prove the basis for an expansion of interdepartmental collaboration in teaching and learning, such as sharing modules across degrees and developing interdisciplinary programmes.
Research topics already underway at UCL include infectious and non-infectious diseases, maternal and child health, health technologies, disability, healthcare services, health inequalities, the history of international medicine and the social determinants of health.
The UCL IGH will focus these diverse experts and their perspectives on the issue of global health, from basic science and the development of novel interactions, through clinical evaluation, to technology and knowledge transfer, through implementation at scale.
Among the departments already engaged in this undertaking are the UCL CIHD, UCL Epidemiology & Public Health, UCL Primary Care & Population Science, UCL Economics, UCL Anthropology, the UCL Bartlett Faculty of the Built Environment, UCL Laws and the UCL Institute for Women’s Health.
Participants at a UCL IGH planning workshop in April 2007 (pictured below, from left) included: Professor Malcolm Grant, President and Provost of UCL; Professor Michael Worton, UCL Vice-Provost (Academic & International); Professor Ed Byrne, Executive Dean of the UCL Medical School; Professor Anthony Costello, UCL CIHD; Professor Anne Johnson, UCL Primary Care & Population Science; Professor Sir Michael Marmot, UCL Epidemiology & Public Health; and Dr Richard Horton, Editor of ‘The Lancet’ and an honorary professor at UCL.
Design 2eFINAL.indd 39 26/9/07 10:04:55 London’s global university
UCL, London’s global university, is located in the heart of the capital’s culturally and intellectually vibrant Bloomsbury quarter, close to the British Library and the British Museum. Its main campus, dating from 1826, is a historic landmark in its own right.
This campus – which is home to leading experts in science, technology, arts, social sciences and humanities – is a hothouse of creative, interdisciplinary thinking, challenging the boundaries of knowledge to the benefit of students, scholars and society alike.
UCL’s record of research and teaching is outstanding, and it has produced no fewer than 19 Nobel Laureates. Of its academic departments, more than eight out of ten are independently rated as producing research of international excellence. Its teaching provision is independently rated ‘Excellent’, averaged across all departments.
UCL is proud that it was the first university in England to have welcomed students of any class, race or religion, and the first to welcome women on equal terms with men. Students from outside the UK were enrolled from the start. This same radical spirit thrives today, attracting the most talented students and staff from all over the world, as well as forging strong relationships with institutions and businesses across the globe.
As London’s research and teaching powerhouse, UCL addresses the world’s problems through the application of its expertise, spanning the sciences, arts, humanities, social sciences and biomedicine.
UCL’s vision today is the same as it was in 1826: to use its strengths and resources as a force for change and progress in education at all levels.
Design 2eFINAL.indd 40 26/9/07 10:05:00 UCL Centre for International Health & Development Uniting the UCL Centre for International Child Health, the UCL International Perinatal Care Unit and the UCL International Health & Medical Education Unit
UCL Institute of Child Health T: +44 (0)20 7905 2122 30 Guilford Street F: +44 (0)20 7404 2062 London WC1N 1EH E: [email protected] UK W: www.cihd.ich.ucl.ac.uk
Design 2eFINAL.indd 1 26/9/07 10:04:21