Joy Lawn

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Joy Lawn

FRCPCH FMedSci
Joy Lawn (cropped).jpg
Alma mater University of Nottingham (MB BS)
Emory University (MPH)
University College London (PhD)
Known forNeonatal deaths, stillbirths,
perinatal epidemiology, public health, women's leadership
Spouse Stephen Lawn [1]
Awards Royal Society Wolfson Research Merit Award
Scientific career
Institutions London School of Hygiene and Tropical Medicine
Save the Children USA
Thesis 4 million neonatal deaths : an analysis of available cause-of-death data and systematic country estimates with a focus on birth asphyxia  (2009)
Doctoral advisor Anthony Costello [2]
Website www.lshtm.ac.uk/aboutus/people/lawn.joy

Joy Elizabeth Lawn FRCPCH FMedSci is a British paediatrician and professor of maternal, reproductive and child health. She is Director of the London School of Hygiene & Tropical Medicine Maternal, Adolescent, Reproductive & Child Health (MARCH) Centre. She developed the epidemiological evidence for the worldwide policy and programming that looks to reduce neonatal deaths and stillbirths and works on large-scale implementation research.

Contents

Education and early career

Lawn's mother was a teacher and missionary in northern Uganda [3] who suffered from an obstructed labour and was transferred to a bush hospital where the medic had never performed a caesarean section before. [3] Lawn and her parents moved to Northern Ireland at the height of The Troubles. [3] She studied medicine at the University of Nottingham and specialised in paediatrics, graduating in 1990. [3] She moved back to Africa in the early 1990s, working as a neonatologist and lecturer at Kumasi in Ghana. [4] She helped set up neonatal care at the University of Ghana Teaching Hospital. [3] She was upset by many neonatal deaths daily and worked to reduce mortality with simple approaches, such as detecting infections early and not rotating nurses off neonatal wards. [3]

Research

Victoria Nakibuuka, Lawn and Uduak Okomo Dr Uduak Okomo, Joy Lawn and Dr Victoria Nakibuuka.jpg
Victoria Nakibuuka, Lawn and Uduak Okomo

Lawn moved to Atlanta with her family in 1997. [3] She became more interested in public health, and joined the Centers for Disease Control and Prevention. Whilst in Atlanta she earned a Master of Public Health at Emory University. She found there were very few statistics on infant mortality as many babies who die in the Developing World are not registered at birth. [3] She moved to the UCL Great Ormond Street Institute of Child Health in 2001, where she completed a PhD in 2009. [2] [5] She worked for Save the Children USA from 2005. She was based in South Africa from 2005 to 2012 with Save the Children USA to work with 9 African countries to save newborn lives and undertaking large scale community trials. [6] [7] The BBC documentary, Invisible Lives, found that Nepal and Malawi were some of the few countries on track to meet the United Nations development goal to end the death of children under 5. [8] In 2013 she was appointed director of MARCH at the LSHTM. [9] She was awarded a Royal Society Wolfson Research Merit Award to improve data on stillbirths and newborns. [10] With the London School of Hygiene & Tropical Medicine, Lawn developed a massive open online course on women's health that was delivered to over 26,000 participants from 130 countries. [11]

Neonatal deaths and stillbirths

Lawn started to coordinate neonatal death and stillbirth estimates for the United Nations with the United Nations Child Health Epidemiology Reference Group from 2004. [12] She developed the first cause of death estimates for neonatal deaths, which was published in The Lancet in 2005. [13] She found in Uttar Pradesh neonatal mortality rates were as high as 60 in 1000 livebirths and 41 per 1000 in Sub-Saharan Africa. [3] In her report she called for an end to the 'unconscionable' 450 newborn deaths per hour. [13] She developed the continuum of care for reproductive, maternal, newborn and child health (RMNCH). [14] She co-led The Lancet Stillbirth series in 2011 and 2016. [15] [16] She worked with the World Health Organization (WHO) to identify that in 2008 there were 2.65 million stillbirths worldwide, with 67% occurring in rural families. [15] The report found that over 98% of the stillbirths worldwide were in middle and low-income families. [17] Lawn presented a Lancet TV series on Ending the Stillbirth epidemic. [18]

She was funded by the Bill & Melinda Gates Foundation as the Director of Evidence and Policy for Save the Children, Saving Newborn Lives Program. [19] She was appointed to the Department for International Development Senior Research Fellow for newborn health in 2011 to 2015. [12] She has worked to draw attention to equity issues and was involved with the Countdown to 2015 initiative. [20] Lawn works on improving community engagement with national policy on healthcare, emphasising that in some countries people will choose to give birth at home even when there are nearby facilities, especially if quality of care is poor. Improving the quality of care at birth in hospitals could save 2 million lives a year [21] [22] Lawn's The Lancet Neonatal Survival Series (2005) was followed ten years later by the Every Newborn Series, which advocated for quality care, facilities and community action at birth. This series led to the UN's Every Newborn Action Plan, and the first ever Global Goal for every country to reduce newborn deaths [23]

Preterm birth was made a World Health Organization priority to reach Millennium Development Goal 4. [24] Lawn believes that kangaroo care could prevent death and disability caused by preterm birth and is an important foundation for intensive care that is family centred. [25] In 2014 she studied preterm birth worldwide, which is now the number one killer of young children under five worldwide. [26] [27] She estimated that over one million children under 5 years old died from complications of pregnancy. [26] These realisations motivated Lawn and Mary Kinney with the March of Dimes and 50 partner agencies to author the Born Too SoonGlobal Action Report on preterm birth, the first ever estimates of preterm birth by country. [24] [28] [29] They found that 44% of child deaths globally occurred during the first month. [30] The report was included as a commitment on the Every Woman Every Child website. [24] Group B streptococcal infection is an important perinatal pathogen. [31] Lawn works on Group B streptococcal infection, hoping to improve health system measurements and intervention trials. [4] In estimates published with Anna Seale and 103 other authors, Group B Strep was found to be responsible for at least 150,000 preventable infant deaths and stillbirths a year. [31]

Awards and honours

Lawn was awarded the 2013 Programme for Global Paediatric Research award for Outstanding Contributions to Global Child Health. [32] In 2014 the Uppsala University awarded her the Nils Rosén medal for paediatrics. [5] in 2015 she was awarded the Sheth Distinguished International Alumni Award, Emory University, Atlanta. She was made a Fellow of the Academy of Medical Sciences in 2016. [33] [34] She was elected to the National Academy of Medicine in 2018. [35]

Personal life

Lawn is the widow of Stephen Lawn, who was a TB/HIV researcher at London School of Hygiene & Tropical Medicine and the University of Cape Town. Stephen died in 2016 of an aggressive brain tumour. They have a son, Tim, and a daughter, Joanna. [1]

Related Research Articles

<span class="mw-page-title-main">Infant mortality</span> Death of children under the age of 1

Infant mortality is the death of an infant before the infant's first birthday. The occurrence of infant mortality in a population can be described by the infant mortality rate (IMR), which is the number of deaths of infants under one year of age per 1,000 live births. Similarly, the child mortality rate, also known as the under-five mortality rate, compares the death rate of children up to the age of five.

<span class="mw-page-title-main">Childbirth</span> Expulsion of a fetus from the pregnant mothers uterus

Childbirth, also known as labour, parturition and delivery, is the completion of pregnancy where one or more babies exits the internal environment of the mother via vaginal delivery or caesarean section. In 2019, there were about 140.11 million human births globally. In the developed countries, most deliveries occur in hospitals, while in the developing countries most are home births.

<span class="mw-page-title-main">Stillbirth</span> Death of a fetus before or during delivery, resulting in delivery of a dead baby

Stillbirth is typically defined as fetal death at or after 20 or 28 weeks of pregnancy, depending on the source. It results in a baby born without signs of life. A stillbirth can often result in the feeling of guilt or grief in the mother. The term is in contrast to miscarriage, which is an early pregnancy loss, and Sudden Infant Death Syndrome, where the baby dies a short time after being born alive.

<span class="mw-page-title-main">Preterm birth</span> Birth at less than a specified gestational age

Preterm birth, also known as premature birth, is the birth of a baby at fewer than 37 weeks gestational age, as opposed to full-term delivery at approximately 40 weeks. Extreme preterm is less than 28 weeks, very early preterm birth is between 28 and 32 weeks, early preterm birth occurs between 32 and 34 weeks, late preterm birth is between 34 and 36 weeks' gestation. These babies are also known as premature babies or colloquially preemies or premmies. Symptoms of preterm labor include uterine contractions which occur more often than every ten minutes and/or the leaking of fluid from the vagina before 37 weeks. Premature infants are at greater risk for cerebral palsy, delays in development, hearing problems and problems with their vision. The earlier a baby is born, the greater these risks will be.

<span class="mw-page-title-main">Neonatal intensive care unit</span> Intensive care unit specializing in the care of ill or premature newborn infants

A neonatal intensive care unit (NICU), also known as an intensive care nursery (ICN), is an intensive care unit (ICU) specializing in the care of ill or premature newborn infants. The NICU is divided into several areas, including a critical care area for babies who require close monitoring and intervention, an intermediate care area for infants who are stable but still require specialized care, and a step down unit where babies who are ready to leave the hospital can receive additional care before being discharged.

Perinatal asphyxia is the medical condition resulting from deprivation of oxygen to a newborn infant that lasts long enough during the birth process to cause physical harm, usually to the brain. It remains a serious condition which causes significant mortality and morbidity. It is also the inability to establish and sustain adequate or spontaneous respiration upon delivery of the newborn, an emergency condition that requires adequate and quick resuscitation measures. Perinatal asphyxia is also an oxygen deficit from the 28th week of gestation to the first seven days following delivery. It is also an insult to the fetus or newborn due to lack of oxygen or lack of perfusion to various organs and may be associated with a lack of ventilation. In accordance with WHO, perinatal asphyxia is characterised by: profound metabolic acidosis, with a pH less than 7.20 on umbilical cord arterial blood sample, persistence of an Apgar score of 3 at the 5th minute, clinical neurologic sequelae in the immediate neonatal period, or evidence of multiorgan system dysfunction in the immediate neonatal period. Hypoxic damage can occur to most of the infant's organs, but brain damage is of most concern and perhaps the least likely to quickly or completely heal. In more pronounced cases, an infant will survive, but with damage to the brain manifested as either mental, such as developmental delay or intellectual disability, or physical, such as spasticity.

In obstetrics, gestational age is a measure of the age of a pregnancy taken from the beginning of the woman's last menstrual period (LMP), or the corresponding age of the gestation as estimated by a more accurate method, if available. Such methods include adding 14 days to a known duration since fertilization, or by obstetric ultrasonography. The popularity of using this measure of pregnancy is largely due to convenience: menstruation is usually noticed, while there is generally no convenient way to discern when fertilization or implantation occurred.

Prenatal development includes the development of the embryo and of the fetus during a viviparous animal's gestation. Prenatal development starts with fertilization, in the germinal stage of embryonic development, and continues in fetal development until birth.

<span class="mw-page-title-main">Child mortality</span> Death rate of infants and young children

Child mortality is the mortality of children under the age of five. The child mortality rate refers to the probability of dying between birth and exactly five years of age expressed per 1,000 live births.

<span class="mw-page-title-main">Perinatal mortality</span> Medical condition

Perinatal mortality (PNM) is the death of a fetus or neonate and is the basis to calculate the perinatal mortality rate. Perinatal means "relating to the period starting a few weeks before birth and including the birth and a few weeks after birth."

Immunization during pregnancy is the administration of a vaccine to a pregnant individual. This may be done either to protect the individual from disease or to induce an antibody response, such that the antibodies cross the placenta and provide passive immunity to the infant after birth. In many countries, including the US, Canada, UK, Australia and New Zealand, vaccination against influenza, COVID-19 and whooping cough is routinely offered during pregnancy.

<span class="mw-page-title-main">Neonatal tetanus</span> Medical condition

Neonatal tetanus is a form of generalised tetanus that occurs in newborns. Infants who have not acquired passive immunity from an immunized mother are at risk. It usually occurs through infection of the unhealed umbilical stump, particularly when the stump is cut with a non-sterile instrument. Neonatal tetanus mostly occurs in developing countries, particularly those with the least developed health infrastructure. It is rare in developed countries.

<span class="mw-page-title-main">Abdullah Baqui</span>

Abdullah H. Baqui is a public health scientist who demonstrated the effectiveness of simple but effective strategies to reduce preventable newborn deaths.

<span class="mw-page-title-main">Anthony Costello</span> British paediatrician

Anthony Costello is a British paediatrician. Until 2015 Costello was Professor of International Child Health and Director of the Institute for Global Health at the University College London. Costello is most notable for his work on improving survival among mothers and their newborn infants in poor populations of developing countries. From 2015 to 2018 he was director of maternal, child and adolescent health at the World Health Organization in Geneva.

<span class="mw-page-title-main">Neena Modi</span> President of the Royal College of Paediatrics and Child Health

Neena Modi is a British physician and Professor of Neonatal medicine at Imperial College London. She is the current president of the UK Medical Women’s Federation, and past president of the Royal College of Paediatrics and Child Health, serving in this role from April 2015 to April 2018. She is one of only four women to ever hold this position.

<span class="mw-page-title-main">Thula Baba Box</span>

The Thula Baba Box is a South African prototype product that is inspired by a Maternity Package created in Finland. Although Finland once had high infant mortality rates 50+ years ago, Finland now has one of the lowest infant mortality rates in the world. The Thula Baba Box is inspired by this trend and aims to promote infant health and wellbeing in South Africa.

<span class="mw-page-title-main">Herbert Barrie</span> Consultant paediatrician

Herbert Barrie, was a British consultant paediatrician and a leading figure in neonatology. He was a pioneer in the emerging specialty of paediatrics and neonatal medicine; and he developed one of the first neonatal intensive care units in London.

Anita Kaniz Mehdi Zaidi is a Pakistani physician. She is the President of the Gender Equality Division and Director of Vaccine Development, Global Health Surveillance, Diarrhea and Enteric Diseases at the Bill & Melinda Gates Foundation. She has previously served as Professor of Paediatrics and Child Health at the Aga Khan University.

Joanne Katz is an epidemiologist, biostatistician, and Professor of International Health at the Johns Hopkins Bloomberg School of Public Health. She holds joint appointments in the Departments of Biostatistics, Epidemiology and Ophthalmology. Her expertise is in maternal, neonatal, and child health. She has contributed to the design, conduct and analysis of data from large community based intervention trials on nutritional and other interventions in Indonesia, Philippines, Bangladesh, Nepal and other countries.

<span class="mw-page-title-main">Henry Halliday (paediatrician)</span> British neonatologist (1945–2022)

Henry Lewis Halliday was a British-Irish peaditrician and neonatologist. In 2021, Halliday was awarded the James Spence Medal for research into neonatology, for coordinating two of the largest neonatal multicentre trials for prevention and treatment of a number of neonatal respiratory illnesses and for a breakthrough in the development of a new lung surfactant that brought relief to very small babies suffering from infant respiratory distress syndrome (RDS).

References

  1. 1 2 Watts, Geoff (2016). "Stephen David Lawn". The Lancet . 388 (10054): 1876. doi: 10.1016/S0140-6736(16)31788-3 . ISSN   0140-6736.
  2. 1 2 Lawn, Joy Elizabeth (2009). 4 million neonatal deaths : an analysis of available cause-of-death data and systematic country estimates with a focus on 'birth asphyxia'. ucl.ac.uk (PhD thesis). University College London. OCLC   829958629. EThOS   uk.bl.ethos.564767. Lock-green.svg
  3. 1 2 3 4 5 6 7 8 9 Kapp, Clare (2008). "Joy Lawn: saving newborn babies' lives". The Lancet. 372 (9644): 1141. doi:10.1016/S0140-6736(08)61466-X. ISSN   0140-6736. PMID   18926264. S2CID   140127149.
  4. 1 2 "Joy Lawn". LSHTM. Retrieved 26 December 2018.
  5. 1 2 "Joy Lawn - Faculty file - SAFE MOTHERS & NEWBORNS". safemothersandnewborns.org. Retrieved 26 December 2018.
  6. ↑ Save the Children USA, Invisible Lives: Save the Children's Dr. Joy Lawn on Saving Newborn Lives , retrieved 26 December 2018
  7. ↑ "Save the Children Featured in BBC World "Invisible Lives" Documentary". Healthy Newborn Network. Retrieved 26 December 2018.
  8. ↑ "Save the Children: Invisible Lives airing on BBC World". Hope Through Healing Hands. 25 January 2010. Retrieved 26 December 2018.[ permanent dead link ]
  9. ↑ "Joy Lawn appointed new MARCH director". MARCH Centre. 15 March 2013. Retrieved 26 December 2018.
  10. ↑ "Royal Society announces new round of Wolfson Research Merit Awards". royalsociety.org. Royal Society . Retrieved 26 December 2018.
  11. ↑ "Free Online Course". MARCH Centre. Retrieved 26 December 2018.
  12. 1 2 "Professor Joy Lawn". HuffPost UK. Retrieved 26 December 2018.
  13. 1 2 Lawn, Joy E; Cousens, Simon; Zupan, Jelka (2005). "4 million neonatal deaths: When? Where? Why?". The Lancet. 365 (9462): 891–900. doi:10.1016/s0140-6736(05)71048-5. ISSN   0140-6736. PMID   15752534. S2CID   20891663.
  14. ↑ "WHO | PMNCH Fact Sheet: RMNCH Continuum of care". WHO. Retrieved 26 December 2018.
  15. 1 2 Lawn, Joy E.; Blencowe, Hannah; Pattinson, Robert; Cousens, Simon; Kumar, Rajesh; Ibiebele, Ibinabo; Gardosi, Jason; Day, Louise T.; Stanton, Cynthia; Lancet's Stillbirths Series steering committee (2011). "Stillbirths: Where? When? Why? How to make the data count?". The Lancet. 377 (9775): 1448–1463. doi:10.1016/s0140-6736(10)62187-3. hdl: 2263/16343 . PMID   21496911. S2CID   14278260.
  16. ↑ Lawn, Joy E.; Blencowe, Hannah; Waiswa, Peter; Amouzou, Agbessi; Mathers, Colin; Hogan, Dan; Flenady, Vicki; Frøen, J Frederik; Qureshi, Zeshan U.; Calderwood, Claire; Shiekh, Suhail; Jassir, Fiorella Bianchi; You, Danzhen; McClure, Elizabeth M.; Mathai, Matthews; Cousens, Simon; Lancet Ending Preventable Stillbirths Series study group; Lancet Stillbirth Epidemiology investigator group (2016). "Stillbirths: Rates, risk factors, and acceleration towards 2030". The Lancet. 387 (10018): 587–603. doi: 10.1016/S0140-6736(15)00837-5 . PMID   26794078.
  17. ↑ "Seven thousand a day stillborn". BBC News. 14 April 2011. Retrieved 26 December 2018.
  18. ↑ TheLancetTV, Stillbirths Series: Ending the epidemic , retrieved 26 December 2018
  19. ↑ "PMNCH | Save the Children, Saving Newborn Lives Program". WHO. Retrieved 26 December 2018.
  20. ↑ "Making every mother and child count | Save the Children International". savethechildren.net. Archived from the original on 26 December 2018. Retrieved 26 December 2018.
  21. ↑ "WHO | An interview with Joy Lawn: Hidden deaths of the world's newborn babies". WHO. Archived from the original on 14 June 2016. Retrieved 26 December 2018.
  22. ↑ "Joy Lawn | DCP3". dcp-3.org. Retrieved 26 December 2018.
  23. ↑ "Every Newborn". thelancet.com. Retrieved 26 December 2018.
  24. 1 2 3 "WHO | Born too soon". WHO. Archived from the original on 24 June 2013. Retrieved 26 December 2018.
  25. ↑ Parkinson, Caroline (15 November 2013). "'Kangaroo care' key for prem babies". BBC News. Retrieved 26 December 2018.
  26. 1 2 Kinney, Mary; Lawn, Joy E. (2014). "Preterm Birth: Now the Leading Cause of Child Death Worldwide". Science Translational Medicine. 6 (263): 263ed21. doi: 10.1126/scitranslmed.aaa2563 . ISSN   1946-6242. PMID   25411468.
  27. ↑ authorSeptember 16, HEARTadminPost; pmPermalink, 2013 at 5:25. "Joy Lawn on healthy newborn babies". HEART. Retrieved 26 December 2018.{{cite web}}: CS1 maint: numeric names: authors list (link)
  28. ↑ "One in 10 babies born premature". BBC News. 2 May 2012. Retrieved 26 December 2018.
  29. ↑ Blencowe, Hannah; Cousens, Simon; Chou, Doris; Oestergaard, Mikkel; Say, Lale; Moller, Ann-Beth; Kinney, Mary; Lawn, Joy (2013). "Born Too Soon: The global epidemiology of 15 million preterm births". Reproductive Health. 10 (Suppl 1): S2. doi: 10.1186/1742-4755-10-S1-S2 . ISSN   1742-4755. PMC   3828585 . PMID   24625129.
  30. ↑ McGrath, Paula (29 June 2014). "Most dangerous day of their life". BBC News. Retrieved 26 December 2018.
  31. 1 2 "Group B Streptococcus infection causes an estimated 150,000 preventable stillbirths and infant deaths every year". LSHTM. Retrieved 26 December 2018.
  32. ↑ Children, The Hospital for Sick. "Past Programs". sickkids.ca. Retrieved 26 December 2018.
  33. ↑ "Joy Lawn and Liam Smeeth elected Fellows of the Academy of Medical Sciences". LSHTM. Retrieved 26 December 2018.
  34. ↑ "Professor Joy Lawn | The Academy of Medical Sciences". acmedsci.ac.uk. Retrieved 26 December 2018.
  35. ↑ "Joy Lawn elected to the U.S. National Academy of Medicine". LSHTM. Retrieved 26 December 2018.
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