Adrienne Testa

Adrienne Testa

My main interests are infectious disease and sexual health among mobile populations in crises settings and fragile states. I'm an Assistant Professor at London School of Hygiene & Tropical Medicine.

Location London, UK

Activity

  • Dear Paul,
    The Q&A session is recorded from the last run of the course. You can either watch it on YouTube here:
    https://www.youtube.com/watch?v=WWH_2f_jtAE
    or read through the transcript in Step 2.12. Any questions please post in the relevant discussion thread.
    I hope you enjoy the session and this week.
    Cheers,
    Adrienne

  • Dear Learners,

    Welcome to Week 2 of the course where we look at the quality of maternal health care. We look forward to you input and engagement, particularly on the discussion steps on Respectful Care and Caesarean-Sections.

    This week we also have the Live Q&A session that was recorded with Lead Educators, Prof Oona Campbell and Prof Wendy Graham, and...

  • Dear Dina,

    Welcome to the course. Please feel free to share details of this course with your Francophone networks and colleagues - this is the first run in French!

    Best wishes,
    Adrienne

  • Dear Jean-Claude,
    Thank you for joining the course all the way from Benin! Please do share news of this course with your Francophone colleagues. I'm afraid the platform doesn't support other languages but please do participate in English. We look forward to hearing more from you.
    Adrienne

  • @ChristabelOkonji
    Issue around disrespect and abuse that you highlight are discussed further in the course, particularly next week:
    2.5 The Importance of respectful care
    2.6 Respectful care - discussion

    You mentioned issues around staffing and pay that may lead to disrespectful care. These issues are touched upon in:
    2.4 Are we giving the illusion of...

  • Dear Patrice,

    You make an important point about under-reporting. As we go progress through the course we will explore the importance of data and the challenges collecting accurate data. Some of the steps you may find particularly interesting are:
    1.6 How do we know the global profile of maternal mortality and morbidity?
    3.8 Developing better data...

  • Dear Chunyi,

    Welcome to the course. We're pleased to offer this course in Chinese - do share details with your colleagues in China.

    I hope you enjoy the course,
    Adrienne

  • Dear Abdou,

    Welcome to the course. This is the first run of the course in French so please feel free to share details with your colleagues in Francophone West Africa.

    I hope you enjoy the course,
    Adrienne

  • Dear Mariangela,

    Welcome to the course. This is the first run of the course in Spanish so please feel free to share details with your colleagues in Latin America.

    I hope you enjoy the course,
    Adrienne

  • Dear Menna,

    Welcome to the course. This is the first run of the course in Arabic so please feel free to share details with your Arabic-speaking colleagues.

    I hope you enjoy the course,
    Adrienne

  • Dear Lucie,

    Welcome to the course. This is the first run of the course in French so please feel free to share details with your colleagues in Francophone West Africa.

    I hope you enjoy the course,
    Adrienne

  • Dear Saliou,

    Welcome to the course. This is the first run of the course in French so please feel free to share details with your colleagues in Francophone West Africa.

    I hope you enjoy the course,
    Adrienne

  • Dear Mariangela,

    Welcome to the course. This is the first run in Spanish - please do feel free to share among your Latin American colleagues. You can also tweet using #FLmaternalhealth #MaternalHealthNow

    I hope you enjoy the course,
    Adrienne

  • Wonderful to see such a diverse course of learners from different disciplines, contexts and countries. Looking forward to much engagement, discussion and learning from each other.

  • @IreneMiotto
    Dear Irene,
    Welcome to the course. This is an open platform course from LSHTM and differs from the MSc courses - here is where you can find out more:
    https://www.lshtm.ac.uk/study/courses/ways-study/distance-learning

    Always good to speak to students like Mark to get an insight into the student experience.

    Cheers,
    Adrienne

  • Dear Learners,

    Welcome to our course - we're delighted you'll be joining us for the next three weeks to learn about and explore issues in global maternal health.

    We encourage you to post comments and discussion points on the course content and your experiences with other learners.

    Best wishes,
    Adrienne

  • Hi Valerie,
    Thank you for sharing a practical example. What was the uptake of the kits and ANC? What were the barriers and enablers in the different contexts?

  • Dear Valerie,

    It's interesting that you highlight the transport issue in Cornwall. Often it's assumed that high-income countries have adequate and timely access to facilities. You mention the use of Birthing Centres - are these available in Cornwall? Is there anything resembling Maternity Waiting Homes (these are used by women from Scottish islands on the...

  • Thanks Isabelle,
    You highlight critical issues about over-medicalisation and the importance of communication. What do you think is preventing conversations with women about their delivery in advance?

  • Thanks Georges.

    Do any learners have experiences or examples of approaches to overcome barriers to birth companions during delivery?

  • Dear Isabelle,
    You draw an interesting comparison between the filed of maternal health and medicines. The message here is about relevant and context appropriate solutions. This is also an issue for guidelines as you mention, which need to be sensitively adapted as discussed in the previous step on guidelines.

  • Dear Deirdre,
    Thank you for sharing your reflections. Your example of accountability in Ghana sounds really interesting.
    Do other learners have examples of how civil society voice platforms in maternal health are developed and functioning?

    You may also be interested in Suellen Miller's reflections in the Step 2.12 Live Q&A where she talks about...

  • Thanks Maryam for sharing an example of isomorphic mimicry. Does Malawi have a population density that requires a health clinic at every 5km (highly unlikely!)? IA there a discrepancy between the facility type and its capability? What, if any, referral mechanisms are in place for pregnant women?

  • Thanks for posting this link Vicky - really interesting. Many of the issues highlighted that affect the role of SBAs are covered in this week of the course, in particular the relationship between providers and women and meeting their needs and woman-centred care. I think you'll enjoy Step 2.4 where Lynn Freedman talks about the illusion of delivering quality...

  • Hi Muhammad,
    There is a growing recognition of the importance of respectful care - and disrespect and abuse. Some organisations working in this area you may be interested in are:
    Human Rights in Childbirth - http://www.humanrightsinchildbirth.org/
    White Ribbon Alliance - http://whiteribbonalliance.org/

  • Dear Muhammad,
    Thanks for your comment. It's an interesting point about having guidelines and adherence to them. One of the steps later this week on 2.11 How can we improve quality of care? covers how to improve adherence and the general quality improvement process. It would be great to hear your reflections on that approach and how it relates to your setting.

  • Dear Learners,

    Welcome to Week 2 of the course where we look at the quality of maternal health care. We look forward to you input and engagement, particularly on the discussion steps on Respectful Care and Caesarean-Sections.

    This week we also have the Live Q&A session held with Lead Educators, Prof Oona Campbell and Prof Wendy Graham, and Series...

  • Which papers did you enjoy and why?

  • Hi Valerie,
    Thank you for sharing this example of improving transportation and referral. What's really encouraging is that the system continued beyond the emergency period.
    Does anyone else have examples of where linking women to care has worked/not worked?

  • Dear Phoebe,
    Thanks for your comment. Next week we have a video from Dr Neel Shah talking about maternal health care in high-income countries, particularly the US, that highlights poor outcomes among some populations.

  • Hi Mary,
    Thanks for your observation. Would you let us know more about your setting - where are you?
    What might be the barriers in your setting to women accessing the well equipped facilities?

  • Hi Adesola,
    Thank you for the fantastic overview of your experience in Nigeria of Conditional Cash Transfers. You mentioned a number of issue we will explore further in the course including issues with distance (Steps 1.10-1.12), attitude of health workers (Steps 2.4-2.6) and the quality and provision of health care (Steps 1.13, 1.14 and week 2 focuses on...

  • Hi Ammar,
    Thanks for your comment. In your setting what sorts of barriers are there to reduce inequalities and increase women's access to quality maternal health care?

  • Hi Ammar,
    Thanks for flagging the burden of maternal health - where are you based?

    There is more in week 3 about the transition between MDGs (Millennium Development Goals) and SDGs (Sustainable Development Goals) and what this means for maternal health.

  • Hi Vicky,
    Thanks for sharing information on your m-Health strategy to improve antenatal health care. We look forward to you sharing more in week 3 on the step on Innovations. What are your initial findings?

    Does anyone else have experience of m-Health in their setting? How is it working? Which populations are reached? Have outcomes improved?

  • Welcome to our new joiners since yesterday. We have a fantastic group on this course spanning so many settings, countries and experiences. Looking forward to all your discussions and comments this week.

  • Thank you for this summary of the situation in Brazil Vicky. Do any other learners have similar or contrasting profiles in your setting?

  • Great to see learners spread so far across the globe and from such a variety of backgrounds. We're looking forward to you sharing your valuable experiences and insights to enrich discussions of the course content.

  • Dear Emma,
    Thank you for sharing your experience in Vancouver or managing lifestyle effects and non-communicable diseases in childbirth. There are a number of steps in the course that explore these issues further next week.

    Step 2.9 focuses on care in high-income countries and Step 2.12 features a Live Q&A with Lead Educators Oona Campbell and Wendy...

  • Dear Yohannes,
    Thanks for your comment. Where are you based? What is the surveillance systems like there to address maternal health issues?

  • Dear Vicky,
    Many thanks for your comment. Would you share your experience of which populations are most affected in Brazil by issues such as obesity, high rates of c-section or lack of access to care?

  • Dear Learners,

    Welcome to our course - we're delighted you'll be joining us for the next three weeks to learn about and explore issues in global maternal health.

    We encourage you to post comments and discussion points on the course content and your experiences with other learners.

    Best wishes,
    Adrienne

  • Hi Nnenna,
    Thanks for your message. There are some sound issues at the beginning which we're aiming to fix. At the moment the video is being edited to a shorter version which will be available in a couple of weeks. If you bear with it you'll be able to hear most of it. It was quite a challenge linking up London, San Francisco, Beirut and Edinburgh :)

  • Hi Sanjeev,
    If you're interested in behavioural economics there is an initiative between social scientists and economists to address large-scale global challenges (including health). It's a very ambitious project and encompasses public-private partnership. Do you think this could be applied to improving maternal...

  • Hi Christine,
    Bilateral aid usually refers to government to government transfers. In the case of the GFF it pools funds from various sources built around a single, harmonised investment case - in part to avoid duplications and inefficient spend as Attahir mentions above.

  • Dear Learners,
    Welcome to our third and final week of the course. We're looking forward to your comments and reflections on the future of maternal health.

    If you missed the Live Q&A on Thursday, you can access a recording and subscribe to the Series YouTube channel here:
    https://www.youtube.com/watch?v=WWH_2f_jtAE

    There are additional resources at...

  • @Andrea Casale @Paula Beeri @
    Dear Andreaq and Paula,
    The quizzes are a personal development opportunity and don't count towards a final score of affect your certificate. You can retake the quiz and the full answers are explained.

  • @ Pien Van Eijnsbergen
    If you're interested in using the resources from this course you can download the videos, PowerPoint presentations and transcripts to use as supporting materials.

    Additionally step 2.11 How can we improve quality of care? will be particularly relevant where Elliot Main highlights a framework for change.

  • Lots of interesting posts here about disrespect and abuse. In Gaurav's video he talks about promising interventions to promote respectful maternal care. Has anyone been part of or know about successful interventions? It would be great to hear about what is being done to strengthen and respect women's rights in childbirth.

  • Dear Mauricio,
    Interestingly in middle-income countries c-section rates are very high and some of the reasons contributing to the trend are as you mention and not based on evidence. Looking forward to your comments on the discussion on c-sections later this week.

  • @Zebyderu Mehari
    Thanks for your response. Lack of equipment is a frustrating constraint. You mentioned delays in treatment - what is the status of referrals in your context (where are you based?)?

  • Dear Christopher - we're really looking forward to you input in the comments this week. Don't forget you can post a question in step 2.12 for the Live Q&A session on Thursday.

  • Dear Sanjeev,
    In relation to WASH and maternal health you may want to look at The Soap Box Collaborative, which Wendy Graham is Chief Scientific Adviser to:
    http://soapboxcollaborative.org/

    As we saw last week on Step 1.13 What is current delivery facility capability?, there are significant issues with facilities lacking infrastructure including water,...

  • Dear Zebyderu,
    Thank you for your insight on the extremes of TLTL and TMTS. Please share with us more about your context - country, type of facility, resources etc? Do you have ideas of approaches to address TLTL and TMTS in your context?

  • Adrienne Testa made a comment

    Dear Learners,

    We're looking forward to answering your question is the Live Q&A this week. Please continue to post below questions on all areas of maternal health, not only what's been covered in the course so far.

    The session is open so feel free to invite your colleagues by sharing the link - even if they are not on the course - Thursday 2nd November...

  • Dear Learners,
    Welcome to week 2 of our course. Thank you for very engaged, thoughtful and inspiring discussions during week 1.

    This week we will have our Live Q&A - please join us live and post your questions in Step 2.12 Live Q&A comments section.

    If you haven't done so already, you can access all content in The Lancet Maternal Health Series freely...

  • Dear Shannon,
    You're in a position many providers find themselves in - knowing practice needs to change with pregnant women's needs, but a lack of evidence-based guidelines on how to do this.
    Next week, Katie Millar's article in Step 2.3 The Current State of Maternal Health Guidelines discusses the challenges developing guidelines that are rooted in...

  • Dear Jean Marie,
    You bring up an important point about social norms and their influence on health seeking behaviour. Thinking about contexts you're familiar with, what social and cultural norms may affect pregnant women's access to healthcare? What can be done to address this issue to improve access? Are you aware of any successful interventions?

  • Thank you April for these excellent insights into delivering maternal care, and the importance of community-based programmes particularly to reach vulnerable women. In what ways, if any, were non-communicable diseases integrated into the interventions?

  • Thanks for your input Lisa. Please do share your experiences in the respectful care discussion next week. We'd love to hear about your colleague's approach to culturally sensitive care.

  • Dear Valerie,
    Thank you for your input - you touch on very important influences on women's pregnancy and childbirth experiences. Later this week you will find content on the impacts on inequalities in maternal care in Lenka Benova's presentation in Step 1.8. In next week of the course we take a deeper look at quality of care, particularly in relation to...

  • Dear Melo,
    mHealth is an area of opportunity highlighted in the Series paper by Kruk et al and will be looked at in Week 3 of the course in Step 3.6 on Innovations. The potential for speedier communication and data sharing can indeed go some way to address underreporting.

    What other examples of MHealth applications do learners have experience of or know...

  • Dear Emman,
    This is the experience of many countries. The Series papers by Graham et al, Campbell et al, Shaw et al and Koblinsky et al are drawn together in Step 3.8 on Developing Better Data Collection and Research. The step highlights key limitations on maternal health data and future opportunities for developing better data collection to inform maternal...

  • Dear Anand - you highlight interesting topics and ones we will come to in the course. In terms of infrastructure, equipment and service providers, this is covered in the second half of this Week of the course - Capability and Coverage of Care.

    There is a case study from Cambodia focusing on links to care that bring alive the challenges to providing quality...

  • Dear Vijaya,
    Thank you for sharing your background and motivation for taking this course. There are a number of steps that will be particularly relevant to your learning objectives, particularly Week 2 which focuses on Quality and Content of Care, in particular:
    Step 2.4 Are We Giving the Illusion of Quality Maternal Health Care Provision?
    Step 2.8...