Paula Griffiths

Professor of Population Health – Sport, Exercise and Health Sciences

Professor Paula Griffiths is her School’s Associate Dean for Research and Innovation (Job Share). Her research focuses on maternal and child health, growth and development outcomes in low- and middle-income countries (LMIC). She works in equal partnership with research partners, health practitioners, stakeholders and NGOs globally to develop appropriate community strategies that tackle and reduce health and development inequalities. In recognition of her contribution to this urgent agenda, she is an Honorary Professor at the University of Witwatersrand, South Africa.

Addressing global inequalities in maternal and child health, growth and development

Improving the survival chances of newborns, children and mothers is an on-going global challenge. Women and children die from preventable or treatable causes, including infectious diseases and complications during pregnancy and childbirth (UNICEF). The work of Paula and her team around the provision of affordable, high-quality community healthcare initiatives has helped to improve the life chances of thousands of women and children across Africa and India.

The UN has put the reduction of maternal mortality and preventable deaths of newborns and children at the heart of SDG3. Progress has been made, but the COVID-19 pandemic has “severely disrupted essential health services, shortened life expectancy, and exacerbated inequities.”

Sustainable Development Goal 3

My research addresses inequalities in maternal and child health, growth and development – and I’m currently involved in several projects across Africa, South Asia, and South America.

I’m particularly interested in the role of community-based interventions to improve nutrition and early child development outcomes and reduce health inequalities.

I also explore changing socio-economic circumstances over the early life-course and how these influence health outcomes in children and adolescents. Another area I’ve been involved in is looking at the impacts of extreme weather events on health and healthcare provision.

I’m currently involved in several projects, including investigating integrated programmes for nurturing care in infants (Kenya); interventions to support double duty actions for infant nutrition (Peru); food security among the urban poor (Kenya); contributing to the FAO’s Regional SOFI report for Asia and the Pacific Region; and challenges in providing health services in the face of extreme climate change (Ghana).

A young child self-feeding (BFCI, Kenya)
A young child self-feeding (BFCI, Kenya)

I work in conjunction with a range of partners – spanning healthcare professionals, government departments, universities and research centres in the global South (including the University of Ghana and the African Population and Health Research Center), NGOS and private companies such as UNICEF, CONCERN Worldwide, Path, and DIKODA. Partnerships are an essential part of my research - it wouldn’t be possible to achieve successful outcomes without them.

Crucially, we work closely with communities to ensure the research is relevant to the problems that they want to tackle – it’s essential that they’re involved in this way. Any potentially life-changing and life-saving intervention we design must be culturally sensitive – meeting the service users’ needs and the context in which they live.

A good example of this approach is our Rockefeller Foundation Food Systems Vision Prize 2050 project – led by Dr Liz Kimani-Murage at the African Population and Health Research Center in Kenya – which has involved stakeholders spanning landowners, churches, community centres and schools.

I’m really lucky to have enjoyed a long-standing collaboration with Dr Kimani-Murage.

Supporting the next generation of researchers worldwide is essential. We need to ensure that work in this area continues so that global healthcare inequalities are eradicated.

The British Academy funded team to incorporate Early Child Development into the BFCI (Kenya)
The British Academy funded team to incorporate Early Child Development into the BFCI (Kenya)

Together – with our research teams, partners and collaborators – we have delivered evidence that is
supporting the development of childcare policies, and their implementation, in Kenya. These are ensuring that parents receive information that supports decision-making around the growth, health and development of the youngest members of Kenyan society – enhancing their chances, not just to survive, but to thrive.

Our work is wide ranging. For example, we’ve improved understanding of what drives poor breastfeeding practices, and tested interventions to improve them in urban and rural areas of Kenya. We’ve also developed guidelines for the implementation of the Baby Friendly Community Initiative which has had a positive and significant impact on the number of mothers breastfeeding in Koibatek County.

In addition, we’ve developed and tested workplace support interventions for optimal infant feeding, and supported nurturing care within community parental support programmes for infants and young children.

Other strands of our work have improved understanding of the needs of nomadic pastoralists in delivering community parental support programmes for optimal infant growth and development (in partnership with Professor Emma Haycraft); uncovered what drives food choices in urban communities from early adolescence through older age groups; and supported communities in developing a voice to express their needs around food security.

Both Baby Friendly Community Initiative (BFCI) images, courtesy of APHRC

My research journey

My interest in this area of research stems from the stories my parents told about food scarcity, having grown up in families struggling for resources. I was lucky not to suffer food poverty as a child, but did experience social inequality.

My primary school teacher told me that she wouldn’t recommend I join the group preparing to take the local private school entrance exam because I lived on a council estate. Undeterred, I did join the group – and was the only child offered a place. Sadly, we were unable to afford it, so had to turn it down. Even so, my family instilled in me the belief that I could shape my own destiny and succeed wherever I studied.

My research journey began on the English south coast when I joined the University of Southampton as a Psychology undergraduate. I quickly realised that my optional modules in Demography were what really interested me. They combined my passion for numbers with learning how to improve human health and nutrition, as well as aspects of human geography. So, I switched course.

My desire to work in low- and middle-income countries was confirmed during a trip I made to Kenya following graduation. I witnessed, for the first time, communities struggling to provide food and essential care for their children.

It struck me that this should not be happening in 1995 and I realised that I wanted to help find locally appropriate solutions. Having fought hard for my own education made me realise that – with a bit of support – communities can find good solutions to resource problems.

So, I was thrilled to be awarded an ESRC Fellowship to complete my PhD on household influences on maternal and child health and nutrition in three states of India.

I was lucky enough to spend a good part of my second PhD year at the Indian Institute for Population Sciences (Mumbai) with fieldwork in Pune and Lucknow. This is where I truly began to learn about global health and to start forming relationships with now long-term partners and communities.

After my PhD, I stayed at Southampton for 18 months working as a Lecturer in Demography. When I secured a Mellon Postdoctoral Fellowship, at the University of North Carolina, I moved to the US. Here, I investigated how nutrition was rapidly changing in India – from undernutrition being the dominant problem to obesity and overweight also becoming widespread.

In 2001, I met Professor Noel Cameron at a conference on obesity, where we talked about the (ongoing) Birth to Twenty Study that he was co-leading in South Africa, and I became very interested in joining his research group at Loughborough – which I did in 2002.

I joined the University as a Lecturer and was promoted to Senior Lecturer in 2006. In 2010, I was appointed Reader in Biosocial Science and was proud to achieve my Professorship in 2016 – three years after giving birth to my wonderful son.

During my early years at Loughborough, I was fortunate to work with the Birth to Twenty team in South Africa – investigating adolescent and child growth, nutrition and health inequalities. This work was funded by an MRC Career Development Award and subsequently a British Academy mid-career fellowship.

It was whilst working in South Africa that I met Dr Liz Kimani-Murage and we began to work together to help improve maternal, infant and young child health, nutrition, growth and development outcomes in Kenya.

Over the years, I’ve supported 15 PhD students – half of whom were international students – and have mentored early career postdoctoral researchers through training fellowships, and sponsored mid-career scientists in Leadership Programmes.

Supporting the next generation of researchers worldwide is essential. We need to ensure that work in this area continues so that global healthcare inequalities are eradicated.

I work part-time and have done since returning from maternity leave in 2014. I’m passionate about my research, but working part-time allows me to manage my other commitments and strike a good work-life balance.

I believe everyone should have the opportunity to combine caring responsibilities with their academic career. To this end, I champion thinking around innovative ways to support this – including proposing the first job share of the Global Challenge in Health and Wellbeing academic lead when I first returned from maternity leave.

I now hold the first job share of an Associate Dean of Research and Innovation role at the University (with Professor Fehmidah Munir). I am passionate about sharing my experiences of job share with others looking at this as an alternative model of leadership.

It’s really heartening that there has been much progress in the areas I’ve been working since I first qualified. For instance, in Kenya exclusive breastfeeding has risen from 32% to 61% in the decade that we’ve worked to improve it.

However, there is still much to be achieved. Food security is currently being challenged again globally with the current political situation coupled with climate change related extreme weather events exacerbating the problem.

Our team is currently trying to secure funds to further our work on urban food gardening in Kenya, supporting the community-owned ideas evolving from our Food Vision Prize programme. Working in partnership with local NGOs and the Kenyan government, we want to try to improve food security for the urban poor whilst enhancing the health of the local environment.

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