LMIC Meaker Visiting Professor Affette McCaw-Binns, University of the West Indies, Mona, Kingston, Jamaica

Investigation of the strategy of mounting an intervention in pregnant women in Jamaica to improve their use of health care services and parenting abilities
Dates of visit: 13 May - 10 Jun 2018

Profile picture of Professor McCaw-Binns


Professor McCaw-Binns is the Professor of Reproductive Health and Epidemiology in the Department of Community Health and Psychiatry, University of the West Indies, Mona. She has had over 30 years of research and consultant experience aimed at improving maternal and perinatal health outcomes and the quality and completeness of vital registration in developing countries, with particular interest in policy and programme design, strategic planning and implementation evaluation. She has collaborated on international projects (Ethiopia, Kenya, Malawi, Latin America and the Caribbean) with the World Health Organization (WHO), Pan American Health Organization (PAHO), United Nations Fund for Population Activities (UNFPA), UN Women and the Institute of Medicine. These activities have focused on measuring maternal morbidity and mortality and infant health outcomes. She is currently a member of WHO Working Groups to End Preventable Maternal Mortality (EPMM) and improve the measurement of Maternal Morbidity and Mortality. In Jamaica she helped to develop specialist antenatal care for high risk mothers; programmes for reducing morbidity from hypertension in pregnancy; guided the development of maternal and perinatal mortality surveillance, audit and response systems, and has undertaken evaluations of, and recommended strategies to, improve vital registration processes, quality and completeness. She is an alumna of New York University (BA), Tulane University (MPH) and the University of Bristol (PhD).


Our detailed epidemiological assessments using a longitudinal perspective have shown that the parental personality characteristic known as ‘locus of control’, when measured in pregnancy, is strongly related to a number of adverse behavioural, cognitive and physical outcomes in their offspring. These include aggressive and hyperactive behaviours, poor academic achievement and obesity in adolescence. Although these results are based on observational studies, the results are so strong that a randomised controlled trial is warranted to determine whether the associations are causal.

There is evidence that an individual’s locus of control orientation can be changed to become more internal (the aspect that is associated with beneficial parenting strategies and improved child outcomes). We propose that Professor McCaw-Binns visits during the summer to overlap with the visit to Bristol of Professor Stephen Nowicki, who is one of the world experts in locus of control. The main object of the visit will be to discuss possible study designs and develop strategies for a clustered randomised intervention study based on health centres. This will result in the development of a grant proposal for future funding.
Jamaica is a country which has shown itself eminently capable of carrying out health services research and translating the results into policy. It has a health service with primary, secondary and tertiary care. Professor McCaw-Binns and Professor Golding have successfully carried out a number of different research projects, including intervention studies in pregnancy. If the proposed study can demonstrate that interventions to change locus of control are successful in LMICs there will be added impetus to advance the strategy worldwide.

During her stay in Bristol Professor Mccaw-Binns will be hosted by Professor Jean Golding (Population Health Sciences) and will give the following lectures/seminars:

Evidence & Policy: the thorny issue of reforming the 19th century law on abortion in a Commonwealth Country
Public lecture, Monday 4th June, 5.15-6.30pm, Lecture Theatre 2D1, Priory Road Complex

In Jamaica any terminations of pregnancy are against the law (for both women and their doctors), with a resulting increase in maternal mortality due to backstreet abortions. Selected Commonwealth Countries, including the United Kingdom, have been able to modernize the relevant sections of the Offences Against the Person Act in the 20th century; this most often occurred under liberal governments.  Following a failed attempt in 2007-8 and the current conservative environment locally and globally, the presentation explores a strategy currently underway of community consultation, employing elements of the success in Jamaica of revising the Dangerous Drugs Act regarding cannabis use.

The lecture will be followed by a drinks reception.

Professor McCaw-Binns will also give a talk to intercalating BSc students in Global Health.