kb330@duke.edu – Global Reproductive Health at Duke

Community Health Campaign: Thoughts Station by Station

July 19, 2018July 19, 2018 by kb330@duke.eduNo Comments

Not much changes yet everything seems different whenever I return to my home country of Kenya. I was reminded of my first time in Kisumu last year with Dr. Megan Huchko & Katelyn Bryant-Comstock and how anxious I was, even though I was in Kenya, I was completely unfamiliar with this region, the local language, and the culture. Last year, I was a rising junior filled with high hopes, yet naïve of the intricacies of proposing a project and carrying it out. This year, I have returned with much more practical expectations as well as a greater capacity to carry out my project: using GIS spatial mapping to enumerate the risk of loss-to-follow up for treatment of HPV. My project is taking place in Migori, Kenya as a part of the ongoing Cervical Cancer Screening & Prevention Study. The use of geographic information systems will help us create correlations between women’s sociodemographic variables as risk-factors and treatment loss-to-follow up rates....

Patient Barriers to Cervical Cancer Prevention in Kenya

July 17, 2018 by kb330@duke.eduNo Comments

Starting at age 21, you get regular pap smears. You get in your car, drive on a paved road to an Ob/Gyn or primary care clinic, and have the pap done, with relatively little effort on your part. That’s how cervical cancer screening works for most women in the United States and most other developed countries. In these countries, pap smears have significantly reduced rates of cervical cancer and resulting deaths. It’s a different story in developing countries like Kenya. In East Africa, cervical cancer is the most common cancer in women, even surpassing breast cancer. In Kenya, only 3.5%[1] of eligible women ever get screened for cervical cancer, and it’s difficult for those that screen positive for precancer or cancer to access treatment. Some barriers relate to infrastructure, as cervical cancer prevention and treatment requires resources including skilled providers, supplies, and transportation of specimens. To try to overcome some of these systems issues, Dr. Megan Huchko (director of the Center for...

When words in Washington translate to tragedy across the globe

July 12, 2018 by kb330@duke.eduNo Comments

When people ask how my summer internship is going, I never know what exactly to say. I usually end up blurting out a rapid mix of emotions: “It’s great!” “I love it!” “But it’s also really sad!” “Super depressing day to day, but I care a lot about the work.” “An awesome place to work but a sad field to be working in right now.” I’m interning at the United Nations Foundation in Washington, DC on the Universal Access Project, which convenes donors and advocates working to improve women’s and girls’ access to family planning around the world. Family planning is a fundamental human right and undeniably one of the best investments countries can make towards sustainable development—it can enable girls to stay in school, prevent maternal deaths, improve women’s financial independence and economic productivity, and has even been identified as a top solution to combat climate change. The Duke Center for Global Reproductive Health and other NGOs have reported frequently about...

So… what are you going to do about it?

July 5, 2018 by kb330@duke.eduNo Comments

I’m currently in Amansie West, Ghana as part of a team conducting research on the barriers and facilitators to family planning use and the role community health workers play in family planning uptake. During this time, I was invited to attend Ghana Health Service’s first National Maternal, Child Health and Nutrition Conference by Millennium Promise, a co-sponsor of the conference and our collaborator in country. The collaboration with Millennium Promise first began back in September when Chief Nat Ebo Nsarko, the Country Director visited Duke University. From the beginning this team has been our guide for conducting research in Ghana through assisting us in each task and facilitating our learning experience. It is through their contributions and dedication which have allowed this research to not only be possible but successful. The theme of the conference was “Strengthening Partnerships for Achieving Universal Health Coverage in Reproductive, Maternal, Newborn, Child and Adolescent Health and Nutrition.” Gladys Ghartey (Head of UN System Unit at...

Reproductive Health Victories

June 29, 2018 by kb330@duke.eduNo Comments

This week has seen an onslaught of negative health news from the United States and around the world. Crisis pregnancy centers in the United States are now allowed to withhold legally available medical options, women in Guam no longer have access to abortion services, and we continue to see daily impacts from the reinstatement of the global gag rule and hear reports of lack of access to reproductive health services from women in refugee camps. It’s easy to get depressed from the seemingly impenetrable amount of work that needs to be done to protect the health and human rights of people around the world. But that’s exactly what we need to do. We need to dig deep, understand the depth of the problems, and develop new partnerships and solutions. I’d like to highlight some exciting news from this past week of just that: people digging deep and developing new solutions to positively impact the health and rights of people across the world. Preventing...

Thailand honored for Cervical Cancer Prevention Program

June 27, 2018 by kb330@duke.eduNo Comments

For years, Thailand had a high incidence of cervical cancer and had seen little success from their pap smear based screening approach. In 2000, Jhpiego, the government of Thailand, the Provincial Health Office of Roi Et, and the Royal Thai College of Obstetricians and Gynecologists implemented a pilot study using a screen-and-treat approach for cervical cancer prevention. This method allows women to attend a single visit with a health care provider and services can be provided by a nurse, allowing for task-sharing within the health system. Based on results from this study, the WHO adopted the screen-and-treat strategy as part of their comprehensive cervical cancer guidelines. These services are now offered in 32 Thai provinces and the government has recently introduced a HPV vaccination campaign to further efforts in cervical cancer prevention. This week, the Roi Et Provincial Health Office was awarded a United Nations Public Service Award honoring their pioneering efforts in cervical cancer prevention....

LGBTQ Rights are Reproductive Rights

June 11, 2018June 13, 2018 by kb330@duke.eduNo Comments

If April showers bring May flowers, what do May flowers bring? June rainbows! Each June in the United States, individuals across the nation join in celebrating LGBTQ Pride Month, a time marked by celebration, protest, activism, and, of course, the bright rainbow Pride flag. The tradition was born out of the 1970 Gay Pride March, which took place in New York City to commemorate the Stonewall uprising. As the LGBTQ movement grew, so did Pride marches and within a few years, this form of political protest had spread across the United States, eventually expanding from a single march to a month of events for all LGBTQ people. Over the years, Pride has shifted from primarily a political protest, to a more celebratory occasion. The increasing sociocultural acceptance of LGBTQ people and same-sex relationships has played a role in this shift, and the recent Supreme Court decision in favor of marriage equality is undoubtedly worth celebrating. Yet queer communities certainly remain marginalized...

Australia establishes abortion clinic protections

June 11, 2018June 11, 2018 by kb330@duke.eduNo Comments

Australian state New South Wales (NSW) has passed a law establishing 150-meter “safe access zones” around abortion clinics. Protesters who intimidate or harass patients within 150 meters of the clinic could face jail time and other punishments. The bill also makes it illegal to film any person within the safe access zone without their consent. NSW is the fifth Australian jurisdiction to establish safe access zones and prohibit harassment of people seeking reproductive services. The bill’s passage marks an important stride toward reproductive freedom in Australia and a victory for reproductive health advocates around the globe. Photo credit: Peter Rae/AAP...

U.S. Supreme Court refuses to hear challenge of restrictive Arkansas abortion law

June 8, 2018June 8, 2018 by kb330@duke.eduNo Comments

The U.S. Supreme Court recently turned down a challenge to a restrictive Arkansas abortion law that ends the use of medication abortion in the state. The law would require physicians providing medication abortions--a series of two medications that safely terminate a pregnancy--to have a contract with a second doctor who has hospital admitting privileges. Though the state claims the law protects women’s safety, it effectively reduces the number of Arkansas abortion clinics from three to one and creates additional barriers for women to access care. This harmful law makes Arkansas the first state to effectively ban medication abortion. Photo Credit: Ricky Carioti/The Washington Post...

Advocacy for Reproductive Justice

May 25, 2018 by kb330@duke.eduNo Comments

Earlier this week, Willie Parker challenged members of the Duke Ob/Gyn Department to remember their role as patient advocates in an inspiring grand rounds lecture, “Advocacy for Reproductive Justice: How Much Fight is there in the Dog?” Dr. Parker, author of Life’s Work: A Moral Argument for Choice, a memoir of how his evangelical upbringing influenced his decision to become an abortion provider, talked about racial and ethnic disparities in unwanted pregnancies, and how the Reproductive Justice movement evolved to address these and broader inequities in sexual and reproductive health. He described how limitations in Medicaid coverage for pregnancy and childcare services disproportionately impact the same groups of women at highest risk for unplanned pregnancy. When access to abortion services is limited, as has been steadily happening for the past 15 years, it is these women who are most vulnerable to not be able to exercise their own choice in determining when and how they want to raise their family. Dr....

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