Community Health Campaign: Thoughts Station by Station

Community Health Campaign: Thoughts Station by Station

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....
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Patient Barriers to Cervical Cancer Prevention in Kenya

Patient Barriers to Cervical Cancer Prevention in Kenya

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...
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Self-Induced Abortion in Times of Crisis, Part 3

Self-Induced Abortion in Times of Crisis, Part 3

Passersby could hardly miss the bright pink stucco building near downtown Jackson, Mississippi in the southern United States. But the unusual color is not all that makes the building unique. The Pink House, as it’s called, is home to the Jackson Women’s Health Organization, the only remaining abortion clinic in the state of Mississippi. With some of the toughest abortion restrictions in the nation, Mississippi is one of 29 states classified as “extremely hostile” to abortion by leading SRHR research organization the Guttmacher Institute. Women currently cannot obtain an abortion after 15 weeks of gestation, the most restrictive ban in the nation. State governor Phil Bryant has repeatedly pledged to make Mississippi “the safest place in American for the unborn child,” joining other lawmakers in a crusade against reproductive freedom.   Yet this ostensible commitment to safety is less a compassion toward Mississippi’s children than a powerful political tool. Despite their professed desire to protect women and children, Governor Bryant and Mississippi state legislators...
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When words in Washington translate to tragedy across the globe

When words in Washington translate to tragedy across the globe

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...
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Director’s Blog: Summer 2018

Director’s Blog: Summer 2018

As we close out the academic year and head into the hot North Carolina summer, the halls of Trent get a lot quieter. To some, this calm may suggest a mass exodus to the beach or some other vacation destination. However, for faculty, students and staff, the empty offices belie a frenzy of work, as many head off to field sites around the world. Summer break represents a time to re-focus on the work that inspires students, trainees and faculty to put in the hours teaching, writing and learning throughout the year. We use this time to launch new projects, reconnect with their research teams and develop or deepen our partnerships. As we previously described, we have a very busy summer planned with work and site visits in western Kenya, while back at home, continuing with the launch of the Collaboratory project and the Big Data for Reproductive Health Summer team. I spent the last two weeks in June in Nairobi,...
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So… what are you going to do about it?

So… what are you going to do about it?

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...
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Self-Induced Abortion in Times of Crisis, Part Two

Self-Induced Abortion in Times of Crisis, Part Two

Content warning: sexual violence Despite rampant criminalization of abortion around the world, the international community tends to agree on one thing: an exception in cases of rape or incest. Even in the United States, where abortion is a hotly debated political issue, a majority of Americans support legalized abortion in cases where the pregnancy was caused by rape or incest. Most people agree that women should not have to be doubly traumatized by being forced to carry a pregnancy conceived through violence. Yet in Myanmar and Bangladesh, Rohingya refugees have little choice but to do just that. Since August 2017, a military campaign of ethnic cleansing in Myanmar’s Rakhine State has forced hundreds of thousands of Rohingya Muslims to flee their homes, causing the fastest growing refugee crisis in the world. As one of many ethnic minorities in Myanmar, the Rohingya numbered nearly one million in early 2017. But the government of Myanmar, a predominantly Buddhist country, refuses to recognize...
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Reproductive Health Victories

Reproductive Health Victories

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...
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Self-Induced Abortion in Times of Crisis, Part One

Self-Induced Abortion in Times of Crisis, Part One

Dried henna powder. Animal feces. Bleach. Grain alcohol. The wire coat-hanger. These are some of the many methods women throughout history have used to terminate an unwanted pregnancy. When the safe method for ending a pregnancy--a surgical or medical abortion--is not available, women turn to these alternative techniques, often risking their bodies and lives in the process. Such methods for terminating a pregnancy or inducing a miscarriage are hardly relics of the past. Improvements in contraceptive access, sexual education, women’s empowerment, and abortion access, though significant, have been disparate. In many places around the world, cultural, legal, and financial barriers continue to prevent women from accessing basic healthcare services like contraception and abortion. These obstacles are often magnified in times of crisis. Natural disasters, wars, economic crises, and a host of other factors can all further infringe upon women’s reproductive freedom. Women may lose access to healthcare services, or become uniquely vulnerable to violence. When faced with an unplanned, unwanted,...
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RTI team provides key advice to Duke Big Data for Reproductive Health Team

RTI team provides key advice to Duke Big Data for Reproductive Health Team

On Monday afternoon, the Big Data for Reproductive Health Data+ Team met with Alex Pavluck and Alison Mitchell LeFew from RTI to describe their project and get direction in how to develop a “minimally viable product.” The meeting represents one of the first educational engagements of the Duke-RTI Collaboration. The goal for the 10-week Data+ project is to build a web-based application that will allow users to visualize and analyze contraceptive calendar data from the DHS. Students presented their research on currently available tools, identifying core elements they liked and key areas a new tool could improve. Pavluck, a senior manager for information and communication development for the Global Health Division of the International Development Group at RTI, shared his experience and provided advice on how to develop an MVP for user testing. The active discussion ranged from big picture needs to the technical details necessary to move the project forward. The meeting was a great example of key stakeholder...
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