Barriers of Access to HIV Treatment Speaker Event

On March 5, 2020, speakers Dr. Tolu Oladele and Dr. Carl Mhina presented on the topic "Barriers of Access to HIV Treatment" as part of the Center for Global Reproductive Health's Reproductive Health in Africa Speaker Series, sponsored by the Africa Initiative. Dr. Oladele is an obstetrician and gynecologist from Nigeria, visiting Duke as a Policy Fellow. Dr. Mhina has studied Health Economics and currently works as a researcher in the Department of Population Health Science who works to understand the impact of HIV on different populations. Dr. Oladele began the presentation speaking about the Prevention of Mother to Child Transmission (PMTCT) of HIV in Nigeria. Only around 50% of expectant mothers are tested for HIV, and attendance at antenatal clinics is low, with around 18% of expectant mothers attending in their first trimester. This inadequate maternal care is in part due to low numbers of facilities that provide such services. In Nigeria, there are approximately 50,000 to 60,000 women with...
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Effects of COVID-19 on Sexual Reproductive Health and Rights (SRHR) among Young People in Africa

By: Sandra Y. Oketch Mid-April, I was privileged to join the Live webcast on discussions around the Effects of COVID-19 on Sexual Reproductive Health and Rights (SRHR) among young people in Africa. The panelists included experts in the medical, advocacy, and policy fields: Dr. Charlene Biwott (KEMRI, Kenya), Millicent Sethaile (Her Voice Ambassador, Botswana), and Levi Singh (Youth SRHR Strategy Officer, South Africa). The moderator was Evelyne Odhiambo (AfNHi Youth Cohort, Kenya). Important to note were conversations around the vulnerability of young people during this pandemic where the younger populations have so far been the least vulnerable to complications and death from COVID-19 and yet play a very key role in flattening the COVID-19 curve by minimizing transmissions to the vulnerable populations in our society that include the immune-compromised and the elderly. Currently, there has been a great shift of focus in Africa to cater to the COVID-19 pandemic thereby impacting negatively in other areas including SRHR. Some of the effects on...
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Feature Collaboration: Kenya Medical Education Trust (KMET)

Feature Collaboration: Kenya Medical Education Trust (KMET)

By: Sandra Y. Oketch The Kenya Medical Education Finance Trust (KMET) is a non-governmental organization founded in 1995 with a focus to promote innovative and sustainable health and education programs among underserved communities. KMET operates in 35 out of the 47 Counties in Kenya, as well as regionally in East and Central Africa. The organization engages in a number of sexual reproductive health and rights (SRHR) programs. Reproductive, Maternal, New-born and Child Health (RMNCH)  KMET endeavors to promote maternal and child health (MCH) services through its RMNCH program. These include: increasing awareness to and use of contraception and comprehensive abortion care services and strengthening the capacity of the health care providers to offer youth-friendly services; Provide gynecological, antenatal and postnatal care services; wide range contraception methods, cervical cancer prevention efforts through early screening and treatment in partnership with the Cure Cervical Cancer Organization. KMET, in partnership with Harvard School and Izumi Foundation, has developed an innovative and affordable device in the management of postpartum...
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An Update on the Rakellz Dream Initiative from Robert Zulu

An Update on the Rakellz Dream Initiative from Robert Zulu

Most cervical cancer is highly preventable and can be cured if diagnosed early, yet women across the world suffer high rates of cervical cancer. One such place is Zambia, where the Rakellz Dream Initiative was founded. After losing his wife to cervical cancer in 2015, Robert Zulu decided to launch a cervical cancer education program in Zambia. Now at 36 years old, he is the the founder and executive director of the Rakellz Dream Initiative, a non-governmental organization with a team of over 50 youth volunteers working to raise awareness around cervical cancer through outreach activities and informational films. The long-term vision of the Rakellz Dream Initiative is to help increase cervical cancer knowledge across Zambia to mitigate and prevent terminal diagnoses by the year 2025. When he spoke about his reasons for forming the Rakellz Dream Initiative, Zulu said he wanted to help reduce the ignorance about cervical cancer among the people of Zambia. “When I was nursing my late wife,...
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ICPD: 25 Years Later

ICPD: 25 Years Later

Article by Diya Chadha The International Conference on Population and Development held in 1994 in Cairo, Egypt, brought 179 countries together behind the common goal of bringing improved reproductive health care and rights to the forefront of international policy and development efforts. Though the call for action primarily dealt with the state of healthcare access in more developing parts of the world, as well as the way women are structurally excluded from such accessibility, the inherent link between health and empowerment was established. Thus, the idea that this access to healthcare is instrumental in achieving women’s empowerment and further gender equality was highlighted. Now 25 years later, the ICPD met in Nairobi, Kenya for ICPD25 to “re-energize” the vision put forward back in Cairo. Specifically, they have resolved to end “all maternal deaths, unmet need for family planning and gender-based violence and harmful practices against women and girls by 2030.” The price tag for this task? $264 billion. Public sector civil organizations,...
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New York Passes Anti-Discrimination Laws on Basis of Reproductive Healthcare History

New York Passes Anti-Discrimination Laws on Basis of Reproductive Healthcare History

Article by Diya Chadha In the wake of attacks on reproductive health rights over the past year, a number of states have taken countering actions by passing pieces of statewide legislation that protect such rights. This has manifested in different ways. Earlier this year, parts of New York listed sexual and reproductive health rights as protected under the New York City Human Rights Law, with coverage ranging from being able to use birth control and contraception to having access to an abortion. New Jersey has been looking towards allocating nearly $9 million worth of state funds to organizations like Planned Parenthood to cover the gap in their funding caused by the defunding of Title X. These are just a few examples among many across the country. Just this past week, New York has again added to this set of protections by passing an antidiscrimination law protecting laborers from discrimination because of their reproductive health decision-making histories. There are three overarching sections:...
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The American Anti-Abortion Strategy

The American Anti-Abortion Strategy

Article By: Diya Chadha Over the past year, a series of restrictive anti-abortion legislation have been passed in states like Georgia, Kentucky, and Alabama. Courts have blocked their constitutionality, with the last case (Alabama) struck down this past month. Passage of such legislation would have resulted in a reversal of Roe v. Wade as many have called for six-week bans, which for many women, would limit their opportunity to get an abortion to a timeline before they may even realize they are pregnant. In other cases, states have called for outright bans on abortion at any stage of pregnancy, with no exceptions for rape and incest. The actions that are taking place “behind the scenes” of this more publicized series of events is equally as problematic. What’s worse is that they receive far less recognition as a relevant force in the anti-abortion effort. These “incremental” laws are state-by-state restrictions that impose what may seem to be minor restraints on the capabilities...
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Evaluating Quality in Maternal Health Interventions Moderator Reflection

By Uma Govindswamy November, as a part of the Center for Global Health’s Reproductive Health in Africa Speaker Series, sponsored by the Africa Initiative, Dr. Joy Noel Baumgartner and Dr. Rohit Ramaswamy lectured on the topic: Evaluating Quality in Maternal Health Interventions. Dr. Joy Noel Baumgartner is the Director of the DGHI Evidence Lab, the lead of the DGHI Global Mental Health Working Group, and a professor here at Duke University. She has been an active public health practitioner and researcher for over 20 years and has worked in countries such as Cameroon, Kenya, India, South Africa, Jamaica, Tanzania, Ghana, and Uganda. Dr. Rohit Ramaswamy is Director of the Center for Global Learning and a Professor in the Department of Maternal and Child Health at UNC’s Gillings School of Global Public Health. His past research has focused on implementing delivery systems that improve the quality of healthcare for women in low-resource settings including India, Ghana, Nigeria, and Uganda, to name a...
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Stigma and Reproductive Health Moderator Reflection

By Saumya Sao On November 1st, 2019, the Center had its first lunch talk in the 2019-2020 Reproductive Health in Africa lunch series. The panel focused on HIV stigma and reproductive health. I had the pleasure of moderating the panel, which was made up by: Megan Huchko, MD, MPH who is an OB/GYN and directs the Center for Global Reproductive Health at DGHI; Michael Relf, PhD, RN who is the Associate Dean for Global and Community Affairs in the School of Nursing; and Godfrey Kisigo, MBChB, who is a second year MSc-GH student and Tanzanian physician. Over the past year, I’ve had the privilege of working with Godfrey on a team led by Dr. Melissa Watt. Our team has been developing and carrying out an HIV stigma reduction intervention in Moshi, Tanzania. Throughout just two years of studying global sexual and reproductive health, I’ve seen how critical it is to consider the impact of stigma on care engagement and reproductive health education, so I...
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Sexual Reproductive Rights – The Case of Social Exclusion

Sexual Reproductive Rights – The Case of Social Exclusion

Article by Sandra Y. Oketch Globally, access to sexual reproductive health rights (SRHR services) have been greatly hampered by social exclusion, more so in Africa. In November 2019, Kenya was privileged to host the United Nations summit -  International Conference on Population and Development (ICPD 25) - which focused on diversity, abortion care, ending gender based violence, elimination of female genital mutilation, FGM, ending unmet need for family planning, comprehensive sexuality education, mental health and psychosocial support, HIV prevention for adolescent girls and women. Women and other minority groups experience social exclusion when women and girls get abortions, when girls fail to undergo traditional practices of some communities, like the FGM, and are considered outcasts, and when individuals identify as Lesbian, Gay, Bisexual, or Transgender, LGBT. There exists high maternal morbidity and mortality in women due to unsafe abortion practices. In Kenya, abortion is illegal and only legalized in instances where the health care provider assesses that the life or health of the...
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