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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Sensitization meeting on RMNCAH and immunization budgeting in Kisumu County

Sensitization meeting on RMNCAH and immunization budgeting in Kisumu County

By: Sandra Y. Oketch The Duke Center for Global reproductive health Kenya team had an interactive session on October 29, 2019 with the Ministry of Health and CSOs to discuss on Reproductive Maternal Neonatal Child and Adolescent Health (RMNCAH) and Immunization advocacy to ensure proper budgeting and sustainability. The discussions revolved around the critical pillars in budgeting that include: transparency and accountability; public participation and strategic planning. Some of the gaps in the Kisumu County Annual Development Plan (ADP) included: The lack of clear cut priorities for the FY 2019/20 and the public participation is not prioritized nor costed. All members present acknowledged the need for advocacy on the key stages in budgeting that include budget formulation, approval, implementation and Auditing. It was an exciting 1st advocacy collaborations to push for more transparent budget cycle on RMNCAH + Immunization with the CSO roles revolving around providing support in dissemination of the National County RMNCAH + Immunization policies and guidelines; Organize and conduct sensitization...
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Dr. Elizabeth Bukusi’s Work on HIV Prevention and Care

Dr. Elizabeth Bukusi’s Work on HIV Prevention and Care

To commemorate World AIDS Day held each year on December 1, we are highlighting Dr. Elizabeth Bukusi’s HIV research in Kenya! Dr. Bukusi is one of the foremost advocates for HIV care. She has conducted various studies in evaluating treatment options for high-risk populations. In one of her recent studies, she explored the value of post-exposure prophylaxis (PEP) and the antibiotic doxycylcine (dPEP) as an STI prevention strategy in African women taking PrEP, PrEP, or HIV pre-exposure prophylaxis, has been used over the past decade to prevent against HIV, however, there has also been a rising incidence of curable STIs in populations taking PrEP. The disproportionate risk that African women face from overlapping HIV-STI epidemics makes them an essential study population. dPEP is beneficial because it can be "woman-controlled," meaning that the effectiveness is not determined by partner participation, and that it's been shown to be safe for women. Dr. Bukusi predicts that dPEP will lead to a substantial reduction in the amount of...
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Pro-Life Obria Medical Clinic Chain Receives Title X Funding

Pro-Life Obria Medical Clinic Chain Receives Title X Funding

Earlier in 2019, the Trump Administration granted $1.7 million in Title X funds to a group of healthcare facilities in and around California, called Obria Medical Clinics. Title X was designed to provide funds for family-planning resources in lower income populations. Obria is a “Christian medical chain” which claims to provide reproductive healthcare services and is seeking to replace Planned Parenthood as a go-to service provider. Although Obria’s website makes no mention of a religious background, it does illustrate the chain’s emphasis on holistic care and “well-woman” services. Additionally, the woman that runs the organization, Kathleen Eaton Bravo, has been open about her pro-life views. The clinic itself does not perform abortion care services, nor does it provide condoms or hormonal birth control options for patients. Instead, the clinic focuses on more “natural” methods of family planning that consist of timing menstrual cycles and an emphasis on abstinence-only sex education. Critics fear that the government-funded group’s misleading information and growing...
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Planned Parenthood Opens New Clinic in Illinois Near Missouri Border

Planned Parenthood Opens New Clinic in Illinois Near Missouri Border

On October 2, 2019, Planned Parenthood of the St. Louis Region and Southwest Missouri announced that it is planning on opening a new facility in Illinois, near the Missouri border, in order to increase access to reproductive healthcare (specifically family-planning and abrotion services) for women in this region. The large facility will replace a smaller one in the region and will expand care to provide both medical and surgical abortion services. This plan comes after several restrictive abortion laws have been passed in Missouri, where state legislature officials also attempted to make abortion after eight weeks illegal. This move failed in court but other restrictions such as a 72 hour waiting period and parental consent for minors, are currently in place to reduce women’s access to abortion and abortion care services. There is currently one facility that provides abortion services in Missouri, and Planned Parenthood officials believe that this new “mega-facility” will address access issues for women living in that...
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New FDA-Approved Drug Zulresso is Successful but Inaccessible for Lower Income Demographic

New FDA-Approved Drug Zulresso is Successful but Inaccessible for Lower Income Demographic

Article by Jackie Vicksman On March 19, 2019, the FDA approved a new drug called Zulresso (brexanolone), manufactured by a company called Sage Therapeutics. The drug is meant to treat moderate to severe postpartum depression (PPD) and claims to begin alleviating symptoms in 2.5 days. It is also the first FDA-approved drug for PPD. At this point, the FDA has only approved the drug for distribution in a closely-monitored program known as Zulresso Risk Evaluation and Mitigation Strategy (REMS) at an enrolled health-care facility. This is due to the fact that Zulresso’s side effects include “excess sleepiness” and “sudden loss of consciousness” which can prove dangerous and/or fatal while patients drive or operate heavy machinery. While the drug has proved successful in treating PPD, it is difficult to obtain for lower income populations. The drug is not covered by Medicare, and costs $34,000 for one round of treatment. Medicare covers up to 50 percent of births in America and therefore, while...
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Bass Connections Update

Bass Connections Update

By Eugene Wang and Dennis Harrsch On November 21st, members of the Big Data for Reproductive Health (bd4rh) Bass Connections research team visited IntraHealth, a Chapel Hill-based international development nonprofit. While there, they presented to IntraHealth staff about the team’s work, with research lead Amy Finnegan, PhD speaking additionally about the value proposition of data science for the development space.  The bd4rh team is split into two main subteams: the machine learning (ML) team, and the research and policy stakeholder (RAPS) subteam. The ML team has been working on developing machine learning algorithms to accurately predict a woman’s contraceptive use patterns based on demographic survey data. They hope to integrate any promising results into their online tool, currently hosted as a website application that displays contraceptive use data through a easy-to-understand visual interface. The RAPS team has been identifying use cases for such a tool by interviewing stakeholders in order to shape the project’s trajectory and maximize deliverable value.  The bd4rh team is...
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Winter 2019 Director’s Message

The end of the semester and calendar lend themselves to reflections on the progress and challenges of the past year, and global health is no exception. In fact, last year we highlighted some of the year’s ups and downs in reproductive health. Both myself and Konyin Adewumi, DGHI MSc ’17, concluded that despite some setbacks, 2018 left us optimistic about progress toward reproductive and sexual health, reflected in a global call toward cervical cancer elimination, a historic decision on abortion rights in Ireland and a record number of women seeking (and achieving) government office in the United States and around the world. This year, the 25th anniversary of the International Conference on Population and Development (ICPD) facilitates reflections on not just the past year, but the past 25 years of achievements in global reproductive health. The momentous discussion at the ICPD in Cairo, Egypt and the resultant 20-year Programme of Action were pivotal in shaping the agenda in women’s health around...
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The Nairobi Summit on the International Conference on Population and Development (ICPD25)

The Nairobi Summit on the International Conference on Population and Development (ICPD25)

From November 10-12, Kenya hosted an international conference with over 9,500 participants from more than 170 countries with a single shared purpose: to achieve the ICPD25 goals. These goals were termed “the three zeroes” - zero maternal mortality, zero unmet needs for family planning and zero tolerance towards gender-based violence. The conference seemed to be a massive success, generating over 1,250 commitments by governments, donors, businesses, non-governmental organizations, civil society and other actors to support work towards the three zeroes. This summit marks the 25th anniversary of the first International Conference on Population and Development held in Cairo. It sought to ensure the continuation of the global promise to prioritize women made at that first conference, where the world agreed that sexual and reproductive health is a human right. Although the support initiated by the conference is promising, there are some challenges to meeting these ambitious goals. According to Dr. Joia Crear Perry, President of the National Birth Equity collaborative in the...
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Global Health Security Agenda Annual Report

Global Health Security Agenda Annual Report

Article by Diya Ginjupalli In May of 2019, the White House released the first U.S. Global Health Security Strategy. This document outlined the United States Government’s approach to preventing and responding to infectious diseases both domestically and globally. In November of 2019, the White House released the annual report "Advancing the Global Health Security Agenda: Results and Impacts of U.S. Government Investments," which illustrated their continued efforts towards global health. The report specified the current strategies used by the United States Government to ensure global health security. The United States is currently partnering with 32 countries and has pledged over one billion dollars in funding for these countries. The focus for the upcoming year falls in eleven "Global Health Security Action Packages": antimicrobial resistance, zoonotic diseases, biosafety & biosecurity, immunization, national laboratory system, real-time surveillance, reporting, workforce development, emergency operations centers, linking public health with law enforcement & multisectoral rapid response, and medical countermeasures & personnel development. These action packages span...
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