TEEN PREGNANCY IN KENYA

TEEN PREGNANCY IN KENYA

A United Nations Population Fund (UNFPA) report in Kenya shows 378,397 adolescent and teenage pregnancies for girls ages 10-19 between July 2016 and June this year. More specifically, there were 28,932 girls ages 10-14 and 349,465 girls ages 15-19 who became pregnant. The counties with the highest number of teenage pregnancies begin with Narok, where 40 per cent of its teenagers became pregnant. The list goes on to include the counties Homa Bay at 33 per cent, West Pokot at 29 per cent, Tana River at 28 per cent, Nyamira at 28 per cent, Samburu at 26 per cent, and Migori and Kwale both at 24 per cent. Teenage pregnancies have been linked to poverty. Many people believe girls in poverty engage in “transitional” sex to meet basic needs. Others blame “absentee parents” or a lack of parental guidance and exposure to information on the Internet - both which can lead to curiosity and therefore teenage pregnancy. Yet, others even say these...
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MY NEWFOUND AWARENESS ON SEXUAL HEALTH RIGHTS FOR PERSONS WITH DISABILITIES

MY NEWFOUND AWARENESS ON SEXUAL HEALTH RIGHTS FOR PERSONS WITH DISABILITIES

As a student physical therapist, my future career is primarily to serve individuals with short-term or long-term physical disability. Working with individuals of various forms of physical disability such as those with cerebral palsy, to stroke survivors, to amputees, I have become more aware and appreciative of buildings and spaces that are physically accessible with ramps, elevators, and ADA bathrooms. However, despite my acute awareness of physical accessibility for individuals with disability, accessibility to sexual and reproductive health for this population was not something that crossed my mind until I stumbled on the anecdote by Stella Chiwaka. Chiwaka, born with albinism, was denied contraceptives at a local health center in Malawi and was told by a health provider that “People like you should not have sex”. As a future health provider, I found this discriminatory act appalling. People with disabilities, just as those without disabilities, have the right to make their own choices--including choices regarding their sexuality and sexual health. To...
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A Seminar Focused on The Finance Behind Global Health Initiatives

A Seminar Focused on The Finance Behind Global Health Initiatives

The Seminar Series: Stories From Africa, Financing Health in Sub-Saharan Africa took place at Duke University on Thursday, October 18. Led by Gavin Yamey, the seminar featured a panel of speakers: Sarah Bermeo, Associate Professor of Political Science, Duke Sanford School of Public Policy; Charles Muiruri Program Director at Duke Global Health Institute and Co-founder Association of Research Administrators in Africa; Kaci Kennedy, Associate Research, Duke Center for Policy Impact in Global Health; Godfrey Kisigo, Masters Student DGHO, Physician at Kilimanjaro Clinical Research Institute, Tanzania; and Osondu Ogbuoji, Deputy Director, Duke Center for Policy Impact in Global Health. The seminar opened with an introduction to global health from a very optimistic perspective. Global health is a cutting edge field that focuses largely on improving the future for humanity. Initiatives in global health are making large and wide impacts, for example, in fields such as child wellness. However, there are also still huge numbers of people suffering from illnesses and burdens that...
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Embracing My Role as a Researcher – Sharing My Small Slice of the HPV Research Pie

Embracing My Role as a Researcher – Sharing My Small Slice of the HPV Research Pie

Guest Blog: Carissa Novak Throughout my recently completed Masters in Global Health Science, Duke’s Global Health Institute faculty regularly stressed the importance and potential impact of disseminating research findings. Therefore, I felt presenting the research findings from my thesis at the 32nd International Papillomavirus Conference inSydney, Australia, this fall was not only appropriate but necessary. Due to ongoing conversations regarding HPV vaccination coverage and HPV screening for cervical cancer communities are witnessing a tremendous increase in screening rates, especially in low-resource settings, where cervical cancer is most common. However, most programs still face significant challenges in addressing HPV positive women’s low rates of follow-up and treatment. My attendance at the conference was an opportunity to share the findings of my thesis work, in which we found that in western Kenya, a setting where resources were limited for all HPV positive women, stigma and isolation were the main differentiating features between women who accessed follow-up and those who did not. Interestingly, I presented...
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Family Planning Use in East Africa

Family Planning Use in East Africa

Family planning (FP) is critical in the promotion of community health. It is an intervention that is proven to save lives and foster development. Research supports the notion that family planning is directly linked to improvement in maternal and child health in addition to socio-economic progress. Understanding the unmet need for family planning services is key to improving worldwide reproductive health. During the last three decades in East Africa, research shows that Kenya and Rwanda are clear leaders in regards to access to and use of contraception. These two countries have a history of implementing targeted and focused programs to improve access to FP services. FP differs in each country in ways such as the amount of methods offered and the extent to which each method is available. Across the sub-region there is an increase in the use of modern contraceptives. But, a steady proportion of women in Ethiopia, Rwanda, and Tanzania are still using traditional methods. While short-term contraception is frequent in the sub-region, there is...
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WORLD CONTRACEPTION DAY CELEBRATION AT KISUMU COUNTY

WORLD CONTRACEPTION DAY CELEBRATION AT KISUMU COUNTY

World Contraception Day annually takes place on September 26th. The worldwide campaign is centered on a vision where every pregnancy is planned and wanted. This year, Kisumu County joined the rest of the world in celebration at the Simba Opepo Dispensary. County officials and over 10 partners attended, with Deputy Governor Dr. Mathews Owino as the chief guest; he expressed commitment to the county leadership and its growth. The community came together to promote and echo important actions on Family Planning (FP) and contraceptives, improve awareness on contraception, and enable young people to make informed reproductive health choices. Healthcare workers were encouraged to support clients in selecting appropriate FP methods and discussing possible side effects. There is a need in the community for counseling on correct methods and their associated potential warning signs. Further, the celebration called for the mentoring of healthcare workers in order for them to have the right attitude towards youths. This attitude will allow patients to freely walk into...
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Partner Updates: Uganda

Partner Updates: Uganda

Our Ugandan colleagues at the Makerere College of Health Sciences have been busy over the past few months. Center members’ work has focused on various aspects of cervical cancer, from prevention to diagnosis and treatment. Dr. Miriam Nakalembe is still leading the NCI-funded effort to evaluate community-based strategies for cervical cancer detection, in partnership with Dr. Megan Huchko. Building on this work, she is a co-investigator on a recently funded two-year project through the Fogarty International Center. The grant seeks to develop a portable imaging technique, called a smartphone confocal endoscope. The new technology would visualize cellular details of human cervix in vivo without taking a biopsy, and after validation would be adapted to provide a low-cost diagnostic tool for other diseases in both resource poor and resource rich settings. Dr. Jane Namugga continues her work with Dr. Paula Lee. The pair have completed data collection for a project to determine rates of completion and adverse events associated with receiving chemotherapy...
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Director’s Blog: Fall 2018

A month into the start of the new school year is a good time to reflect on the value the Center can bring to an academic setting like Duke. More salient is the recognition of the value that students and learners bring to Center. This is my third semester teaching Global Sexual and Reproductive Health, one of the core Center courses. The undergraduates continue to impress me with the experience and passion they bring to the classroom, to their research assignments and to their lives in the Duke community. Every year, I learn new things and gain new perspective from the discussions and viewpoints in brought forth in the course. This year, I’m leading two additional student research initiatives in which I already recognize that I’ll learn much more than I will teach the students. I have been working with students through the Big Data for Reproductive Health project since May, when Amy Finnegan and I helped manage a Data Plus...
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Notes from the Field: Equipping Kenya County Health Facilities Remains a Challenge

Notes from the Field: Equipping Kenya County Health Facilities Remains a Challenge

Cryotherapy is a method used to destroy precancerous cells to keep them from turning into cancer later on. According to medical experts, early detection and treatment of cervical cancer has demonstrated to dramatically improve the chances of survival. This is good news, as cervical cancer remains the most prevalent form of cancer in women in many developing countries, Kenya included and worst more to HIV+ women who are more likely to suffer from this type of cancer due to compromised immunity. There have been concerted efforts by both the Kenyan government and the private sector to raise awareness and scale up screening and treatment services across the country, which has led to a steady rise and improvement in treatment facilities. The ability of a patient to attend a screening clinic and to return to clinic follow-up evaluation and possible treatment is an important component to the success of a screening program.  Once she surpasses the myriad barriers she may face in understanding...
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Notes from the Field: “If only I stepped up to the gate of a school” life could have been better

Reproductive health remains a health problem in Sub-Saharan Africa, Kenya included. Unless efforts to reduce maternal and newborn mortality and morbidity, improving access to family planning, and preventing HIV infection are scaled up, the majority of Kenyans remain at risk for poor health outcomes. Women face unsafe abortions, early marriage, and various forms of gender-based violence. They suffer silently from sexually transmitted diseases that make them vulnerable to cervical cancer and infertility, without access to the simple preventive measures like screening and vaccination. My experience working directly in the community and in health facilities has given me the opportunity to interact with various partners and many disadvantaged young men and women. Listening to their stories of teenage pregnancy, their beliefs in myths related to use of contraception, and experiences with HIV has made me keen to understand and try to address issues related to reproductive health. I met "Aisha" (not her real name) when her child was enrolled in a study I...
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