Reports from the Field: Freedom House, a Safe Space supported by KMET

Reports from the Field: Freedom House, a Safe Space supported by KMET

By Faith Otewa: One of our goals of the Center is to highlight some of the important work in Sexual and Reproductive Health taking place in Kisumu and Nyanza. We were thrilled to sit down with the Director of KMET (Kisumu Medical and Education Trust), a Kisumu-based NGO working to promote innovative and sustainable reproductive health and education programs among underserved communities. KMET works in the areas of Maternal, Child, Adolescent and Child Health, livelihoods and nutrition, education and youth/adolescent empowerment and quality healthcare financing. The organization has adopted an integrated model to provide a holistic care to women by offering specialized diagnostic services like Family Planning Services (FP), Immunization, and HIV Testing, Cervical Cancer Screening and Laboratory services. A well-stocked dispensing pharmacy is also in place. KMET also houses a Youth Friendly Clinic for its youthful clients of reproductive age. The services offered at the center are affordable. With growing evidence that a substantial number of girls, children and women in Kisumu...
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All in a Day’s Work: Engaging the Community through HPV testing in Kisumu

All in a Day’s Work: Engaging the Community through HPV testing in Kisumu

Blog by Faith Otewa In my role as site coordinator of the Kisumu Center office, I’ve had the opportunity to oversee the “Hybrid Study,” in which we are looking at integrating HPV testing into community health campaigns providing multiple other disease services, including HIV testing, family planning and TB testing.  Many of the experiences will linger on with us for many years to come; while some illustrate the challenges encountered in conducting research and community-based care in Africa, others show the power of community mobilization and knowledge. It is the 10th week out in the field and the study team are getting ready to recruit at the 3rd set of campaigns. However, as if often the case in western Kenya, and certainly when we are working in tents set out in the middle of fields, the climate has had a big impact on study.  The harsh weather and copious rainstorms experienced in the month of May this vastly affected recruitment. There has...
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Health Systems Barriers to Cervical Cancer Prevention in Kenya

Health Systems Barriers to Cervical Cancer Prevention in Kenya

Blog by Charlotte Page, Ob/Gyn Resident: This is a follow-up post to “Patient Barriers to Cervical Cancer Prevention in Kenya”. I’ve realized while in Kenya that there are a lot of things I take for granted in bathrooms in the US: running water, a toilet that flushes, toilet paper, soap, and electricity. If you’re missing one of these things, the restroom is that much more uncomfortable – or perhaps even unfunctional. Similarly, small systems issues here in Kenya can inhibit women from receiving the healthcare they need. For the HPV-positive women in the study I’m working on, such problems can significantly increase the amount of time and effort required to get treated with cryotherapy, to the point that some women don’t obtain treatment at all. To paint a picture: yesterday I was at Migori County Referral Hospital (MCRH), one of the sites where cryotherapy is provided in our study. This procedure uses compressed gas to freeze precancerous cells on the cervix, thereby preventing them...
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Gaining Insight into Kenyan Community Health

Gaining Insight into Kenyan Community Health

Blog by Amber Fleck, MS2, University of Colorado: In the United States, health education is seemingly everywhere: ads online reminding women of the importance of pap smears, TV commercials advising against smoking, or posters in bar bathrooms providing safe sex advice. With this abundance of exposure to health education, it is a striking difference to visit a country where many communities don’t have regular access to this kind of information, especially if that information regards sexual or reproductive health. In an effort to bridge this gap and enhance community health education the Kenya Ministry of Health began using lay workers, also known as community health volunteers (CHVs). CHVs travel door-to-door in their assigned communities to educate individuals about disease management, including reproductive and maternal health, and provide referrals to the clinic when necessary. In theory, this is an excellent way to increase access to health information and care; however, these programs have had some significant challenges. One challenge is that these are...
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Data+ Team Introduces Novel Visualization Methods to Understand Contraceptive Trends

Data+ Team Introduces Novel Visualization Methods to Understand Contraceptive Trends

Saumya Sao (T ’20, Gender, Feminist and Sexuality; Global Health) and Melanie Lai Wei (Masters’ Candidate, Statistical Science) were proud to share the results of their 10-week Data+ project, Big Data for Reproductive Health, or BD4RH. The pair was just one of 25 teams that spent the summer using data-driven approaches to solve interdisciplinary challenges. The BD4RH team, led by Amy Finnegan and Megan Huchko, sought to build a web-based application that will allow users to visualize and analyze contraceptive calendar data from the DHS. To ground their project, they did a mapping exercise to identify currently available tools, identifying core elements they liked and key areas a new tool could improve. Using this data, and user feedback from various stakeholders in the field, they created a website that hosts four different data visualization methods to interpret trends in contraceptive use from the DHS contraceptive calendar. The site currently uses Kenya data to demonstrate efficacy, but datasets will be added...
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Using GIS Spatial Mapping to Enumerate the Risk of Loss-to-Follow-up for Cervical Cancer Treatment in Western Kenya

Using GIS Spatial Mapping to Enumerate the Risk of Loss-to-Follow-up for Cervical Cancer Treatment in Western Kenya

By Moreen Njoroge, T-19 Cervical cancer is the second most common cancer in women worldwide and the most common cancer among women in sub-Saharan Africa. The risk for cervical pre-cancer and cancer is increased by the biological effects of co-infection with HIV and HPV, both of which have a higher prevalence in sub-Saharan Africa and especially in Migori, Kenya where the seroprevalence of HIV/AIDS is not uncommon. The social and economic factors in Migori, Kenya make cervical cancer control more difficult to achieve with the established standard of care in developed countries. A major barrier to accessing screening and treatment services for cervical cancer in this region is poor health literacy associated with the lower educational-attainment rates in Kenya, especially for women. Structural barriers associated with increased cervical cancer mortality rates include lack of diagnostic tools for screening, understaffing in clinics and hospitals, a paucity of pathology laboratories and the long waiting times associated with screening-result transmission. The lack of treatment...
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Sex Ed Goes Global: the Netherlands

Sex Ed Goes Global: the Netherlands

The sex education I received was decent, by American standards. When I was eight, my female peers and I were ushered to the music room, where we ate our boxed lunches on the floor and learned about the menstrual cycle. I shuddered at the thought of ever bleeding from “down there” and spent the next several years terrified that I would get my first period in public. When I was twelve, my middle school health teacher projected grainy slides of STD-afflicted genitals and explained that pregnancy and childbirth would ruin your life. The class did, however, cover various forms of contraception and a very brief lesson on consent. When a classmate asked if sperm could, like, crawl up your leg, we all laughed at her question while secretly waiting to hear the answer. When I was fifteen, and approaching a time in my life where comprehensive sexuality education might be especially useful, my otherwise progressive high school recommended an online...
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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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