Cervical Health Awareness Month

Cervical Health Awareness Month

People across the U.S. are kicking off 2018 right with health-conscious resolutions. According to Statista, 45% of Americans hope to “lose weight or get in shape” in 2018. But January offers another opportunity to celebrate and jump-start health awareness: it’s Cervical Health Awareness Month. In the U.S. there are between 11,000 and 13,000 new cases of cervical cancer annually, and cervical cancer is the fourth most prevalent form of cancer among women globally. While patients diagnosed with early-stage cervical cancer have 5-year survival rates of up to 91%, the disease becomes far more deadly as cancerous cells spread to other parts of the body. Fortunately, proactive methods like HPV vaccinations and screenings can keep cervical cancer at bay, and mitigate almost all deaths related to cervical cancer. However, access to such healthcare often depends on a woman’s geographic location and socioeconomic status. According to the WHO, “approximately 90% [of] the 270,000 deaths from cervical cancer in 2015 occurred in low- and middle-income countries.” Duke...
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Human Rights, Feminism, and Abortion Law Reform

Human Rights, Feminism, and Abortion Law Reform

In the seminal international human rights treaties there is no express legal guarantee for abortion rights. Nevertheless, since the 1990s, women’s rights activists have used international human rights forums and mechanisms to advance abortion rights. Cumulatively, human rights law can now be said to call for the decriminalization of abortion and the legalization of abortion in cases where the pregnancy threatens the life or health of the woman, is the result of rape or incest, or there is severe fetal impairment. Despite this promising trajectory, international human rights law does not recognize a woman’s right to decide whether to carry a pregnancy to term as a matter of her autonomy, equality or self-determination. One reason for this is advocates have attempted to follow the path of least resistance for abortion rights and focused instead on the right to health, the right to be free from cruel, inhuman and degrading treatment, and the right to privacy. Recognizing unsafe abortion as a major public...
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The Value of Big Data for Family Planning

The Value of Big Data for Family Planning

While the use of modern methods of contraception are now commonplace in many countries, one-third of women in developing countries who begin using a modern method of contraception quit within the first year and half quit within two years[i]. Most discontinuation occurs among women who want to avoid pregnancy putting them at risk for unwanted pregnancies, maternal morbidity and mortality[ii]. Traditional measures of contraceptive use are collected retrospectively from population representative surveys conducted only every five years which are not well-suited to measuring contemporary trends in contraceptive discontinuation. This is problematic because advocates and health ministries cannot address concerns in a reasonable amount of time to impact widespread change. "Big Data" can supplement these static sources by providing dynamic, real time tracking of the reasons women discontinue using contraceptives and open up possibilities to prevent discontinuation or help facilitate switching between methods. So what exactly is "Big Data" and how can it supplement traditional reproductive health data? Big data is commonly thought...
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Big Data for Reproductive Health

Big Data for Reproductive Health

"Curious about contraceptive discontinuation?  Intrigued by intersections of technology and sexual health?  Apply to join the Data+ “Big Data for Reproductive Health” team! This summer, participants will collaborate with Duke Global Health Institute reproductive health investigators, producing a digital resource that repackages basic Demographic and Health Surveys (DHS) information on contraceptive discontinuation as actionable intelligence for family planning organizations. During the 10-week program, students will also seek feedback from RTI researchers and determine appropriate distribution tactics for their social media-integrated platform. Like other Data+ programs, this project is interdisciplinary, combining the fields of computer science, global health, gender, sexuality and feminist studies, public policy and, of course, data.  To find out more and apply, click here."...
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Photo Essays: HIV/AIDS

Photo Essays: HIV/AIDS

While a stream of statistics sheds valuable light on global impacts of HIV/AIDS, evaluations of programs and populations can make it easy to forget the epidemic, at its core, is about individuals.  Though words are among humanity's most powerful tools, they may fail to convey the full narrative.  In a world divided by a plethora of languages, sometimes photographs--a universal form of communication--tell the best stories. In preparation for #WorldAIDSDay2017 tomorrow, we've compiled a list of photo essays that document the impacts of HIV/AIDS over time and across the world.  Keep scrolling to check them out and learn about efforts to combat this issue around the globe. "Life on London's First AIDS Ward" (photo courtesy Gideon Mendel) "26 Powerful Photos Of The US AIDS Crisis In The '80s" (photo courtesy Barbara Alper/Getty Images) "Namibia's HIV/AIDS and Poverty Crisis" (photo courtesy UNICEF) "Sex and Drugs in an HIV-Infected Paradise" (photo courtesy Mia Collis/PBS NewsHour) "HIV/AIDS in Eastern Europe" (photo courtesy Malcolm Linton) "World AIDS Day 2012: Imagine being...
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Notes from the Field: Uganda

Notes from the Field: Uganda

This summer, after a long, solo trip across the world, I arrived in East Africa for the first time. As a Master of Science in Global Health student at Duke University, I spent my first year paired with a mentor, Dr. Megan Huchko, working as a research assistant. During that time we worked together to design a research study which I would conduct the following summer in Kenya. Dr. Huchko and I chose to interview HPV positive women from her ongoing cluster-randomized trial to find ways to reduce the substantial loss to follow up seen with a two-visit screen and treat strategy.  Upon entering this program, I knew I wanted to work in women’s reproductive health. Cervical cancer is the leading cause of cancer in women in Africa, so having the opportunity to have a hand in research being conducted to reduce that burden is a privilege. Our goal was to improve treatment acquisition among HPV positive women, to reduce...
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Let’s Talk About Sex: Peer-Led Comprehensive Sexuality Education in Rural Kenya

Let’s Talk About Sex: Peer-Led Comprehensive Sexuality Education in Rural Kenya

What is the function of the clitoris? Before I began teaching comprehensive sexuality education (CSE) at WISER Girls’, a secondary school located in Muhuru Bay, Kenya, I never imagined that this would be the most frequently asked question. Especially among a class of female third-year high school students. When I was first asked, I gave a cursory – and yes, somewhat bashful – reply, explaining the clitoris as the “anatomical source of sexual pleasure in females.” But this answer did not satisfy the students, and they probed for more information. As we engaged in a discussion, I learned that many weren’t familiar with an external representation of the female genitalia – especially one with a “non-reproductive” function. As my answers became more justificatory about the significance of the clitoris, I realized that my attitudes about legitimized female sexuality had begun to leak into my responses. While I tried to remove any bias from my answers, I struggled with leaving my...
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Recap of Women’s Health Symposium

Recap of Women’s Health Symposium

On Friday, October 20th, public health professionals from around the Triangle gathered at Duke to discuss how best to advance women’s health in the current political environment. Keynote speeches were given by Jen Kates, Vice President and Director of Global HIV Policy at the Kaiser Family Foundation, and North Carolina Congressman David Price. Women’s health right now is in an era of uncertainty. Jen Kates focused on this as she outlined many of the questions that remain regarding how the Trump administration will implement many of its proposed changes to global health policy. Unfortunately, this uncertainty extends to women’s health domestically as well. Congressman David Price described expected and potential changes to the Affordable Care Act and the devastating effect these could have on women and girls across the United States. After hearing a broad overview, the afternoon concluded with two panels which honed in on specific impacts current and proposed policies will have. Lindsay Robinson of Planned Parenthood South Atlantic reminded...
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We Make Inroads

We Make Inroads

This year, we will host a series of reproductive health talks. These talks are designed to expose audience members to a broad range of reproductive health topics, organizations, researchers, and projects. The first talk of the semester was facilitated by the co-conveners of Inroads. Kati LeTourneau and Katie Gillum gave an engaging presentation on their work and how individuals and organizations are combatting abortion stigma around the world. Rather than being a network of organizations, the Inroads network is comprised of individual members. Gillum and LeTourneau stressed the importance of this, because “we interact with stigma as humans and individuals first” so transforming and dismantling stigma must start on an individual level.  One of their goals is “to transform (stigma) by bringing people together who don’t often get together.” Each member brings their own expertise to the community, provides support to other members, and asks for guidance and feedback from the network. So why stigma? As Kati said, “Stigma is a barrier...
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Can we translate the multilateral strategies for cervical cancer prevention to address other global health disparities?

Can we translate the multilateral strategies for cervical cancer prevention to address other global health disparities?

Cervical cancer is an example of a glaring health disparity between wealthy and poor countries, and remains an immediate health threat to many women in low- and middle-income countries (LMICs). Evidence-based, cost-effective protocols recommended by the World Health Organization have not been widely implemented due to limited health care infrastructure augmented by a lack of funding and political will. Although there are some unique factors contributing to the disparity in cervical cancer outcomes between high and LMICs, there are some common root causes shared across health systems: poor health care infrastructure, lack of awareness of early signs or symptoms, lack of funding prioritization within local governments, and limited operationalization of proven technologies used in high-income countries. These root causes must be addressed through both innovation and adaptation of successful interventions to fit the target community and the priorities of local governments (i.e. be both low-cost and cost-effective). To achieve this, clinicians and researchers need to partner with policy experts and...
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