Settings and Preparedness in Protecting the Most Undeserved in Humanitarian and Fragile Settings During the COVID-19 Pandemic

Settings and Preparedness in Protecting the Most Undeserved in Humanitarian and Fragile Settings During the COVID-19 Pandemic

By: Sandra Yvonne Oketch COVID-19 has impacted negatively the women’s, children and adolescents’ health and wellbeing in immeasurable ways. The Lives in the balance COVID- 19 virtual summit held on July 1 and 2, 2020 brought together experts from different fields for an opportunity to listen, discuss and actually reflect on COVID-19 impact and collectively work on a healthy recovery. The breakout sessions included reflections on: One, understanding the humanitarian and fragile settings around protecting the most undeserved including women, children and adolescents; Two, the preparedness in protecting the most undeserved including women, children and adolescents in humanitarian and fragile settings. SETTINGS. Protecting the most undeserved: women, children and adolescents in humanitarian and fragile settings This session was facilitated by Marydale Oppert from International Rescue Committee, IRC who discussed on ways to protect the undeserved in humanitarian and fragile settings. IRC works in over 40 countries in the world mostly with displaced populations and refugees. The pandemic has led to increased disparities in...
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Building Evidence on COVID-19’s Impact on the Health of Women, Adolescents and Children

Building Evidence on COVID-19’s Impact on the Health of Women, Adolescents and Children

By: Sandra Yvonne Oketch The Lives in the balance COVID- 19 virtual summit on July 1 and 2 had an interesting breakout session examining evidence on COVID-19 impact on the health of women, children and adolescents. This session was facilitated by Joy Lawn, Professor, London School of Hygiene & Tropical Medicine. It is important to note that in 2019, there were already over 9 million deaths of women and children, with over 50% of these deaths related to pregnancy and birth. This current pandemic exacerbates this situation and undermines the ‘Every Woman Every Child’ campaign efforts.  The ‘Every Woman Every Child’ campaign is a global movement launched by the United Nations that mobilizes and intensifies actors including International and National action by Governments, multilaterals and civil societies to address the major health challenges facing women and children globally. Some of the campaign’s targets to end preventable death for women and children and ensure their health and well-being include: No woman should die...
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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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COVID-19 and Gender

During the current COVID-19 pandemic, it is important to view aspects of how the virus and its crisis affect men and women differently across the world and specifically in the United States (COVID-19: A Gender Lens). It seems that in areas where thousands have been diagnosed with COVID-19, more men appear to be infected and dying than women—although the biologic reasons behind these observations are not yet fully clear. A news article published on April 7, 2020, figures reported from New York City’s Health Department show “there have been nearly 43 Covid-19 deaths for every 100,000 men in the city, compared with 23 such deaths for every 100,000 women” (Rabin). According to the article “The gendered dimensions of COVID-19” in The LANCET, an organization called Global Health 50/50 tracks sex-disaggregated infection and mortality COVID-19 data from 39 countries (The Lancet). This data from Global Health 50/50 shows more men are dying from COVID-19 and finds that particularly threatening outcomes of the...
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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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April 2020 Director’s Message

April 2020 Director’s Message

As this very unusual semester comes to an end, the world around us is filled with uncertainty. The Covid-19 crisis has changed our learning, working, and social environments in profound ways that would have seemed unimaginable just a few months ago. The challenges of transitioning to online learning are capped by the disappointment of missing out on the rituals that come with spring at Duke, especially LDOC and graduation activities. We are faced with uncertainty about when we’ll see friends and classmates again, stress associated with working at home while ostensibly caring for and schooling our children, and navigating the continuously changing work demands and structures. On top of this, most of us are worried about the health and safety of loved ones and are wondering when we will get back to normal—and what normal will look like. It may seem that now is not the time to focus on sexual and reproductive health and to prioritize issues directly related...
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Trump and “Birth Tourism”

Trump and “Birth Tourism”

A development to the U.S. visa policy instituted by President Trump occurred this past week on January 24th—officials now have the authority to deny a woman a tourist visa if they think that the woman is pregnant and coming to the U.S. in order to give birth (CNN). In analyzing this rule, it is pertinent to note the 14th amendment which states, “All persons born or naturalized in the United States, and subject to the jurisdiction thereof, are citizens of the United States," and it is relevant because even if a child’s parents are not citizens of the U.S., if they are born on U.S. soil, they can claim citizenship (NPR). The State Department defended the rule by stating “birth tourism poses risks to national security” and women wanting to secure citizenship for their children should not be allowed into the country (NPR). This rule however does not apply to 39 countries, the majority of which are in Europe, that...
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Pilot Study: Use of mSaada Application to Address Cervical Cancer in Kenya

Pilot Study: Use of mSaada Application to Address Cervical Cancer in Kenya

Article by: Emmy Duerr At the DGRH Think Global Talk on October 15, Jacob Stocks presented his work on the mSaada mobile application platform. Prior to his pilot study, Stocks developed mSaada (meaning “support” in Swahili), an application designed to be a support tool for community-based cervical cancer screening for low-income communities. The app was intended to provide counseling/decision support for community health volunteers as well as patient and specimen tracking to better ensure follow up and patient retention. Stocks implemented a small (n = 19) 5-week pilot study in Migori and Kisumu between July and August of 2019. The pilot study consisted of six iterative feedback sessions with the goal of refining the mSaada platform. The first week of the study involved three group sessions with four participants in each session, using a mixed methods approach of a combination of qualitative in-depth interviews and quantitative usability surveys. Weeks 2-4 provided app developers time for feedback integration, and allowed them to implement...
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Abortion-Rights Bill Introduced in California Aimed at Public Universities

Abortion-Rights Bill Introduced in California Aimed at Public Universities

Last week, an abortion-rights bill targeted at public universities in California was passed inspired by a student-led movement at the University of California, Berkeley. If signed into law by Gov. Gavin Newsom during the next month, this legislation would mandate all on-campus health centers of California public universities to offer medication abortion by 2023. In the state of California, this legislation would therefore directly apply to 34 college campuses. Medication abortion requires taking two different pills which are approved by law to end pregnancy during the first 10 weeks. There have already been around $10.3 million dollars of donations raised privately that would go toward training staff at campus health centers and equipping the centers with proper medical devices for medication abortion. A study published in August 2018 directly analyzed California college students desire and access to medication abortion and concluded, “College students face cost, scheduling, and travel barriers to abortion care. Offering medication abortion on campus could reduce these...
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