Meet Our Research Team in Kisumu, Kenya This Summer

Meet Our Research Team in Kisumu, Kenya This Summer

This summer, we have 5 Duke Scholars working with the Duke Center for Global Reproductive Health in Kisumu, Kenya. We have 3 undergraduate students joining the Center as part of the Student Research Training Program (SRT), a Masters of Global Health Student, and a 3rd year OB/GYN resident all conducting research in Kenya. Read below to learn a bit about these passionate students and hear about their work and what they are most looking forward to.    SRT Students: Sydney Chen (she/her) Sydney is a double major in Global Health and International Comparative Studies with a Biology Minor. She calls Herndon, Virginia home. When asked about what her time spent in Kisumu looks like, she reflected that “The team and I are working on various ways to improve an app called mSaada which helps women in East Africa receive screening for cervical cancer. I’m specifically working on the FAQ portion of the app by making sure that the answers are clinically accurate and using...
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Faculty Spotlight:  An Interview with Dr. Jonas Swartz

Faculty Spotlight: An Interview with Dr. Jonas Swartz

Jonas Swartz, MD, MPH is an OB/GYN and an Assistant Professor of Obstetrics and Gynecology. He completed his undergrad at Duke University and then his MPH and MD at the University of North Carolina at Chapel Hill. He completed his residency in Obstetrics and Gynecology at the Oregon Health and Science University, followed with a fellowship in Complex Family Planning back at UNC. I had a conversation with Dr. Swartz to understand more about how he became involved in health policy and reproductive health access. “Well, I grew up in North Carolina and did Medical School here, and one of the striking things when I was a medical student was the discrepancy in care during pregnancy for people who were citizens versus non-citizens. And, in particular, thinking about low-income people who use Medicaid.” Swartz described his early medical training and becoming acquainted with the Federal Emergency Medicaid program, which only pays for labor and delivery services for authorized immigrants. He noted that...
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SRT Spring 2022 Reflection

SRT Spring 2022 Reflection

This summer, 4 students will join the Center as part of the Student Research Training Program (SRT). Hear their thoughts heading into the program.   Bentley Choi When I first applied to the SRT program, I merely expected to ‘conduct’ research abroad. In reality, I learned more important skills such as writing IRB amendments, scheduling a meeting with teammates, and communicating with a research team in Kisumu. My goal for this summer is to apply what I learned from Dr. Eric Green’s Global Health Research Methods class into a real-life setting, and I believe we are making our way to this goal since the team proposed a new way to evaluate the intervention! I look forward to conducting observational study and focus group discussions. Also, I am hoping to learn how to navigate myself in a new living environment and what are Kenya’s unique cultural factors that influence stigma and perception towards reproductive health since it is also related to my senior thesis...
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BD4RH Spring 2022 Reflection

BD4RH Spring 2022 Reflection

Our Big Data for Reproductive Health Bass Connections team worked on three teams throughout the year and presented their work at the Bass Connections Showcase. Using Natural Language Processing (NLP) Techniques to examine Stigma with Cervical Cancer in Kenya Members: Foxx Hart, Lynne Wang, Alexandra Lawerence, and Neha Shrishail For our project, we utilized topic modeling to identify recurring themes and sentiments in HIV interview data with Kenyan women, as well as develop an understanding of stigma frameworks. This year we were able to learn new technical and project management skills while diving deeper into the emerging interdisciplinary space between quantitative machine learning and qualitative social science research. Due to the many nuances and complexities involved with categorizing stigma, we have concluded that rudimentary NLP is not sufficient for identifying the various forms of stigma in qualitative data. However, we believe that this was a great introduction to applying these methods to an important area in global reproductive health. We hope more research...
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May 2022 Director’s Message

May 2022 Director’s Message

May is a time of growth and excitement, from magnolia blooms and longer, warmer days to the celebrations popping up around campus. Along with the inherent optimism of spring on Duke’s campus, it feels that we are starting to sense what life in a more stable peri-Covid world will look like. For many, getting together in person to celebrate events and achievements, or even just to brainstorm in the same room, is a salve after these past two years. Graduation and summer opportunities provide a blank canvas for new experiences and adventures for students. This year’s graduating class spent much of their time at Duke in conditions altered by the pandemic, and yet most of the ones that I have worked with have not let that hinder their ambition or achievements. Their resilience, flexibility and grace will serve them well. In fact, the confluence of the pandemic and the national reckoning with race and racism that has so profoundly impacted...
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Hybrid GRH

Our paper, “Uptake and correlates of cervical cancer screening among women attending a community-based multi-disease health campaign in Kenya,” is published in the BMC Women’s Health. In this paper, we describe the acceptability and uptake of a model of integrated HPV-based cervical cancer screening as part of a series of multi-disease community health campaigns offered in Kisumu, Kenya. We also describe the prevalence and predictors of both screening and positive HPV results among women attending these campaigns. Although there is an increased risk of cervical cancer among women living with HIV, many HIV-care programs do not offer integrated cervical cancer screening. To address the cervical cancer screening gap in Kenya, we leveraged the community health campaigns facilitated by the Family AIDS Care & Education Services and provided multi-disease testing to achieve a high population coverage for HIV-testing and HPV-based cervical cancer screening in western Kenya, an area with high rates of HIV. In addition to HIV testing, the campaigns provided screening...
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Returning to the Field

Returning to the Field

In March 2022, I was able to return to Kenya to resume my dissertation research. It was wonderful to be back after two years away and to see and work with Kenyan colleagues in person again. I spent part of the time conducting follow-up interviews with sexual and reproductive health NGOs in Kisumu and part of the time preparing to conduct a survey in Migori County later this year. My qualitative work began in February 2020 when I was last in Kenya. I met with several Kisumu-based sexual and reproductive health NGOs to learn about how the US’s global gag rule had impacted their operations, relationships with donors, and relationships with other NGOs. When the pandemic hit and Kenya experienced lockdowns, I along with my undergraduate research assistants Ema Kuczura and Sarah Hubner, conducted semi-structured interviews over zoom with roughly 35 NGOs to understand how they were responding to issues related to the COVID-19 pandemic, including increased demand for their services,...
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Michele O’Shea and her recruitment observations in Kenya

By: Michele O'Shea During October to November 2021, I spent 6 weeks Kisumu Kenya working with our collaborators at Jaramogi Oginga Odinga Teaching and Referral Hospital. Our specific project is aimed at evaluating a new set of illustrations to assess for symptomatic pelvic organ prolapse and urinary incontinence. It is an early step in the process of understanding the burden of pelvic floor disorders in Kenya and informing strategies to better diagnose and treat patients with these conditions. As part of the study, we are asking patients presenting for outpatient care to tell us whether they have the symptoms represented in different illustrations of prolapse, urgency urinary incontinence and stress urinary incontinence. Then, to determine whether the patient clinically has symptomatic prolapse or urinary incontinence, we speak with the patient about her symptoms and perform a brief pelvic exam. From the study’s start, we were plagued by slow recruitment, primarily related to patients declining to undergo a pelvic exam. My co-investigators, Dr....
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Jacob Stocks and his experience working on mSaada

Jacob Stocks and his experience working on mSaada

Duke MsGH ’20, Jacob Stocks, talks about his experience working on an mHealth app to support cervical cancer screening in western Kenya.  The app was developed by four Duke seniors (‘T20) as part of their Computer Science Capstone course. Stocks’ experience co-designing the app with end-users, clinicians and community health volunteers in Kenya, was published recently in JMIR Formative Research. In 2019, I worked alongside members of the Center for Global Reproductive Health to develop and pilot test mSaada, a mobile phone app for use by lay-providers during cervical cancer screening. This experience was an exercise in self-reflection, flexibility, and perseverance, as the study team had to acknowledge the gaps in our intervention and work effectively and efficiently to address them while adapting to additional challenges as they arose. Our team, working face-to-face with local collaborators as well as virtually with app developers, conducted feedback sessions with community health volunteers and clinicians in Kisumu and Migori, Kenya. The main findings of this...
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From Dormmates to Research Collaborators

From Dormmates to Research Collaborators

In fall 2019, when Rachel Mundaden and Ramya Ginjupalli (T’22) applied to spend the following summer in Kisumu, Kenya, as part of the Center’s Student Research Training program, no one could have predicted the COVID-19 pandemic, and the resultant global disruptions in almost every aspect of people’s lives.  Travel and fieldwork were soon out of the question, but these two were able to pivot to develop the content expertise and skills in qualitative methods necessary to carry out an analysis of focus groups discussions designed to better understand stigma related to cervical cancer and human papillomavirus in Kenya.  They spoke to DGHI about their experience and how it felt to have a published manuscript resulting from this work. Check it out here: https://globalhealth.duke.edu/news/dormmates-research-collaborators    ...
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