Webinar Series

Webinar Series

The Center for Global Reproductive Health and the Center for Policy Impact in Global Health recently partnered to convene a webinar on “The unfinished agenda of maternal and child health in Africa and Asia: promising directions to address maternal mortality challenges.” The panel, moderated by Dr. Megan Huchko, included: Dr. Mariam Claeson, former Director of the Global Financing Facility for Every Women Every Child at the World Bank and now at the Karolinska Institute Dr. Qjan Long, Assistant Professor at Duke Kunshan University, formerly worked at the Department of Reproductive Health and Research, WHO Ms. Jacquelyn Caglia, Director of Learning, Communications for Merck for Mothers Experts discussed the historic and current challenges in addressing maternal and child mortality in the region, and brought up some promising innovations and strategies with the potential to effect these disparities in the future. The webinar can be seen here, with a fill description of the background and discussion on the CPIGH website....
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The Failures of American Sex-Education

The Failures of American Sex-Education

As the topic of sexual and reproductive health re-enters the public consciousness in America through the overturning of Roe v. Wade, it becomes increasingly important to access American Sex Education, or rather, the failures of it, and how we teach these topics to our most impressionable population, children. The state of sex-education in this country is in shambles. Though the majority of Americans support sex-education in middle school and in high school, what exactly does that education look like?  The first and one of the most important things to note about sex-education in the states is that there is no universal regulation of it. Only thirty nine states, plus DC, even have government mandated sex-education [5]. Within the states with mandated sex-education, only thirteen must provide “medically accurate” sex-education [1]. The content of what is covered in sex-education varies widely from state to state, within states that do have government mandated sex-education, it is often left to individual districts to decide...
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Maternal Mortality: Why is Race a Factor?

Maternal Mortality: Why is Race a Factor?

The United States is one of the leading nations in medical advancement and spends a significant portion of expenditures in healthcare and yet, we have the highest rate of maternal mortality (ratio of 57) among developed countries. About 57 mothers die during childbirth per 100,000 birth in a year. Maternal mortality is defined as the death of a mother due to pregnancy and/or childbirth complications [3]. These complications can arise due to a variety of factors including environmental lifestyle, predisposing conditions, risk factors, genetics and socioeconomic factors [1]. Pregnancy complications are likely to arise in women with higher maternal age and those with chronic cardiovascular conditions. Preeclampsia is a condition in which women develop high blood pressure due to preexisting cardiovascular conditions and kidney disease. Black non-Hispanic mothers are 2.5 times more likely to die from pregnancy or labor complications compared to white women and 3.5 times more likely to die than Hispanic women [3]. Why is there a disparity in...
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Myna Mahila Foundation Combats Period Taboo in Urban Indian Communities

Myna Mahila Foundation Combats Period Taboo in Urban Indian Communities

Although stigma surrounding menstruation exists around the world, this stigma manifests in a way that has a deeply negative effect on the lives of menstruators in some communities in India. In these communities, periods are treated as dirty and impure. Many menstruators are not allowed to pray, go to the temple, or enter the kitchen while on their period. Due to the negative stigma surrounding menstruation, menstruators in these communities do not discuss menstruation. Many men do not even know what menstruation is. Menstruators feel ashamed buying sanitary pads from male workers at health stores and are thus forced to use unsanitary cloth rags during their cycles. As a result of the lack of access to proper menstrual hygiene products and community support, in some Indian communities, young menstruators are forced to end their education after they get their period.  Despite how pervasive this taboo is in many Indian communities, there are a variety of efforts to combat this detrimental stigma....
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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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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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Comfort Women?

Every Wednesday in front of the Japanese Embassy in Seoul, people gather around to demand the Japanese government formally apologize for their forced sexual slavery system during World War II. Even though it has been over 20 years of Koreans raising this issue, the Japanese government has only tried to offer monetary compensation, and has not issued an official apology. The Asian Women’s Fund estimates the number of victims ranges from 50,000 to a quarter million, but the number has remained vague due to incomplete data archives and stigma among victims after the war (1). A few survivors of this sexual slavery system have spoken in front of global leaders to raise awareness: one of them, Hak-sun Kim, delivered her first testimony in 1991. During this testimony, Kim said that when she was seventeen, she was forcibly sent to the Japanese military’s comfort station (a sexual slavery station) in China (2). She resisted, but soldiers threatened and kicked her to be...
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Contraceptive Calendar

Contraceptive Calendar

Our team seeks to understand how conflict impacts contraceptive use using data from Sub-Saharan African countries. More specifically, we are looking at trends in contraceptive use for women in the time preceding, during, and following the conflict period--to do so, we are utilizing geocoded data for sub-Saharan Africa from the Uppsala Conflict Dataset and contraceptive calendar data from the Demographic and Health Surveys. This research has important implications for women’s health: firstly, it can help us understand the demographic consequences of conflict on family planning, births, and outcomes, and secondly, it can help inform policy interventions that can target and improve reproductive health in humanitarian settings. We are personally interested in this project because, collectively, our team is passionate about understanding health inequities and empowering women by leveraging policy as a tool. Participation in this project can help to provide us a foundational understanding of how conflict interacts with women’s reproductive autonomy in a way that gives us independent research...
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Natural Language Processing Group

We are the Natural Language Processing group from the Big Data for Reproductive Health Bass Connections team. Our names are Lynne Wang, Foxx Hart, Alexandra Lawrence, and Neha Shrishail. Currently, we are working through “Text Mining with R” to gain a better understanding of text mining, sentiment analysis, and topic modeling. Additionally, we are examining the stigma summary scale as well as other texts related to stigma to form a solid foundation on the resources at hand. We are interested in this project for the opportunity to learn new technical and project management skills, as well as dive deeper into the emerging interdisciplinary space between quantitative machine learning and qualitative social science research. We’re especially excited to apply these methods to an important area in global reproductive health. At the end of our research, we hope to become proficient in using natural language processing and gain a better understanding of how it can be applied to future projects....
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