Reflection on Contraceptive Product Development and Introduction Panel

During one of Duke’s wellness days, Kate Rademacher and Rebecca Callahan from FHI 360 presented the work being done at FHI 360 related to contraceptive development and accessibility/ acceptability in low- to middle- income countries (LMIC). As a part of FHI 360’s Contraceptive Technology Innovation Team and a public health scientist, Rebecca Callahan researches new contraceptive methods and product availability; As a technical director for the LEAP Initiative for FHI 360, Kate Rademacher supports the development of long-active contraceptives for low resources settings. At the start of the panel, Dr. Callahan introduced the research being done in FHI 360, exploring different forms of existing contraceptives and how they differ in use world-wide. Notably, she focuses on contraceptive usage in LMIC and discusses how for contraceptives to be properly received by these populations, they must have qualities like “safe and effective”, “discreet”, “low cost”, etc. Because contraceptive development is not as profitable for larger pharmaceutical companies, FHI 360 engages research for the...
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Student Spotlight: Ema Kuczura and Sarah Hubner

Student Spotlight: Ema Kuczura and Sarah Hubner

As we just finished the end of the spring semester, we wanted to highlight the work of two of our talented students: Ema Kuczura and Sarah Hubner. Q: Tell us a little bit about yourself.  Ema: I am originally from Chicago, IL. I recently graduated Duke where I majored in Public Policy and Global Health. I am a member of the Duke Women's Rowing team where I am finishing up my last season. While at Duke, I also participated in the Rubenstein-Bing Athlete Civic Engagement program, served as Co-President of the One Love student club, and served on the executive board of Duke SHAPE (Sexual Harassment and Assault Prevention and Education). Sarah: I am originally from Long Island, New York. I studied Political Science with a concentration in Security Peace, and Conflict and Global Health, and pursued a Markets and Management Studies Certificate. I have long been interested in the intersection of US foreign policy and economic development on health outcomes among marginalized populations...
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Economic Sanctions and Maternal Mortality

Economic Sanctions and Maternal Mortality

As this academic year comes to a close, so does my two-year tenure as the Duke Global Health Institute Doctoral Scholar working with the Center for Global Reproductive Health. I have been so fortunate to be mentored by Dr. Huchko and the staff both here in Durham and in Kisumu. A true highlight has been collaborating with community partners as well as undergrads and grad students here at Duke. Pei-Yu Wei, another PhD student and I started a project investigating the impact of economic sanctions on women’s rights and maternal mortality, which we recently had the opportunity to present at a national conference and two academic workshops. Economic sanctions are policy instruments used to influence the behavior of another international actor. While generally a less harmful method for countries to settle disputes compared to military force, sanctions still have the ability to adversely affect the civilian population in the targeted state. Much research has been done on the negative consequences of...
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The Implications of the Newest Wave of Pre-Implantation Genetic Diagnosis and Testing on Global Inequality

In 1997, the film Gattaca was released and while it was not a commercial success, it did raise questions about the future of genetic technology. The movie predicted a dystopian future in which eugenics dictate the futures of humankind – those who are genetically “superior” rule over those who have less desirable genetic traits. In the movie this is done through a procedure where parents pick their embryos based on their genes prior to implantation (Maslin).  In reality, Pre-Implantation Genetic Diagnosis and Testing (PGD/T) has been around for almost 40 years. It involves the testing of genetic material from the blastula of a developing embryo that is external to the body (to be later implanted using embryo transfer). It is an extra step during the process of In-Vitro Fertilization (IVF), which begins with egg retrieval and sperm retrieval from both parents, and then fertilization occurs external to the womb to create an embryo. After the embryo reaches a certain size, a small number of cells are...
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Faculty Spotlight: Sara LeGrand or Liz Turner selected as part of WomenLift Health’s 2021 Global Leadership Journey cohort

Faculty Spotlight: Sara LeGrand or Liz Turner selected as part of WomenLift Health’s 2021 Global Leadership Journey cohort

Sara LeGrand Serving as an Associate Research Professor of Global Health and as the co-director of the Duke Sexual and Gender Minority Health Program, Sara LeGrand has done incredible work in exploring health care disparities worldwide through her research and her teaching. Across her 10 years at Duke, Dr. LeGrand’s research has investigated HIV prevention & disparities among sexual and gender minorities and developed digital health interventions to improve antiretroviral adherence. Her research on sexual and gender minorities also explores social determinants of health that affect mental, physical, and social health outcomes globally. Recently, Dr. LeGrand has recently been published in the International Journal of Transgender Health in the study “Mental health and challenges of transgender women: A qualitative study in Brazil and India”, exploring the lived experiences of transgender women in low - and middle - income countries with high rates of transphobia and gender-based violence.   Elizabeth Turner In her work as the Director of Duke Global Health Institute’s Research and Design...
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Challenges to Maternal Mental Health During the COVID-19 Crisis

Challenges to Maternal Mental Health During the COVID-19 Crisis

The current SARS-CoV-2 pandemic has devastated communities across the United States since early this spring and continues to do so on a global scale. The impact on maternal health and welfare, and by extension child health has not been lost on mothers across the world. Hospitals have closed their doors to visitors and accompanying loved ones for those seeking healthcare – victims of COVID-19 fight alone and too often succumb to the illness without their primary emotional support systems, but rather in isolated rooms with little human contact. In the case of pregnant and expectant mothers, this means potentially giving birth alone. These women are now also kept in isolation rooms, away from their families and loved ones, and surrounded by healthcare workers masked in personal protective equipment – a far cry from the societal norms previously established and long withstanding (Hermann, Fitelson, & Bergink, 2020). This newfound isolation and the impact of the pandemic extends to reaching antenatal care and...
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What President-Elect Biden’s win means for COVID relief in Kenya and other low- and middle-income countries

What President-Elect Biden’s win means for COVID relief in Kenya and other low- and middle-income countries

Recent attention has been focused on what the Biden-Harris administration can accomplish with executive orders starting from day one. From student debt relief to fully implementing the Defense Production Act, these actions can have a direct impact on domestic economic relief and health care. History tells us that, like every recent Democratic presidential administration, within the first few days of office Biden will also repeal the Global Gag Rule. This executive order will permit non-governmental organizations (NGOs) receiving U.S. foreign aid to provide comprehensive sexual and reproductive health care, including abortion advocacy and abortion services. But the impact this action could have goes well beyond abortion and into other areas of public health as well. From July-October 2020, my two undergraduate research assistants (Ema Kuczura and Sarah Hubner) and I interviewed 35 sexual and reproductive health NGOs in Kenya who universally reported that the Global Gag Rule (implemented by the Trump administration in January 2017 and expanded by Secretary of State...
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Director’s Blog December 2020

Director’s Blog December 2020

The past eight months have been a time of unexpected and often stressful changes as we navigate life with Covid-19 amidst a period of social and political unrest in this country. As the year comes to a close, we’ve chosen to focus this newsletter on the changes we’ve experienced over the past semester—what we’ll keep, what we’ve learned and how this has been a powerful catalyst for our work.  At this stage in the pandemic, the changes that felt temporary have become engrained into our daily lives—it’s natural to grab a mask before leaving the house, standing six feet away is the norm and it’s assumed that when we set up a meeting, it will be by Zoom.  While most of us can’t wait to resume more normalcy in our social and personal lives, some of these necessary changes have turned out to have unexpected benefits. Personally, I get to see my kids a lot more than I did before...
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Washington Sex-Ed Curriculum

Washington Sex-Ed Curriculum

This November 3rd, voters in Washington will be voting on a law to ensure a comprehensive sexual education curriculum in schools. The new law, called Referendum 90, would require schools districts to adopt a sexual education curriculum consistent with state standards. This new law encourages schools to follow a curriculum approved by the state, although they are allowed to develop their own provided that they are inclusive, age-appropriate, and teach medically accurate information about contraceptives and disease prevention. Parents are allowed to review material and request to excuse their children. The curriculum mandates at least 6 lessons throughout grades K-12, with a minimum of one lesson between kindergarten and third grade, one in grade four or five, two in middle school, and two in high school. In the earlier lessons, content would focus on social-emotional learning such as how to cope with feelings or how to set goals. Proponents of the bills cite rising sexually transmitted infections, unintended pregnancies, and...
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Supreme Court’s Recent Ruling on Abortion Drug

Supreme Court’s Recent Ruling on Abortion Drug

The latest victory for abortion rights: the supreme court declined to reinstate restriction for patients seeking to obtain a drug used for early pregnancy abortions. With COVID-19 continuing to ravage through the country, the Supreme Court allowed a blocking of FDA rules requiring an in-person visit with a medical professional to pick up mifepristone, the drug in question which is the first of two drugs taken to terminate pregnancies less than 10 weeks. The ACLU argues on behalf of the American College of Obstetricians and Gynecologists that the FDA rules served no purpose and forced women to face unnecessary risks with added trips to the doctor during the pandemic. Mifepristone is the only medication that the FDA forced patients to pick up in clinic, despite the fact that women can take the pill without supervision. This comes as a blow to the Trump administration, as he asked the supreme court to reinstate this rule earlier in the year despite the...
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