State Policies and Reproductive Rights

Reproductive rights remain a contested and highly debated topic, largely left up to the discretion of states to decide on more or less restrictive policies. However, recent research has provided evidence that states with less restrictive policies see better birth outcomes. In a new study released just a week ago on October 13th, Sudhinaraset and her team compared several reproductive policies across states including, mandatory parent consent for minors seeking abortion, mandatory waiting periods, restrictions on public funding for abortion, percentage of women living in counties with abortion providers, expanded eligibility for Medicaid family planning services, and mandatory sexual education in schools. The results show that women in most restrictive states showed a 7% higher low birth weight risk when compared to women in the least restrictive states. They also showed the less restrictive policies are particularly protective against adverse birth outcomes for Black women. As more restrictive policies are being put in place and status of certain reproductive rights...
Read More

Restrictions on US Global Health Assistance Reduce Key Health Services in Supported Countries

The 2017 Mexico City Policy, or Global Gag Rule, prohibits non-US-based NGOs from receiving US global health assistance if they either perform or refer for abortion services. Sherwood et al. (2020) studied the effects of the expanded policy on implementing partners of US-funded HIV programming by the President's Emergency Plan for AIDS Relief (PEPFAR) via a survey in all recipient countries. Survey results showed that 28% of organizations reported stopping or reducing at least one service in response to the policy. The delivery of information about sexual and reproductive health, pregnancy counseling, contraceptive provision, and HIV testing were services reduced. These disproportionately harmed pregnant women, youth and vulnerable populations such as sex workers and men who have sex with men. Thus, the intended beneficiaries of PEPFAR funding may be the most negatively impacted, especially in areas with high HIV prevalence. This study calls attention to policy makers to respond to disruptions in service delivery from the expanded Mexico City Policy...
Read More

An Interview with Dr. Joy Noel Baumgartner

What originally sparked your passion in global sexual and reproductive health? I was originally interested in child welfare issues and realized how closely related that is with women’s ability to realize their reproductive intentions.   Have you had any mentorship opportunities that brought you to where you are today? I didn’t get into SRH work until after my PhD, while working at FHI 360. I can’t say there was one particular mentor—more like a committed environment of like-minded individuals dedicated to social and reproductive justice issues.   Do you have any guiding principles that keep you on track? I’m an applied researcher. At the end of day, I have to see how any project I’m working on will impact practice or policy—not “someday” but within a tangible time period.  That usually means very close collaborations with my research partners endure past the end of the funding.   Do you have any advice for students intending to follow the same professional pathway? If you’re interested in global SRH, know the countries/regions...
Read More
Summarizing the panel: “Facing Hard Numbers and Hard Conversations: The Impact of Race and Socioeconomic Status in Women’s Health and Gynecology”

Summarizing the panel: “Facing Hard Numbers and Hard Conversations: The Impact of Race and Socioeconomic Status in Women’s Health and Gynecology”

Last week, we heard from three amazing speakers Nikki Mahendru, Dr. Chemtai Mungo, and Dr. Megan Huchko about the impact of race and socioeconomic status in women’s health and gynecology in an event held by Duke University’s Center for Global Women’s Health Technologies.  As an undergraduate student, Nikki spoke about the perspective she gained on this topic from shadowing an OB/GYN as well as her own mother’s experiences.  She provided great insight to the importance of an OB/GYN’s office as the birthplace of a woman hating or loving her body.  Dr. Huchko detailed her experiences in Niger working on a surgical team to repair fistulas.   Despite their great work, one woman suffered an unnecessary surgery due to the biased views of the doctors; today, this experience motivates Dr. Huchko to recognize and fight against implicit biases that may impede optimal care for a patient.  On the other hand, Dr. Huchko noted the recent positive shifts away from racism with more of an emphasis on centering the patient in care.  Next, Dr. Mungo...
Read More
Adolescent girls and young women are disproportionately affected by COVID-19

Adolescent girls and young women are disproportionately affected by COVID-19

This last summer I worked as a Policy Intern at Friends of the Global Fight Against AIDS, Tuberculosis, and Malaria. Friends of the Global Fight Against AIDS, Tuberculosis, and Malaria advocates for U.S. support and investment in the Global Fund and other health programs by engaging with U.S. policymakers, connecting with key stakeholders, and educating the broader community about improving global health. The COVID-19 pandemic presents serious threats to progress made in the fight against AIDS, tuberculosis, and malaria—specifically, analyses from Imperial College, UNAIDS, the Stop TB Partnership, WHO, and others suggest that the annual death tolls of these three diseases could nearly double due to consequences of COVID-19. As a result, Friends has shifted gears to directly recognize COVID-19 as a leading global health threat. Friends is actively involved in actions to mitigate the spread and effects of COVID-19 and is currently focused on boosting U.S. investment in a global response to the virus.  During my internship, I had the...
Read More
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...
Read More

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...
Read More

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...
Read More
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...
Read More
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...
Read More