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...
Read More
Cervical cancer screening and women’s empowerment in rural Kenya:  Identifying mechanisms for promoting empowerment and assessing resiliency in the wake of the COVID-19 pandemic

Cervical cancer screening and women’s empowerment in rural Kenya: Identifying mechanisms for promoting empowerment and assessing resiliency in the wake of the COVID-19 pandemic

The empowerment of women and girls in low and middle-income countries has long been recognized as a cornerstone of sustainable development. Yet despite billions in foreign aid spent on development projects annually, the international community is falling short on meeting the sustainable development goal (SDG) to achieve gender equality. The gendered impacts of the COVID-19 pandemic have provided further setbacks for women. However, incorporating mechanisms aimed at increasing women’s empowerment into existing and future development projects is one potential solution to close the gender gap. Indeed, interdependencies of the SDGs can encourage positive spillovers or downstream effects; efforts targeted at one SDG can also impact another. Following this assumption, it is possible for interventions aimed at SDG 3 (ensure healthy lives and promote well-being for all at all ages) to, for example, impact SDG 5 (achieve gender equality and empowerment of all women and girls). My dissertation project leverages these interdependencies and exploits an external health intervention targeted at women...
Read More
Director’s Blog March 2021

Director’s Blog March 2021

Today, March 8, is the International Women’s Day (IWD) a global day to celebrate the social, economic, cultural and political achievements of women. It’s also the date that the Duke Center for Global Reproductive Health launched three years ago. This year’s theme for IWD is #choosetochallenge. Reflecting not only the immense challenges of the past year, but many of the longstanding gender and other biases that impact our world, the organizers have called on people around the world to challenge and call out gender bias and inequality while seeking out and celebrating women’s achievements. You can join the challenge here. Gender bias alone is not the only challenge impacting women’s health, health equity and equal participation in the workforce. February and March are Black history and Women’s history months, respectively. This past February, twenty leading health organizations released a statement designating February 28 and March 1 as dates to acknowledge the three enslaved women, Betsey, Lucy and Anarcha, who were experimented...
Read More
Launch of the Kisumu Cervical Cancer Alliance Website

Launch of the Kisumu Cervical Cancer Alliance Website

On Thursday, January 14, the Kisumu Cervical Cancer Alliance held a Zoom meeting to review current plans and status of cervical cancer prevention in the region, and to launch their new website: www.kisumucanceralliance.org. The KCCA was started approximately three years ago to harmonize and increase the impact of cervical cancer prevention efforts among health care systems, non-profit organizations and government programs. Their mission is to “create an alliance of partners and stakeholder working to improve cancer screening, treatment and rehabilitation services in Kisumu County.” The website will serve as a resource for people interested in learning more about screening and vaccination and for women diagnosed with cervical cancer. Partners working in cervical cancer can share their work, and learn more about what control efforts in the region. The Kisumu first lady, Dorothy Nyongo, who has been a powerful advocate in cancer control for the region, was in attendance. She lauded the work, stating that “despite Covid, she is proud that...
Read More
Abortion Rights, Global Aid, & COVID-19: How Do They all Tie Together?

Abortion Rights, Global Aid, & COVID-19: How Do They all Tie Together?

Ethiopian health clinics supporting teenagers have been shut down. Decades worth of HIV care integration and family planning progress have completely unraveled in Kenya (Henderson, 2020). The duties of government workers dedicated to traveling the Himalayas to share health related information have been stopped (Henderson, 2020). These are some of the effects from the implementation of President Trump’s 2017 global aid policy, “Protecting Life in Global Health Assistance.”  The “Protecting Life in Global Health Assistance,” also referred to as the “The Global Gag Rule,” has made lasting impacts under the Trump administration (Kaiser Family Foundation, 2020). This policy requires non-governmental organizations to refrain from using funds from U.S. and non-U.S. sources to promote or provide abortion care as a form of family planning (Kaiser Family Foundation, 2020). This policy is an extension of the Mexico City Policy which was first announced in 1984 at an international conference under President Reagan's administration and the policy has been in and out of effect...
Read More
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...
Read More
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...
Read More

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

Proposed Changes to US Global Gag Rule Threaten Wider Harm

The Global Gag Rule, which already forces health providers to choose between providing information to patients or receiving US funding, is now set to be expanded even further by the Trump Administration. This policy cuts US government funds to overseas programs that use non-US funds to provide or discuss safe abortion care, family planning services, HIV care, and all other US-funded global health assistance. The proposed expansion of this rule would cover all contracts and subcontracts funded partially or wholly with US global health assistance. This includes organizations subcontracted by organizations that receive US funding, which are often small, local organizations. Ultimately, this expansion would increase restrictions limiting health care and information to people in need. It would not reduce the number of abortions; according to The Lancet, it instead would lead to more and riskier abortions in poor countries. This would be further exacerbated by the COVID-19 pandemic, which has disrupted sexual and reproductive health services....
Read More