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

Evaluating Quality in Maternal Health Interventions Moderator Reflection

By Uma Govindswamy November, as a part of the Center for Global Health’s Reproductive Health in Africa Speaker Series, sponsored by the Africa Initiative, Dr. Joy Noel Baumgartner and Dr. Rohit Ramaswamy lectured on the topic: Evaluating Quality in Maternal Health Interventions. Dr. Joy Noel Baumgartner is the Director of the DGHI Evidence Lab, the lead of the DGHI Global Mental Health Working Group, and a professor here at Duke University. She has been an active public health practitioner and researcher for over 20 years and has worked in countries such as Cameroon, Kenya, India, South Africa, Jamaica, Tanzania, Ghana, and Uganda. Dr. Rohit Ramaswamy is Director of the Center for Global Learning and a Professor in the Department of Maternal and Child Health at UNC’s Gillings School of Global Public Health. His past research has focused on implementing delivery systems that improve the quality of healthcare for women in low-resource settings including India, Ghana, Nigeria, and Uganda, to name a...
Read More

Stigma and Reproductive Health Moderator Reflection

By Saumya Sao On November 1st, 2019, the Center had its first lunch talk in the 2019-2020 Reproductive Health in Africa lunch series. The panel focused on HIV stigma and reproductive health. I had the pleasure of moderating the panel, which was made up by: Megan Huchko, MD, MPH who is an OB/GYN and directs the Center for Global Reproductive Health at DGHI; Michael Relf, PhD, RN who is the Associate Dean for Global and Community Affairs in the School of Nursing; and Godfrey Kisigo, MBChB, who is a second year MSc-GH student and Tanzanian physician. Over the past year, I’ve had the privilege of working with Godfrey on a team led by Dr. Melissa Watt. Our team has been developing and carrying out an HIV stigma reduction intervention in Moshi, Tanzania. Throughout just two years of studying global sexual and reproductive health, I’ve seen how critical it is to consider the impact of stigma on care engagement and reproductive health education, so I...
Read More
Sensitization meeting on RMNCAH and immunization budgeting in Kisumu County

Sensitization meeting on RMNCAH and immunization budgeting in Kisumu County

By: Sandra Y. Oketch The Duke Center for Global reproductive health Kenya team had an interactive session on October 29, 2019 with the Ministry of Health and CSOs to discuss on Reproductive Maternal Neonatal Child and Adolescent Health (RMNCAH) and Immunization advocacy to ensure proper budgeting and sustainability. The discussions revolved around the critical pillars in budgeting that include: transparency and accountability; public participation and strategic planning. Some of the gaps in the Kisumu County Annual Development Plan (ADP) included: The lack of clear cut priorities for the FY 2019/20 and the public participation is not prioritized nor costed. All members present acknowledged the need for advocacy on the key stages in budgeting that include budget formulation, approval, implementation and Auditing. It was an exciting 1st advocacy collaborations to push for more transparent budget cycle on RMNCAH + Immunization with the CSO roles revolving around providing support in dissemination of the National County RMNCAH + Immunization policies and guidelines; Organize and conduct sensitization...
Read More
Dr. Elizabeth Bukusi’s Work on HIV Prevention and Care

Dr. Elizabeth Bukusi’s Work on HIV Prevention and Care

To commemorate World AIDS Day held each year on December 1, we are highlighting Dr. Elizabeth Bukusi’s HIV research in Kenya! Dr. Bukusi is one of the foremost advocates for HIV care. She has conducted various studies in evaluating treatment options for high-risk populations. In one of her recent studies, she explored the value of post-exposure prophylaxis (PEP) and the antibiotic doxycylcine (dPEP) as an STI prevention strategy in African women taking PrEP, PrEP, or HIV pre-exposure prophylaxis, has been used over the past decade to prevent against HIV, however, there has also been a rising incidence of curable STIs in populations taking PrEP. The disproportionate risk that African women face from overlapping HIV-STI epidemics makes them an essential study population. dPEP is beneficial because it can be "woman-controlled," meaning that the effectiveness is not determined by partner participation, and that it's been shown to be safe for women. Dr. Bukusi predicts that dPEP will lead to a substantial reduction in the amount of...
Read More
Bass Connections Update

Bass Connections Update

By Eugene Wang and Dennis Harrsch On November 21st, members of the Big Data for Reproductive Health (bd4rh) Bass Connections research team visited IntraHealth, a Chapel Hill-based international development nonprofit. While there, they presented to IntraHealth staff about the team’s work, with research lead Amy Finnegan, PhD speaking additionally about the value proposition of data science for the development space.  The bd4rh team is split into two main subteams: the machine learning (ML) team, and the research and policy stakeholder (RAPS) subteam. The ML team has been working on developing machine learning algorithms to accurately predict a woman’s contraceptive use patterns based on demographic survey data. They hope to integrate any promising results into their online tool, currently hosted as a website application that displays contraceptive use data through a easy-to-understand visual interface. The RAPS team has been identifying use cases for such a tool by interviewing stakeholders in order to shape the project’s trajectory and maximize deliverable value.  The bd4rh team is...
Read More

Winter 2019 Director’s Message

The end of the semester and calendar lend themselves to reflections on the progress and challenges of the past year, and global health is no exception. In fact, last year we highlighted some of the year’s ups and downs in reproductive health. Both myself and Konyin Adewumi, DGHI MSc ’17, concluded that despite some setbacks, 2018 left us optimistic about progress toward reproductive and sexual health, reflected in a global call toward cervical cancer elimination, a historic decision on abortion rights in Ireland and a record number of women seeking (and achieving) government office in the United States and around the world. This year, the 25th anniversary of the International Conference on Population and Development (ICPD) facilitates reflections on not just the past year, but the past 25 years of achievements in global reproductive health. The momentous discussion at the ICPD in Cairo, Egypt and the resultant 20-year Programme of Action were pivotal in shaping the agenda in women’s health around...
Read More
Welcome Back!

Welcome Back!

With classes back in session, the halls are flowing with students talking about the trials and triumphs of their summers—whether they were in the field, interning in DC, trying out consulting work or just had an amazing vacation. The new school year brings with it a sense of new beginning and purpose—and sometimes an overwhelming feeling of everything needing to get “scheduled” during these first weeks of September.  A colleague recently started an email with the greeting: “did you have a relaxing or productive summer?  I feel like it’s either one or the other.”  It made me reflect on how we take advantage of being out of the classroom, trying to fit in various opportunities for travel, fieldwork and writing time that become harder during the semester, while also taking time to regroup and relax with family and friends. I hope everyone was able to have a little balance this summer, and come into the new school year with renewed...
Read More
Re-building Rwanda’s Access to Ob/Gyn Services

Re-building Rwanda’s Access to Ob/Gyn Services

"In 2011 the Rwandan government embarked on a novel medical education program to improve their health care system.  Human Resources for Health (HRH) Rwanda, a partnership between the government of Rwanda and a consortium of 22 U.S. academic institutions, was designed as a 7-year training program to produce qualified medical personnel with the aim of increasing quality and access to health care for Rwandans."  As one of the earliest ob/gyn specialists to work in Rwanda with HRH, Duke's Dr. Maria Small led an evaluation of the first five years of the program with the aims of 1) examining the number of trained ob/gyn specialists who graduated from the University of Rwanda as beneficiaries of the HRH program, and 2) conducting a geospatial analysis of pregnant women’s access to Rwandan public hospitals with trained Obstetrics and Gynecology providers using a WorldPop data set. Study Results: "In 2011, there were only 14 ob/gyns in the country.  By the end of HRH year 5,...
Read More
Perspectives of women participating in a cervical cancer screening campaign with community-based HPV self-sampling in rural western Kenya: a qualitative study

Perspectives of women participating in a cervical cancer screening campaign with community-based HPV self-sampling in rural western Kenya: a qualitative study

Our very own Sandra Oketch has published a research article in BMC Women's Health about our cervical cancer screening work in western Kenya.  Congrats, Sandra!    ...
Read More