From the Field – Page 5 – Global Reproductive Health at Duke

Returning to the Field

April 10, 2022December 10, 2024 by Kelly HunterNo Comments

In March 2022, I was able to return to Kenya to resume my dissertation research. It was wonderful to be back after two years away and to see and work with Kenyan colleagues in person again. I spent part of the time conducting follow-up interviews with sexual and reproductive health NGOs in Kisumu and part of the time preparing to conduct a survey in Migori County later this year. My qualitative work began in February 2020 when I was last in Kenya. I met with several Kisumu-based sexual and reproductive health NGOs to learn about how the US’s global gag rule had impacted their operations, relationships with donors, and relationships with other NGOs. When the pandemic hit and Kenya experienced lockdowns, I along with my undergraduate research assistants Ema Kuczura and Sarah Hubner, conducted semi-structured interviews over zoom with roughly 35 NGOs to understand how they were responding to issues related to the COVID-19 pandemic, including increased demand for their services,...

Michele O’Shea and her recruitment observations in Kenya

March 22, 2022December 10, 2024 by Aarushi VenkatakrishnanNo Comments

By: Michele O'Shea During October to November 2021, I spent 6 weeks Kisumu Kenya working with our collaborators at Jaramogi Oginga Odinga Teaching and Referral Hospital. Our specific project is aimed at evaluating a new set of illustrations to assess for symptomatic pelvic organ prolapse and urinary incontinence. It is an early step in the process of understanding the burden of pelvic floor disorders in Kenya and informing strategies to better diagnose and treat patients with these conditions. As part of the study, we are asking patients presenting for outpatient care to tell us whether they have the symptoms represented in different illustrations of prolapse, urgency urinary incontinence and stress urinary incontinence. Then, to determine whether the patient clinically has symptomatic prolapse or urinary incontinence, we speak with the patient about her symptoms and perform a brief pelvic exam. From the study’s start, we were plagued by slow recruitment, primarily related to patients declining to undergo a pelvic exam. My co-investigators, Dr....

Jacob Stocks and his experience working on mSaada

March 18, 2022April 4, 2025 by Jacob StocksNo Comments

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...

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

October 7, 2020December 10, 2024 by Emily WoodrowNo Comments

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...

Studying Global, Staying Local

October 7, 2020April 3, 2025 by Aarushi VenkatakrishnanNo Comments

By: Ema Kuczura and Sarah Hubner When we entered the Student Research Training Program, we were preparing ourselves to deal with many challenges, including learning new research skills and navigating cultural differences. Working with DGHI Doctoral Scholar, Kelly Hunter, our goal was to understand the impact of the Global Gag Rule on health care providers and non-governmental organizations in Western Kenya. The Global Gag Rule formally referred to as the Protecting Life in Global Health Assistance Policy, “aims to ensure that US tax-payer funding does not support foreign non-governmental organizations that perform or actively promote abortion as a method of family planning” (Michael Pompeo, US Secretary of State). We were planning on using our time in Kisumu to conduct in-person interviews with stakeholders in the reproductive health sector. However, when we heard the news that pandemic would make it impossible to travel to Kenya as we initially anticipated, we knew achieving the goals we set forth for the summer would require newfound...

Effects of COVID-19 on Sexual Reproductive Health and Rights (SRHR) among Young People in Africa

April 26, 2020December 10, 2024 by Aarushi Venkatakrishnan3 Comments

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...

Pilot Study: Use of mSaada Application to Address Cervical Cancer in Kenya

November 7, 2019April 4, 2025 by Aarushi VenkatakrishnanNo Comments

Article by: Emmy Duerr At the DGRH Think Global Talk on October 15, Jacob Stocks presented his work on the mSaada mobile application platform. Prior to his pilot study, Stocks developed mSaada (meaning “support” in Swahili), an application designed to be a support tool for community-based cervical cancer screening for low-income communities. The app was intended to provide counseling/decision support for community health volunteers as well as patient and specimen tracking to better ensure follow up and patient retention. Stocks implemented a small (n = 19) 5-week pilot study in Migori and Kisumu between July and August of 2019. The pilot study consisted of six iterative feedback sessions with the goal of refining the mSaada platform. The first week of the study involved three group sessions with four participants in each session, using a mixed methods approach of a combination of qualitative in-depth interviews and quantitative usability surveys. Weeks 2-4 provided app developers time for feedback integration, and allowed them to implement...

HPV Vaccine Launch in Kisumu, Kenya

October 29, 2019December 10, 2024 by Aarushi VenkatakrishnanNo Comments

Article by: Sandra Y. Oketch The launch of the HPV vaccination into the routine immunization schedule available for all 10-year old girls from September 2019 onward is a great milestone for Kenya. The Kisumu County launched the HPV vaccine Program on October 25th, 2019 at the Kisumu County Referral Hospital, accompanied by several activities such as HPV health information, speeches and educational entertainment. The Chief Guest of honor was Dr. Dickens Onyang, the Kisumu County Director of Health Services. Onyango voiced that the vaccine has been successfully included in the healthcare cascade of all Government of Kenya health facilities, and that the Ministry of Health will work hand in hand with the Ministry of Education and all other partners to ensure an effective and efficient implementation of the program. He reiterated the benefits of the launch stating, “The HPV vaccine is the silver bullet to prevention of cervical cancer that will greatly reduce the cervical cancer burden as has been in the 115...

Sandra Oketch: The Voice of Cervical Cancer Prevention in Kisumu County

October 1, 2019December 10, 2024 by Megan HuchkoNo Comments

Sandra Oketch, the Kisumu Research Director for the Center has been making the rounds of the radio talk shows to share information about human papillomavirus testing in anticipation of this week’s cancer awareness activities. During this media blitz, Oketch has been speaking on radio shows in Luo, Kiswahili and English, she is working with key members of the Ministry of Health to raise awareness of cervical cancer, educate women on their risk and how to get screened. Activities will include in-person education, screening and a cancer awareness walk on the second and third of October. Key stakeholders will take advantage of the momentum to convene of meeting of partners actively engaged in cancer prevention and treatment to help develop a cancer prevention alliance that works synergistically, without duplication of activities. The First Lady of Kisumu, Dorothy Nyong’o, long a supporter of cancer control activities in the region, has promised to serve as a patron for the Kisumu County Cancer Alliance....

Trump, Faith, and Reproductive Healthcare

September 4, 2019December 10, 2024 by Molly PaleyNo Comments

This summer I worked as a Legislative Assistant on the Government Relations, Advocacy, and Community Engagement (GRACE) team at the Anti-Defamation League (ADL) in Washington, DC. The mission of the ADL is to stop the defamation of the Jewish people and secure justice and fair treatment for all. Among the organization's core policy issues is protecting religious freedom by ensuring separation of Church and State. The ADL advances separation of Church and State by filing amici briefs in nearly every religious freedom case. Moreover, the ADL supports legislation such as the Do No Harm Act that ensures religious freedom cannot be misused to discriminate. Throughout my internship, I had the opportunity to attend hearings, write blog posts, and write public comments in response to different issues related to religious freedom such as LGBTQ equality and access to healthcare. Throughout college, my policy interests have been focused on domestic and global women’s health issues. My passion for reproductive health is rooted in...

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