Together with Duke SRT students, undergraduate app developers, and Kenya-based members of the Center for Global Reproductive Health, I will be leading a pilot usability study of an integrated digital platform called mSaada. The goal of this platform, placed in the hands of community health volunteers (CHVs) during HPV-based cervical cancer screening, is to help facilitate the successful completion of the cervical cancer prevention cascade. This will be achieved by mSaada’s many features: patient education, protocol and counseling support for CHVs, results notification, service reminders, and patient tracking. Over the course of the summer, we will train CHVs on proper use of mSaada, allow them to use the app in a clinical setting, and gather periodic feedback through quantitative questionnaires and structured in-depth interviews. We aim to gain a strong understanding of user experience, acceptability, and feasibility of the mSaada platform within the context of Western Kenya. My interest in this project is multifactorial. First, by studying and working to combat...
Last week the office at the Duke Center for Reproductive Health in Kisumu held a two-day qualitative research training session led by facilitators Cyrilla Amanya and Muli Emmanuel from ACE, Africa. Attendees included the Duke Reproductive Health Center’s Kisumu staff, a DGHI master’s student, and members of the Duke Global Health Institute’s (DGHI) Student Research Training Program (SRT). The members of SRT (Andrea Chalem, Suzanna Larkin, and I) are here in Kisumu, Kenya for 8 weeks working on two different studies concerning cervical cancer awareness, screening, and prevention. Andrea is working on an mHealth study with Jacob Stocks, a master’s student at DGHI, and Suzanna and I are working on a stigma study. We used the In-Depth Interviews (IDIs) created for the stigma project as a jumping off point for discussion and role play during the qualitative training session. On day one, we learned helpful tips on how to make interviews conversational and comfortable for the participant. These included using the...
"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,...
By: Jacob B. Stocks & Sandra Yvonne Oketch - June 18th, 2019
On May 23rd, 2019, a stakeholders meeting on palliative care and treatment of cervical cancer for partners in Kisumu County was hosted at the KMET Complex in Kisumu. The main objectives of the meeting were 1) to share experiences on palliative care and cervical cancer services in Kisumu County and 2) to identify opportunities for networking and collaboration among partners. The 7-hour meeting began with a discussion of structural barriers to effective referral and treatment of cervical cancer in Kisumu County. The presenter, Brenda Otieno, discussed barriers such as the complexity of intra-facility referrals and client tracking, the lack of centrally located data on cancer patients (i.e. lack of a county-level cancer registry), and the lack of financial protection for clients seeking treatment. Following this session, Dr. Chemtai Mungo, an OB/GYN from UCSF, presented the evidence for cervical cancer screening via HPV testing by citing multiple studies discussing the cost-effectiveness...
In order to ensure participants had a strong understanding of mSaada and the planned pilot usability study, members of the mSaada study team hosted a two-day training, June 6th and 7th, at the Kisumu Office of the Center for Global Reproductive Health. Twelve study participants, four researchers, and two research assistants were in attendance. The first day of the training began with a general overview of research, its importance, those involved, and a lengthy discussion of informed consent. After a tea break, we proceeded with a discussion of HPV and cervical cancer, and prevention, screening, and treatment strategies. In addition to lively audience participation during a session of review questions, each study participant displayed their understanding of the steps necessary to successfully complete HPV self-collection by demonstrating how to explain the process to a female client. Finally, the first day of training concluded with a 2-hour session on mhealth strategies and details of the planned mSaada pilot usability study. Day two of...
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! ...
This summer the Center office in Kisumu will be hosting three students through a Student Research Training (SRT) summer program. They will be joined by a Masters in Global Health student, an ob/gyn resident and a post-doctoral fellow, all researching various aspects of cervical cancer prevention and health systems strengthening for reproductive health. They've just arrived in Kenya, and I've asked them to share some of their plans and expectations for the summer. Follow this page to see updates on their projects and reflections throughout the summer. Emma Mehlhop, T'21 Since this summer will be my first experience in field work of any kind, I have much to anticipate. First, I am looking forward to reflecting on not just why I am passionate about Global Health, but what I am personally able to contribute to the field. During the Global Health Ethics course, we spent time reflecting on the work of Boniface Mwangi, a Kenyan photojournalist, who asks Global Health workers and...
I had the opportunity to meet with Harun, the Head of Programs at the Omega Foundation (OF) at the Kisumu Office. The OF mission is, “to strengthen the capacity of communities to live meaningful lives through integrated health and innovative livelihood solutions” across 12 counties in Kenya: Kisumu, Siaya, Migori, Homa Bay, Busia, Bungoma, Nandi, Uasin-Gishu, Kakamega, Vihiga, and Bomet. OF undertakes various projects including Sexual and Reproductive Health Service Delivery and Advocacy projects funded by Planned Parenthood Global. The projects are being implemented in Kisumu, Siaya, and Homa Bay counties respectively with an objective to increase awareness of, access to, and use of quality family planning (FP) and Post Abortion Care (PAC) services. Twenty facilities in Kisumu are supported in delivery of the services and focus on strengthening the capacity of partners to provide facility-based FP and PAC services and advocate for expansion of Sexual and Reproductive Health (SRH) rights and services. To achieve their goals, the OF supports provision of...
This past year, I had the opportunity to work on a Bass Connections research team: Big Data for Reproductive Health (BD4RH). Bass Connections projects are interdisciplinary teams of undergraduate and graduate students, professors, and researchers. I became interested in reproductive health research after taking Dr. Megan Huchko’s global reproductive health course in the spring of 2017. It was through her course that I developed my understanding of and passion for reproductive health policy and gender equality. The BD4RH team reflected my passion for reproductive health through the project’s commitment to reduce contraceptive discontinuation rates. The initial goals of our research were to create and disseminate data visualization tools that use reproductive health data from USAID’s Demographic and Health Surveys (DHS). The DHS collect data in over 80 different countries, and the surveys’ contraceptive calendar tracks women’s month-by-month contraceptive use over a five-year period. Our project began in the summer of 2018 when undergraduate student, Saumya Sao, and Masters student, Melanie Wai,...
The Helper and the Witness Guest post by Kelly Hunter In 2018 the Nobel Peace Prize was shared by two very different individuals: Denis Mukwege, a 63-year-old Congolese doctor who founded the Panzi Hospital, and Nadia Murad, a 24-year-old Iraqi Yazidi human rights activist, who at age 19 was kidnapped by ISIS. What cause united these unique individuals from disparate parts of the globe? The Nobel committee recognized their advocacy for victims of wartime sexual violence, defined by scholars as “rape; sexual slavery and forced marriage; forced prostitution, pregnancy, and sterilization; sexual mutilation; and sexual torture” (Elizabeth Jean Wood, 2018). Dr. Mukwege has dedicated his career as a gynecologist to physically healing victims of conflict-related sexual violence in Africa and Ms. Murad, a survivor of such violence has founded an organization to raise funds and awareness to support other women brutalized by this increasingly common war crime/crime against humanity. The Nobel committee’s recognition reflects what scholars and international organizations have long realized:...
