I recently landed back home in Boston after spending most of my summer in Nairobi, Kenya researching cross-cultural early childhood development with Universal Baby. Universal Baby is a public health, caregiver coaching intervention that creates videos to share current neuroscience and child development information across the globe. Towards the end of my time in Kenya, I visited a Maasai Village in Kajiado South sub-county, about 5-6 hours outside of the Nairobi. The Maasai are one of Kenya’s ethnic tribes, originally from the lower Nile Valley. I embarked on this journey, acutely aware of how the injustice and violence of colonialism has shaped the education systems and subsequent socioeconomic advancements in Kenya. We stopped for the night in the rural town of Bisil before starting off early the following morning for the village, passing giraffes and ostriches on the drive there. Our first stop was Loolkair Primary School, a K-8 school with nearly 400 students and only eight teachers. As we arrived, hundreds of...
The Center for Global Reproductive Health and the Center for Policy Impact in Global Health recently partnered to convene a webinar on “The unfinished agenda of maternal and child health in Africa and Asia: promising directions to address maternal mortality challenges.” The panel, moderated by Dr. Megan Huchko, included: Dr. Mariam Claeson, former Director of the Global Financing Facility for Every Women Every Child at the World Bank and now at the Karolinska Institute
Dr. Qjan Long, Assistant Professor at Duke Kunshan University, formerly worked at the Department of Reproductive Health and Research, WHO
Ms. Jacquelyn Caglia, Director of Learning, Communications for Merck for Mothers Experts discussed the historic and current challenges in addressing maternal and child mortality in the region, and brought up some promising innovations and strategies with the potential to effect these disparities in the future. The webinar can be seen here, with a fill description of the background and discussion on the CPIGH website....
It is hard to believe I have called Kisumu home for almost a year, with time cut short by the elections set for early August. Our team is busy, skillfully orchestrating multiple studies concurrently. The stigma education study, looking at the impact of a stigma-responsive educational video on cervical cancer screening behavior, is in full swing. The six health facility sites are offering research-supported HPV self-testing as part of their cervical cancer screening program, led by community healthcare volunteers (CHVs). Our three intervention sites are also showing the HPV stigma-responsive education video. The team then visits each site once a week to ask women to participate in a validated HPV/cervical cancer stigma measurement tool. Jeniffer, our study clinician, is leading the project with grace, balancing the day-to-day activities with each facility. Getting positive feedback from the CHVs and women of the community about a cervical cancer screening technique that avoids a speculum helps to keep us motivated. Some of the sites are...
As we start our eighth and final week in Kisumu, the SRT team is finishing up the last stages of our on-the-ground research, and preparing for our trip back to the US! At this point in time, we are almost finished with our clinic observations. Despite several scheduling changes, we will complete our project with five to six observation sessions at each of the six clinics. Additionally, we have set in motion the plans for the Kisumu team to conduct focus group discussions (FGDs) at the intervention clinics after we leave. The purpose of the FGDs is to understand women’s opinions about our educational intervention, and how they feel about incorporating peer navigation services into the clinics. Unfortunately, we will not be here to witness the FGDs as we originally anticipated, but we’ve been working on setting everything up so that they will run smoothly in our absence. That includes getting participant recruitment up and running, going over our questions and...
Pictured above: People marching in Boulder, Colorado for Reproductive Health Rights in May of 2022 with signs that say “Your right to abortion should not depend on your zip code.” Unfortunately, though, zip codes shaping access to abortions may very much be more of a reality with the overturning of Roe v. Wade. The New York Times reveals how the Supreme Court’s ruling on the Mississippi law could weaken or even overturn Roe v. Wade which could ultimately lead to legal abortion access dramatically decreasing, particularly in the American South and Midwest (Bui et al., 2021). This geographic discrepancy is even more reinforced through social class differences and communities that are “disproportionately Black, Latina, teenagers, uninsured, and undocumented immigrants” (Miller & Sanger-Katz, 2022). Ultimately, leading not only to be a social justice issue and human rights issue, but also a racial justice issue. Bui et al. quotes Caitlin Knowles Myers saying, “A post Roe-United States isn’t one in which abortion isn’t...
First and foremost, we have passed the halfway point of our time in Kenya! Time flies by, and we are discussing what we want to get out of the next four weeks. Insofar, we collected more than 20 observation data to evaluate the workflow of stigma education at the clinic. During this process, we faced multiple hiccups, especially scheduling a visit and clearing up logistics. Three of our observation clinics had a twelve-day-long CHV training, so we had to flip our schedule to ensure we could collect the data we initially planned. We spent the last couple of days creating a contingency plan so that our time in Kenya could contribute to the depth of our data. Listening to what other teammates thought helped us, as a team, solidify the future direction of our study, such as what variables to analyze in observation studies, codes for focus group discussion, and the focus of our manuscript. Besides working on an observational study,...
We have made it through week three of our time in Kisumu, Kenya! The weeks are truly flying by because our research is progressing, and we are enjoying our time in the city. The other SRT students and I officially started our workflow analysis observations at each of the six clinics this past week. There are three intervention clinics, at which community health volunteers (CHVs) display an educational video about human-papillomavirus (HPV) self-screening, and three control clinics, where CHVs provide health education talks about HPV and offer the self-screening. Through our observations so far, it is clear that all the CHVs are quick learning, adaptable, and passionate about increasing HPV screening for women in Kisumu! We have enjoyed our first week of observations because of all the positive aspects we have seen with our study. Fortunately, many women are opting into HPV self-screening, and we are able to increase prevention of cervical cancer in many of the Kisumu sub-counties! We...
Sunday marked the first full week that the rest of the students from the Kenyan Reproductive Health SRT team and I have been in Kisumu, Kenya. Our experience thus far has been full of introductions and familiarizations, and we have had an exciting time learning from the field while finding our footing in a new area. After we flew into Kisumu, we were able to get situated in our new living space and learn to make ourselves at home for the next two months, starting to cook for ourselves and establishing new rituals (like bonding through watching Suits together during dinner). We have learned to navigate some parts of the town with the help of our local partners, learning where to buy groceries and hot meals, and we have done a bit of exploring on the weekends and our walks to work. Although moving to an unfamiliar area has been challenging, we have been able to improvise and overcome to...
Jonas Swartz, MD, MPH is an OB/GYN and an Assistant Professor of Obstetrics and Gynecology. He completed his undergrad at Duke University and then his MPH and MD at the University of North Carolina at Chapel Hill. He completed his residency in Obstetrics and Gynecology at the Oregon Health and Science University, followed with a fellowship in Complex Family Planning back at UNC. I had a conversation with Dr. Swartz to understand more about how he became involved in health policy and reproductive health access. “Well, I grew up in North Carolina and did Medical School here, and one of the striking things when I was a medical student was the discrepancy in care during pregnancy for people who were citizens versus non-citizens. And, in particular, thinking about low-income people who use Medicaid.” Swartz described his early medical training and becoming acquainted with the Federal Emergency Medicaid program, which only pays for labor and delivery services for authorized immigrants. He noted that...
This summer, 4 students will join the Center as part of the Student Research Training Program (SRT). Hear their thoughts heading into the program.
Bentley Choi
When I first applied to the SRT program, I merely expected to ‘conduct’ research abroad. In reality, I learned more important skills such as writing IRB amendments, scheduling a meeting with teammates, and communicating with a research team in Kisumu. My goal for this summer is to apply what I learned from Dr. Eric Green’s Global Health Research Methods class into a real-life setting, and I believe we are making our way to this goal since the team proposed a new way to evaluate the intervention! I look forward to conducting observational study and focus group discussions. Also, I am hoping to learn how to navigate myself in a new living environment and what are Kenya’s unique cultural factors that influence stigma and perception towards reproductive health since it is also related to my senior thesis...
