Insights & Updates – Page 19 – Global Reproductive Health at Duke

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

July 2, 2019December 9, 2024 by Stacey DixsonNo Comments

"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,...

Important New Study Regarding Injectable Contraceptives

June 23, 2019December 9, 2024 by Emily WoodrowNo Comments

There is an unmet need affecting 47% of women in Africa who want modern contraception in order to prevent pregnancy. During the last few years, there has been an increase in the use of injectable contraceptives, such as Depo-Provera, across the continent specifically in Mali, Sierra Leone, Chad, Ethiopia, Kenya, and Uganda. Many African women rely on these types of shots because they are more easily concealable compared to other forms of contraception such as a daily birth control pill. Also, in some health clinics, these shots are the only method of contraception offered. Many women need secret protection due to men refusing condoms and the women wanting to avoid any social, physical, and mental consequences they may endure if they are found trying to keep away from pregnancy. A specialist in HIV at Britain’s Medical Research Council, Dr. Sheena McCormack, stated that African women’s, “husbands or partners, and their families, often want them to have children.” Along with the...

Stakeholders Meeting on Palliative Care and Treatment of Cervical Cancer

June 23, 2019April 4, 2025 by Jacob StocksNo Comments

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...

Mhealth App User Training

June 17, 2019April 4, 2025 by Jacob StocksNo Comments

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...

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

June 13, 2019December 9, 2024 by Stacey Dixson2 Comments

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! ...

Pelvic Health Physical Therapy

June 12, 2019December 9, 2024 by Kayla Chee1 Comment

Part 3: Mama, LLC In Part 2 of this Pelvic Health Physical Therapy, we were introduced to Dr. Laura Keyser, a physical therapist who specializes in maternal and child health. She also is the co-founder of Mama, LLC. Dr. Keyser was able to share some aspects of her work at Mama, LLC and to inform us of some projects the firm is working on. Mama, LLC is a physical therapy and public health consulting firm that specializes in domestic and international women’s and girl’s health. Mama, LLC partners with humanitarian organizations, professional organizations, educational institutions, and for-profit groups to meet maternal and women’s health needs around the world. The firm’s work includes but is not limited to education efforts, promotion and advocacy, research, and rehabilitation capacity building. When asked about her work at Mama, LLC, Dr. Keyser reports: “We see the health concerns of women and girls around the world as experiences on the same continuum. While women in low income, low resource settings...

New State Abortion Bans

June 10, 2019December 9, 2024 by Molly PaleyNo Comments

Photo Credits: John Benson After the recent passage of restrictive abortion legislation in Georgia and Alabama, abortion continues to be under attack across the country. The abortion bans signal continued attempts by states to undermine a woman’s right to access an abortion. Last week, Louisiana Democratic governor, John Bel Edwards, signed into law a restrictive “heartbeat” bill. The law, like other recent abortion legislation, would prohibit an abortion after an ultrasound detects electric pulsing of what will become a fetus’ heart—which can occur before most women know they are pregnant. Moreover, the Louisiana law does not include exceptions for rape or incest. Although the law will not go into effect immediately, it is likely to be stalled in the courts. In Missouri, only one abortion clinic remains open. If it closes, it would be the first time a state does not have an abortion clinic since 1974—when the Supreme Court ruled on Roe v. Wade. A judge is expected to a settle...

Missing and Murdered Indigenous Women in Canada and United States

June 10, 2019December 6, 2024 by Molly PaleyNo Comments

In 2014, Tina Fontaine, a member of the Sagkeeng First Nation in Canada was murdered. Her death garnered national attention as it highlighted the alarmingly high rate of violence against indigenous women in Canada. Such violence prompted the creation of the National Inquiry into Missing and Murdered Indigenous Women and Girls. After nearly three years of investigation, a report was published earlier this week that calls the treatment of indigenous women “a genocide.” The report included policy recommendations that seek to mitigate the violence and address its causes. As in Canada, native women in the United States disproportionately experience violence. A report conducted by the Department of Justice (DOJ) found that some counties in the U.S. have murder rates against indigenous women that are more than ten times the national average. Moreover, limited data and reporting on crimes against indigenous women and girls in the United States make it more difficult to understand the extent of the violence. According to a...

International Pelvic Health Physical Therapy

June 4, 2019December 6, 2024 by Kayla CheeNo Comments

Part 2: How Physical Therapists Are Helping Women’s Health on the Global Stage In January, I attended a presentation by Dr. Laura Keyser, a prominent figure in world of pelvic and global health. Keyser has been a physical therapist for 12 years and has developed public health expertise in maternal and child health. She also is the co-founder of Mama, LLC, which is a physical therapy and public health consulting firm that specializes in women’s and girl’s health. I had the wonderful opportunity to pick Dr. Keyser’s brain about global women’s health issues and how she sees physical therapy helping solve those problems. For the past ten years, Dr. Keyser has acted as a consultant to local and international organizations such as Global Strategies, EngenderHealth, the Harvard Humanitarian Initiative, Panzi Hospital and Foundations and HEAL Africa DRC. Through this role she has developed rehabilitation programs and community outreach initiatives in many parts of Africa and south Asia. When asked about her first...

Summer SRT team joins Kisumu office

June 4, 2019April 3, 2025 by Megan Huchko2 Comments

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...

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