Insights & Updates – Page 2 – Global Reproductive Health at Duke

Reflections from the Field: SRT Student, Afraaz’s Reflections in Kisumu

July 5, 2024October 14, 2024 by Afraaz MalickNo Comments

We are rapidly approaching the end of our time here in Kisumu, and I can hardly believe it. It feels like just yesterday that we were meeting the team and getting our bearings. Skylar, Kelsey, and Sahil did a great recap in their posts, and I hope I can share a few memorable moments. We were fortunate enough to have Dr. Megan Huchko and Christina Makarushka stop here in Kisumu before attending a conference in Eldoret. While they were here, we got the opportunity to see this incredible team in action—outside of the office. As you've heard before, the local team impressively manages multiple studies and coordinates with partners across the world. However, what is most impressive to me is how well they work with each other. Last Tuesday was a team-building session led by a facilitator, featuring games such as a sponge race, egg & spoon race, and a variation of ships & sailors. During these games, the competitive and...

Reflections from the Field: SRT student, Skylar’s Reflection in Kisumu

July 2, 2024October 14, 2024 by Skylar WebbNo Comments

We have officially passed our halfway mark here in Kisumu, and time has flown by! Picking right up where Sahil and Kelsey left off in their posts, our work on the Elimisha survey visits has continued to evolve. From our first visit to our current fifth visit at different facilities, we've observed significant changes. Starting with the clinics furthest from town, such as Kinasia and Nyakongo, we've gradually moved closer to Kisumu proper through Bunde and Ahero, and now to the Central and West Kisumu districts. As we've moved closer, we've noticed discernible differences in the facilities and the time it takes for women to complete the surveys. Women at the more distant facilities faced greater challenges with literacy and digital literacy. The conditions of the facilities themselves also differ significantly. This underscores the importance of adapting to the wide range of conditions and contexts that each site presents. It has been a powerful reminder of the necessity of adaptability in...

Reflections from the Field: SRT Student, Kelsey’s Reflection in Kisumu

June 24, 2024October 14, 2024 by Kelsey GoldweinNo Comments

This is my first time in Kenya, and it's wonderful. We've been making the most of our time here, spending our weekends on Safari, taking a boat trip on Lake Victoria, and eating some truly incredible pineapple from Jubilee Market. Outshining all of that though, is the team. We're so fortunate to be working with so many strong and joyous people who are doing such difficult and impactful work. In his post last week, Sahil gave a great overview of the ongoing projects and daily work the team is responsible for. I want to zoom out a bit and provide some context for this work. Cervical cancer claims hundreds of thousands of lives every year, and the vast majority of these deaths are in low- and middle-income countries. With HPV vaccinations and screenings, cervical cancer is entirely preventable. But here in Western Kenya, the health system has no capacity for these services. So not only is the team's work helping to...

Reflections from the Field: SRT Student, Sahil’s Reflection in Kisumu

June 20, 2024October 14, 2024 by Sahil ChoudhriNo Comments

Four weeks into our Duke Global Health SRT program in Kisumu, Kenya, Afraaz, Kelsey, Skylar, and I (Sahil) have been assisting in launching a pilot study for a mobile health app designed to facilitate HPV screening and cervical cancer prevention. While our initial focus was on integrating feedback from community health promoters (CHPs) who use the app, we quickly found ourselves contributing to two other critical projects: U54, focused on HPV vaccination and screening, and Elimisha, aimed at community education and stigma reduction around HPV and cervical cancer. Our first field visit took us to three primary schools, where we met with head teachers and the local chief to discuss an upcoming free vaccination and screening clinic. This involved securing permission for girls to attend the multi-day clinic, even if it meant missing some school. Since then, our primary contribution to U54 has been creating a one-pager to advertise the clinic, set to be distributed starting July 1st. The second field visit,...

Implementing Jali Watoto: Childcare in Lumumba Hospital

June 17, 2024October 14, 2024 by Sydney Chen and Melat Woldetensae1 Comment

What had changed: Compared to our trip in the summer of 2023, Melat and I felt much more comfortable navigating Kisumu, Kenya. Sure, we were working in a different location, with new people, on a completely separate project, but the distinct uncertainty at every turn was nowhere to be found. It was a welcome shift. What had not changed: The core reason for our visit. Mothers attending Lumumba Hospital still struggled with finding childcare while they attended healthcare appointments. This meant mothers arrived late, left early, or missed their appointments entirely. Alternatively, they brought their children to appointments which affected the quality of services when the children cried, held on to their mothers, ran around, or generally distracted both the mother and the healthcare provider. It was our hope that the childcare center we worked on over the year would ease the choice mothers often have to make between caring for themselves or their children. We were also grateful to find another...

Establishing a Child Care Center in a Kenyan Hospital and the Summer Ahead

February 29, 2024October 14, 2024 by Sydney ChenNo Comments

Babies were crying. Mothers were patting them on the back. Names were being called for appointments. “With all this information, what will you do about it?” Florence Mawere, a research technician with the Center for Global Reproductive Health, was taking us on a tour of the Lumumba Sub-County hospital in Kisumu, Kenya and specifically demonstrating her work testing samples for HPV in the lab. She asked us that question at the end of the day, referring to a different project we were working on. At that moment, though, we had a different idea. Isabel, Melat, and I (Sydney) spent two months in Kisumu working on launching the pilot study of a mobile health app that facilitates HPV screening for cervical cancer prevention. Part of our work was to understand how Florence processes samples at her lab, hence our presence at Lumumba. In our conversations with her, she explained the barriers to reproductive health and mentioned how the lack of childcare sometimes...

Effects of vaccine hesitancy have now reached pregnant individuals as the winter season approaches

November 21, 2023October 14, 2024 by Kayla CaoNo Comments

Vaccine hesitancy has long remained a pervasive and global issue. The unwillingness to receive vaccines despite their availability and accessibility, remains a major global health issue. This phenomenon was especially felt during the COVID-19 pandemic four years ago. Misinformation and limited trust in institutions are main factors that increased vaccine hesitancy during this time. Unfortunately, we are still seeing patterns of vaccine hesitancy today, particularly in pregnant individuals. As winter approaches, 2023 will be the first year that four vaccines are recommended during pregnancy. However, trends already show that fewer pregnant individuals are getting vaccinated. A maternal-fetal medicine specialist at UCLA Health Dr. Neil Silverman, expresses that he has never seen this kind of pushback before the pandemic. Now, he says that all vaccines are lumped together as “bad”. Before COVID-19, the CDC reported that about 17.2% of pregnant people were “very hesistant” about getting a flu shot. Now, that hesitancy has been raised to almost 25%. Luckily, people tend...

Tori Bowie: Don’t ever stop saying her name.

November 1, 2023October 14, 2024 by Amber SmithNo Comments

*trigger warning: mention of death Say her name. Frentorish “Tori” Bowie. Dr. Shalon Irving. Tatia Oden French. Kira Dixon Johnson. Yolanda “Shiphrah” Kadima. Amber Rose Isaac. The list could continue extensively. I lead with these women’s names because sometimes they get lost in the horrific statistics that that show a Black women is almost 3 times more likely to die from pregnancy or childbirth related causes than a non-Hispanic white women (Craft-Blacksheare & Kahn, 2023). The maternal mortality rate for Black women in 2021 was 69.9 deaths per 100,000 live births (Hoyert, 2023) with 393 deaths in 2019 alone (Fleszar et al., 2023), and most of these maternal deaths were deemed preventable (Fleszar et al., 2023). Further, Black newborns are over two times greater to die in their first year than white newborns. The role of racism in these preventable deaths is highlighted in the fact that the mortality rate of infants of college-educated African American mothers experience an infant mortality rate that is greater than those of white...

Reflection From the Field: Dr. Thao Nguyen’s Reflections in Kisumu

August 8, 2023October 14, 2024 by Nguyên Thảo Thị NguyễnNo Comments

In 2021 I had the opportunity to join a start-up that provided support for schools and businesses to safely reopen in the COVID-19 pandemic. We developed an app to support symptom monitoring, created a vaccine navigator program, and collaborated with local organizations to host vaccine clinics in historically marginalized communities. That was the first time I began to dream about what it could mean to center technology within local communities to bridge disparities in healthcare. When Dr. Huchko offered me the opportunity to join her team to develop a new iteration of a mobile app, I couldn’t have been more excited. Our app, mSaada, is an integrated digital platform that provides support for community health volunteer-led cervical cancer prevention services. It seeks to improve completion of the key steps in the cervical cancer screening cascade by providing patient education and screening reminders, specimen tracking, result management, follow-up support, and treatment scheduling as needed. I started developing the barebones of the app in...

Reflection From the Field: SRT Student, Melat’s Reflection in Kisumu

July 19, 2023October 14, 2024 by Melat WoldetensaeNo Comments

We’re on the last week of our trip, and these eight weeks have flown by fast! Our summer trip is winding down, and we’re wrapping up our plans as we prepare to leave in one week, but it feels like we should stay a few more. The app mSaada is really coming together (go Thao!), and we’ve learned SO much on the daily challenges of global health projects. Currently we’re wrapping the Standard Operating Procedure, FAQs, and training manuals for Community Health Volunteers (CHVs), research assistants, and other members of the team. There are still many logistical challenges to work though like how to mobilize over 400 CHVs to the different communities that they serve, and how to register each CHV and their clients. We’re here only over the summer, but the team here in Kisumu does so much work for mSaada, and I’ll miss them when we leave. The best part about being in the office is being able...

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