Insights & Updates – Page 26 – Global Reproductive Health at Duke

Notes from the Field: Dissemination Meeting for a Community Health Volunteer Study

October 29, 2018October 14, 2024 by Faith OtewaNo Comments

The Center for Global Reproductive Health's Research Coordinator, Yujung Choi, and I held a dissemination meeting on October 19th to share the findings from one of our studies. The study describes the characteristics, motivations, and experiences of community health volunteers (CHVs) in Kisumu county, and looks to understand CHV knowledge and self-efficacy of reproductive health counseling and services. The purpose of the meeting was to share the study outcomes with key stakeholders and elicit feedback in order to inform future interventions to measure CHV performance and increase CHV retention rates. Among those who attended the meeting were CHV supervisors who had participated in the study, Sub-County Community Health Strategy Focal Persons, a former study staff, and a Program Officer from the NGO Community Initiatives Concerns. We summarized the study findings on various topics, including: -CHVs’ reasons for becoming CHVs -CHV level of comfort in teaching health topics such as family planning -child care and nutrition -HIV, malaria, and cervical cancer -challenges in carrying out daily tasks -relationship...

C-Sections: A Global Dichotomy of Overuse and Inaccessibility

October 27, 2018October 14, 2024 by Carly JonesNo Comments

A new health care study by Lancet has illuminated a frightening trend in the global prevalence of caesarean sections. In wealthy countries, C-sections are often performed in the absence of underlying medical causes, while in developing countries, C-sections are inaccessible even when medically necessary. As of 2015, the C-sections were used for approximately 30% of births in North America, 44% in Latin America and the Caribbean, and only 5% in East Africa, standing in stark opposition to the World Health Organization’s recommendation rate of 10-15%. C-sections invite major risk, including maternal and postpartum infections, in addition to newborn death or extended hospitalization. However, many women report that they are not informed by doctors of the implications and possible risk involved with this procedure and report being immensely pressured to receive C-sections. In short, the decision is driven not by mothers, but by doctors who allow financial motivations, fear of litigation, and even racial bias to inform their decisions. One potential...

TEEN PREGNANCY IN KENYA

October 25, 2018October 14, 2024 by Faith OtewaNo Comments

A United Nations Population Fund (UNFPA) report in Kenya shows 378,397 adolescent and teenage pregnancies for girls ages 10-19 between July 2016 and June this year. More specifically, there were 28,932 girls ages 10-14 and 349,465 girls ages 15-19 who became pregnant. The counties with the highest number of teenage pregnancies begin with Narok, where 40 per cent of its teenagers became pregnant. The list goes on to include the counties Homa Bay at 33 per cent, West Pokot at 29 per cent, Tana River at 28 per cent, Nyamira at 28 per cent, Samburu at 26 per cent, and Migori and Kwale both at 24 per cent. Teenage pregnancies have been linked to poverty. Many people believe girls in poverty engage in “transitional” sex to meet basic needs. Others blame “absentee parents” or a lack of parental guidance and exposure to information on the Internet - both which can lead to curiosity and therefore teenage pregnancy. Yet, others even say these...

Immigrant Women Facing Maternal Health Struggles

October 25, 2018October 14, 2024 by Emily WoodrowNo Comments

In a recent CNN piece, obstetrician Dr. Cristina Gamboa reveals her insights on trends in regards to her pregnant immigrant patients at the community health center Salud Para La Gente in Watsonville, California. She has noted that patients who are Mexican Immigrants seem to be suffering from increases in stress during their pregnancy. These increases have led to high blood pressure which can be further characterized as the condition preeclampsia. Stress can be a result of a multitude of factors, but Dr. Gamboa analyzes that America’s current political climate could be a root cause. It is considered a crime for someone to enter and stay in the United States without permission. Approximately 25% of unauthorized immigrants reside in California and 26.9% of the population in Watsonville are non-US citizens. Although there are no scientific studies connecting a woman’s immigration status and maternal health, Dr. Gamboa believes research is needed. There is, however, evidence pointing to a lack of general health...

MY NEWFOUND AWARENESS ON SEXUAL HEALTH RIGHTS FOR PERSONS WITH DISABILITIES

October 25, 2018October 14, 2024 by Kayla CheeNo Comments

As a student physical therapist, my future career is primarily to serve individuals with short-term or long-term physical disability. Working with individuals of various forms of physical disability such as those with cerebral palsy, to stroke survivors, to amputees, I have become more aware and appreciative of buildings and spaces that are physically accessible with ramps, elevators, and ADA bathrooms. However, despite my acute awareness of physical accessibility for individuals with disability, accessibility to sexual and reproductive health for this population was not something that crossed my mind until I stumbled on the anecdote by Stella Chiwaka. Chiwaka, born with albinism, was denied contraceptives at a local health center in Malawi and was told by a health provider that “People like you should not have sex”. As a future health provider, I found this discriminatory act appalling. People with disabilities, just as those without disabilities, have the right to make their own choices--including choices regarding their sexuality and sexual health. To...

A Seminar Focused on The Finance Behind Global Health Initiatives

October 23, 2018October 14, 2024 by Emily WoodrowNo Comments

The Seminar Series: Stories From Africa, Financing Health in Sub-Saharan Africa took place at Duke University on Thursday, October 18. Led by Gavin Yamey, the seminar featured a panel of speakers: Sarah Bermeo, Associate Professor of Political Science, Duke Sanford School of Public Policy; Charles Muiruri Program Director at Duke Global Health Institute and Co-founder Association of Research Administrators in Africa; Kaci Kennedy, Associate Research, Duke Center for Policy Impact in Global Health; Godfrey Kisigo, Masters Student DGHO, Physician at Kilimanjaro Clinical Research Institute, Tanzania; and Osondu Ogbuoji, Deputy Director, Duke Center for Policy Impact in Global Health. The seminar opened with an introduction to global health from a very optimistic perspective. Global health is a cutting edge field that focuses largely on improving the future for humanity. Initiatives in global health are making large and wide impacts, for example, in fields such as child wellness. However, there are also still huge numbers of people suffering from illnesses and burdens that...

Embracing My Role as a Researcher – Sharing My Small Slice of the HPV Research Pie

October 21, 2018October 14, 2024 by Megan HuchkoNo Comments

Guest Blog: Carissa Novak Throughout my recently completed Masters in Global Health Science, Duke’s Global Health Institute faculty regularly stressed the importance and potential impact of disseminating research findings. Therefore, I felt presenting the research findings from my thesis at the 32nd International Papillomavirus Conference inSydney, Australia, this fall was not only appropriate but necessary. Due to ongoing conversations regarding HPV vaccination coverage and HPV screening for cervical cancer communities are witnessing a tremendous increase in screening rates, especially in low-resource settings, where cervical cancer is most common. However, most programs still face significant challenges in addressing HPV positive women’s low rates of follow-up and treatment. My attendance at the conference was an opportunity to share the findings of my thesis work, in which we found that in western Kenya, a setting where resources were limited for all HPV positive women, stigma and isolation were the main differentiating features between women who accessed follow-up and those who did not. Interestingly, I presented...

When Social Constructs Incorrectly Assume Scientific Validity: The Myth of Virginity and Incidence of “Virginity Testing”

October 19, 2018October 14, 2024 by Carly JonesNo Comments

This past Wednesday, the United Nations called for the end of a practice known as “virginity testing,” declaring such tests a violation of human rights. While these tests possess zero scientific merit or clinical foundation, they are still performed in nearly 20 countries, including but not limited to India, Brazil, Afghanistan, South Africa, Iran, Iraq, Sri Lanka, Turkey, Northern Ireland, and Jordan. Virginity testing entails a physical examination of the hymen, usually by an insertion of fingers, to determine whether a woman has had sex. However, such measures are incapable of determining whether a woman has had intercourse or not, and reinforce the anatomically incorrect term “intact hymen.” Furthermore, as delineated in the UN’s statement, this test, "further reinforces socio-cultural norms that perpetuate women’s inequality, including stereotyped views of female morality and sexuality, and serves to exercise control over women and girls." In short, "virginity testing" robs women of the right to protection from discrimination, and of the right to...

Family Planning Use in East Africa

October 17, 2018October 14, 2024 by Faith OtewaNo Comments

Family planning (FP) is critical in the promotion of community health. It is an intervention that is proven to save lives and foster development. Research supports the notion that family planning is directly linked to improvement in maternal and child health in addition to socio-economic progress. Understanding the unmet need for family planning services is key to improving worldwide reproductive health. During the last three decades in East Africa, research shows that Kenya and Rwanda are clear leaders in regards to access to and use of contraception. These two countries have a history of implementing targeted and focused programs to improve access to FP services. FP differs in each country in ways such as the amount of methods offered and the extent to which each method is available. Across the sub-region there is an increase in the use of modern contraceptives. But, a steady proportion of women in Ethiopia, Rwanda, and Tanzania are still using traditional methods. While short-term contraception is frequent in the sub-region, there is...

Sharp Rise in C-Section Births Around the Globe

October 16, 2018October 14, 2024 by Emily WoodrowNo Comments

A study recently published in The Lancet journal reveals that from 2000 to 2015 there has been approximately a double in the number of cesarean section (C-section) births in the world. C-section births occur when a surgery is performed to open a woman’s lower abdomen and remove the baby. These procedures can either be planned in advance or they can happen suddenly if problems occur during birthing. There are risks to C-section births for the woman, such as infection and postpartum heavy bleeding, and the baby, such as trouble breathing and injury. Additionally, C-sections create a more complicated labor recovery for the mother and pose a threat to future labor complications. The figures from the study state that in 2000 C-sections accounted for 12.1% of all births and in 2015 they accounted for 21.1% of all births. There is evidence published by the World Health Organization stating that there is "no justification for any region to have a caesarean section...

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