Insights & Updates – Page 27 – Global Reproductive Health at Duke

State Department looks to Ban Term ‘Sexual Health’

November 9, 2018December 4, 2024 by Jessica WilliamsNo Comments

As leaked by Foreign Policy last week, recent State Department memos suggest that American diplomats may soon be unable to use words essential to discussions of reproductive rights. If Secretary of State Mike Pompeo approves the memos' proposal, officials will be banned from saying "sexual and reproductive health" and "comprehensive sexuality education," and would instead use the term "reproduction and the related health services." This follows the State Department's pattern of treatment of gender-related language. Its annual human rights report this year trimmed language focused on family planning, and officials have worked to remove the term "gender" from multiple UN human rights documents. While the policy implications of this change remain unclear, the alteration in language could complicate United Nations discussions regarding reproductive health issues and funding for NGOs that maintain their vocabulary use. The removal of "gender" from State Department usage further excludes transgender individuals from political discussions; the Department of Health and Human Services also recently moved to establish...

Ensuring Health Care for All in Kenya

November 6, 2018December 4, 2024 by Faith OtewaNo Comments

According to the World Health Organization (WHO), Universal Health Care (UHC) is aimed at ensuring that all people are able to receive medicine and treatment without suffering financial hardships. Kenya is working to implement this healthcare strategy, with the goal of allowing more Kenyans access to healthcare in public health facilities. Additionally, Kenyans will be able to access the same services in private hospitals without digging very deep into their pockets. Despite this bold move by the Kenyan President to create affordable healthcare for all, human resources, finance, essential medical products, technologies and service delivery remain challenges. The story of a woman under the alias of “Dorothy” exemplifies the financial challenge in assessing care at treatment sites. Dorothy was enrolled in a study looking at integrating HPV testing into community health campaigns, and was ultimately referred to a selected health facility in Kisumu where she was booked for treatment. After she received treatment, she further was referred for biopsy testing. But,...

Oregon, a champion of women’s health, is one of states with abortion challenge on ballot

November 5, 2018December 4, 2024 by Megan HuchkoNo Comments

Guest Blog by Suzanna Larkin, T '21 Oregon, my home state, is a unique champion in women’s right to abortion. While more than 400 abortion restrictions have passed in 33 states in the past 7 years, Oregon remains a key state in support for reproductive health rights. It was the first state to allow pharmacists to prescribe birth control directly to women in 2015. More recently, Governor Kate Brown signed the Reproductive Health Equity Act in August 2017, which expands coverage of abortion and other reproductive health services to thousands of Oregonians by allocating nearly $500,000 of Oregon’s general fund to expand cost-free reproductive and abortion services for those who are ineligible for Medicaid. It also requires all private insurance companies to cover abortions for free. There is one caveat to this legislation: Providence Health Plan, a large health insurance provider in Oregon, is insurer exempt from providing abortion services—the only insurance provider in the state with an exemption. This is because...

Ovarian Cancer Needs more Attention and Awareness

November 4, 2018December 4, 2024 by Emily WoodrowNo Comments

Ovarian cancer is the 7th most common cancer in the world. Nearly 300,000 women are predicted to develop ovarian cancer this year and less than half of these women diagnosed are expected to survive after 5 years. However, there is very little awareness of ovarian cancer and its effects. A survey conducted by the World Ovarian Cancer Coalition gathered information from 1,531 women across 44 countries. The women who participated were from high, middle, and low income countries and were asked to answer online questions about their experiences with ovarian cancer. The study points to the fact that over two thirds of women who participated had never even heard of ovarian cancer or knew nothing about it before they were diagnosed. Additionally, less than half of these women attempted to find care or answers for their symptoms within the first month they appeared, and one in every ten women did not seek medical help for 6 months. This data is important...

One Man, His Wife’s Legacy, and the “Monarch of Dreams”: Cervical Cancer Prevention in Zambia

November 3, 2018December 4, 2024 by Carly Jones1 Comment

The women of Zambia have the world’s fourth highest rate of cervical cancer; yet, Zambia’s government provides free cervical cancer screening services. This begs the question: why does such a high incidence of cervical cancer persist? The answer is due, in part, to a lack of awareness amongst the female population regarding this disease, particularly in rural areas. Robert Zulu, in upholding the legacy of his late wife whom he lost to cervical cancer, aims to inform and empower Zambia’s women by encouraging regular cervical cancer screenings. These preventative measures are especially important for HIV, which disproportionately affects Zambia’s women, as this disease increases the likelihood of cervical cancer diagnosis by three times. Zulu’s non-profit, Rakellz Dream Initiative, takes an incredibly unique approach to this end of raising awareness, producing plays and movies about cervical cancer. Zulu’s latest film, “Monarch of Dreams,” which is based on his wife’s battle with cancer, premiered on October 31st in Lusaka, Zambia’s capital. The...

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

October 29, 2018April 4, 2025 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, 2018November 15, 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, 2018November 15, 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, 2018November 15, 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, 2018November 15, 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...

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