Insights & Updates – Page 29 – Global Reproductive Health at Duke

One Woman, Her Dream, and Kenya’s Menstrual Revolution

September 11, 2018October 14, 2024 by Carly JonesNo Comments

Article by Carly Jones Access to feminine hygiene products is the cornerstone of a woman’s ability to claim agency over her body. Yet, with the feminine hygiene product market generating billions of dollars in revenue, these products are often made inaccessible by their price. This disparity in access is especially profound within low- and middle-income countries, such as Kenya, begging the need for Megan White Mukuria’s non-profit foundation, ZanaAfrica. In Kenya, 60% of girls are unable to access menstrual products. As a result, they are forced to endanger both their physical health and security, resorting to fashioning homemade products from rags, or even exchanging sex for sanitary napkins. Additionally, because of the shame associated with menstruation within Kenya’s culture, girls often remain confined to their homes throughout their cycles, with 60% of this demographic eventually dropping out of high school. ZanaAfrica not only addresses this physical need, supplying menstrual products to marginalized girls, but also provides community resources necessary to educate...

Kavanaugh on Abortion: Many Questions, Few Answers

September 11, 2018October 14, 2024 by Jessica WilliamsNo Comments

Article by Jessica Williams As Judge Brett Kavanaugh’s hearing in the Senate Judiciary Committee to become a Supreme Court justice began last Tuesday, it became immediately clear that his stance on abortion would take center stage. The Hart Senate Office building was filled with protesters dressed as ‘handmaids’ from Margaret Atwood’s dystopian “The Handmaid’s Tale,” reflecting fears that Kavanaugh’s appointment would lead to a country in which women do not have control over their reproductive decisions. As the hearing has progressed, though, little information about Kavanaugh’s stance on abortion has come to light. When asked about a woman’s right to abortion, Kavanaugh described the current precedent—Roe v. Wade’s 1973 establishment of abortion as a constitutional right, and Planned Parenthood v. Casey’s 1992 reaffirmation of that decision. While he did say that “precedent also reinforces the impartiality and independence of the judiciary,” new leaked documents suggest he may be willing to overrule the Roe precedent. In a 2003 email he stated “I am...

The Rohingya Displacement Crisis and Its Effect on Reproductive Health

September 5, 2018October 14, 2024 by Kayla CheeNo Comments

Article by Kayla Chee It has been just over a year since the beginning of the Rohingya displacement crisis. Since August 2017, Rohingya Muslims living in the Rakhine State of Myanmar have endured the brutal and inhumane ethnic cleansing of their people at the hands of Myanmar security forces. Mass killings, sexual violence, arson, and other humanitarian crimes inflicted by the Rakhine State military have motivated many Rohingya Muslims to escape and seek refuge in neighboring countries. The United Nations estimates close to 900,000 Rohingya Muslims have fled out of Myanmar to nearby Bangladesh. Bangladesh, a lower-middle income country with existing problems of poor economic development, high population density, and limited access to healthcare, has little to offer the Rohingya Muslims living in these displacement camps of Cox’s Bazaar. The camps’ immense overcrowding and unstable hillside terrain prone to landslides and floods make living conditions dangerous with little access to basic needs. The culminating problems of food insecurity, unsafe shelter, poor water...

US Faces Sharp Increase in STD Rates

September 5, 2018October 14, 2024 by Emily WoodrowNo Comments

Article by Emily Woodrow Syphilis, gonorrhea, and chlamydia are the most common sexually transmitted diseases in the United States. All three are caused by bacteria and can be treated and cured with the proper screening, diagnosis and medication. The U.S. Center for Disease Control and Prevention has recently released statistics noting a record high of 2.3 million cases of these STDs in 2017, which is an increase of 200,000 cases from 2016. Gail Bolan, the director of STD Prevention at the CDC, noted that after years of success in STD control, the US has seen sharp increased over the past four years. David Harvey, Executive of the National Coalition of STD Directors, said, "The U.S. continues to have the highest STD rates in the industrialized world.” This is largely due to the fact that so many people do not know they are infected with STDs; symptoms may not arise for weeks after one is infected. Therefore people may be unaware that are...

All in a Day’s Work: Engaging the Community through HPV testing in Kisumu

August 30, 2018October 14, 2024 by Yujung ChoiNo Comments

Blog by Faith Otewa In my role as site coordinator of the Kisumu Center office, I’ve had the opportunity to oversee the “Hybrid Study,” in which we are looking at integrating HPV testing into community health campaigns providing multiple other disease services, including HIV testing, family planning and TB testing. Many of the experiences will linger on with us for many years to come; while some illustrate the challenges encountered in conducting research and community-based care in Africa, others show the power of community mobilization and knowledge. It is the 10th week out in the field and the study team are getting ready to recruit at the 3rd set of campaigns. However, as if often the case in western Kenya, and certainly when we are working in tents set out in the middle of fields, the climate has had a big impact on study. The harsh weather and copious rainstorms experienced in the month of May this vastly affected recruitment. There has...

Links Between Maternal Depression in a Mother and her Child’s Psychological and Immune Health

August 29, 2018October 14, 2024 by Emily WoodrowNo Comments

Maternal depression is a global public health concern that occurs before and after pregnancy and largely affects the mental health and daily life of a woman. The CDC states that 1 in every 9 women can experience postpartum depression which occurs after having a baby. Often, this type of depression women face goes undiagnosed and they do not receive treatment. Recent studies have concluded that a mother’s depression can have long term impacts on her child. Investigators found that mothers with depression have higher amounts of cortisol, a stress hormone, and SIgA, an antibody that indicates an activation of the immune system. Additionally, in studies of these same mother’s behaviors, their actions are found to be more insensitive and intrusive in regards to the treatment of their child causing the child’s stress level to be greatly impacted. Results also pointed to higher levels of SIgA in children of mothers facing maternal depression meaning their immune systems are more frequently disrupted....

Innovative Ways for Women in Refugee Camps to Find Maternal Health Care

August 24, 2018October 14, 2024 by Emily WoodrowNo Comments

For women living in refugee camps, there is a lack of maternal health facilities on site and finding aid and safe transportation to offsite facilities can be very difficult. Often, refugee camps can be located in rural areas and or conflict zones causing a lack of specialized doctors close to the camp and security issues with traveling outside the camp such as attacks on ambulances. It is vital for a pregnant woman to be able to receive obstetric care in any emergency situation. In order to help refugee women find timely and quality care, mobile clinics and “mama taxis” have been installed in many camps to aid prenatal and postpartum healthcare. The UNFPA (United Nations Population Fund) has led the development of mobile clinics which are “clinics on wheels” equipped with necessary medicines, tools, machines, doctors, nurses, etc. and can meet a woman in need so she does not have to travel around or leave a camp. With similar intentions,...

US Preventive Services Task Force recommends primary cervical HPV testing as an effective cervical cancer screening method

August 22, 2018October 14, 2024 by Emily WoodrowNo Comments

Cervical cancer is the fourth most common cancer in women worldwide. In the US, deaths from cervical cancer have decreased by more than 50 percent over the past 60 years, since the introduction of regular screening tests that detect high-grade precancerous cervical lesions and cervical cancer. However, over 13,000 women are diagnosed with cervical cancer annually and about 4,200 women die from it, even with screening and treatment. Recommendations continue to evolve, reflecting the latest screening technology and evidence. The new USPSTF recommendations for screening have been recently published in the latest issue of JAMA. Women over 30 now have three options for screening, including HPV testing alone; the other two options are pap smear and a combination of pap smear and HPV testing. HPV testing has been shown to be more effective than a pap test as it is able to detect precancerous cells earlier and more accurately than cytology. These screening guidelines update the previous guidelines; now, for...

Health Systems Barriers to Cervical Cancer Prevention in Kenya

August 20, 2018October 14, 2024 by Megan HuchkoNo Comments

Blog by Charlotte Page, Ob/Gyn Resident: This is a follow-up post to “Patient Barriers to Cervical Cancer Prevention in Kenya”. I’ve realized while in Kenya that there are a lot of things I take for granted in bathrooms in the US: running water, a toilet that flushes, toilet paper, soap, and electricity. If you’re missing one of these things, the restroom is that much more uncomfortable – or perhaps even unfunctional. Similarly, small systems issues here in Kenya can inhibit women from receiving the healthcare they need. For the HPV-positive women in the study I’m working on, such problems can significantly increase the amount of time and effort required to get treated with cryotherapy, to the point that some women don’t obtain treatment at all. To paint a picture: yesterday I was at Migori County Referral Hospital (MCRH), one of the sites where cryotherapy is provided in our study. This procedure uses compressed gas to freeze precancerous cells on the cervix, thereby preventing them...

CDC Report Finds Increased Risk of Birth Defects and Developmental Problems in Infants Born to Zika-Exposed Mothers

August 17, 2018October 14, 2024 by Megan HuchkoNo Comments

The world’s public health experts have been actively addressing the Zika crisis since it was discovered two years ago. Travel warnings, diagnostics testing, pregnancy guidelines and vector control have prevented substantial numbers of infants born with the devastating impacts of microcephaly. The CDC followed up 1450 US children born to mothers who had suspected or confirmed Zika, and released the findings from their one year follow-up. In addition to microcephaly, the infants had an increased rate of birth defects and neurodevelopmental delays. The study also found that the majority of children had not undergone neuroimaging or an eye examination, leading to missed opportunities to detect and possibly address problems at an early age. The authors recommended increased screening among pediatric providers and referral to specialists for children of zika-exposed mothers. The CDC will continue to follow these infants, and is currently following up a Brazilian cohort through the ZODIAC study. As we await the results of these longer-term studies, these...

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