Insights & Updates – Page 3 – Global Reproductive Health at Duke

Implementing Jali Watoto: Childcare in Lumumba Hospital

June 17, 2024December 10, 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, 2024December 10, 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, 2023December 10, 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, 2023December 10, 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, 2023April 4, 2025 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, 2023April 3, 2025 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...

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

July 4, 2023April 3, 2025 by Isabel SiebrechtNo Comments

Starting right where Sydney left off, I, too, just had my first experience going into the field. As Sydney mentioned, each of us will get a chance to tag along for a site visit to a sub-county, and after spending thirty days in Kenya, it was finally my turn! I accompanied Breandan, Jennifer, and Purity to the Nyando sub-county. After meeting with the MoH representative at Ahero Hospital, we conducted site visits for Ahero and four other hospitals in the county. As I quietly took notes, I couldn't help but notice the passion and dedication of every director, community volunteer, doctor, administrator, and healthcare provider. Unlike the privatized systems in the U.S., the healthcare system in Kisumu relies heavily on community involvement. As a global health research team, it is our responsibility to work closely with the community, and our meetings have created a collaborative space where all parties are enthusiastic about our proposed project. Our collaborative efforts aren't limited to...

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

June 21, 2023April 3, 2025 by Sydney ChenNo Comments

Flew internationally totally alone; bargained for prices; saw a male lion (pictured); saw a dead, half-eaten buffalo that two lionesses just killed (not pictured); ate smokies (a hot dog with tomatoes, onion, and a spicy sauce inside). These are some highlights from my “first time ever” list since leaving the U.S.. Novelty and unfamiliarity were our neighbors for the first two weeks living in Kisumu, Kenya. At the end of the third week, we were off to another “first time ever”: a visit to the Lumumba Hospital. We – okay, hold on. “We” refers to my fellow researchers (and now my friends) Isabel and Melat. They are both proud Seattlites (first time ever learning that’s how you refer to people from Seattle) which has led to times where I learn more about Seattle than I do Kenya. We’ve really gelled as a unit no matter how fast I walk, how many limes Melat eats, or how many random romcoms Isabel suggests. Anyways,...

Meet Our Research Team in Kisumu, Kenya This Summer

June 14, 2023April 4, 2025 by Amber SmithNo Comments

This summer, we have 5 Duke Scholars working with the Duke Center for Global Reproductive Health in Kisumu, Kenya. We have 3 undergraduate students joining the Center as part of the Student Research Training Program (SRT), a Masters of Global Health Student, and a 3rd year OB/GYN resident all conducting research in Kenya. Read below to learn a bit about these passionate students and hear about their work and what they are most looking forward to. SRT Students: Sydney Chen (she/her) Sydney is a double major in Global Health and International Comparative Studies with a Biology Minor. She calls Herndon, Virginia home. When asked about what her time spent in Kisumu looks like, she reflected that “The team and I are working on various ways to improve an app called mSaada which helps women in East Africa receive screening for cervical cancer. I’m specifically working on the FAQ portion of the app by making sure that the answers are clinically accurate and using...

How OPT Sexual and Reproductive Health is Shaped by Israeli Forces

January 10, 2023December 10, 2024 by Zara ThaljiNo Comments

In “SRH in Palestine: A Medical Student’s Experience in Health Education,” Duha Shelah, a medical student at An-Najah National University, explains the strengths and weakness in sexual reproductive health care in Palestine. Shelah has worked as a volunteer health educator for the Palestinian medical Relief Society since 2020, working with communities in the Occupied Palestinian Territories. Surprisingly, the majority of Palestinian women receive adequate antenatal care and had a skilled health staff at livebirths. However, a lot of the research on Palestinian reproductive and sexual health is incomplete, especially on menopause, preconception, and psychosocial services. Shelah found that the Israeli involvement in Occupied Palestinian Territories, and the imposition of closures and military checkpoints, restricts access to medical facilities. Therefore, sexual and reproductive health is heavily impacted by times of heightened violence, such as the 2014 bombing of the Gaza strip. Moreover, between 1999 and 2002, home births grew by over 20% due to increased Israeli military presence. Shelah argues that...

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