Insights & Updates – Page 30 – Global Reproductive Health at Duke

Gaining Insight into Kenyan Community Health

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

Blog by Amber Fleck, MS2, University of Colorado: In the United States, health education is seemingly everywhere: ads online reminding women of the importance of pap smears, TV commercials advising against smoking, or posters in bar bathrooms providing safe sex advice. With this abundance of exposure to health education, it is a striking difference to visit a country where many communities don’t have regular access to this kind of information, especially if that information regards sexual or reproductive health. In an effort to bridge this gap and enhance community health education the Kenya Ministry of Health began using lay workers, also known as community health volunteers (CHVs). CHVs travel door-to-door in their assigned communities to educate individuals about disease management, including reproductive and maternal health, and provide referrals to the clinic when necessary. In theory, this is an excellent way to increase access to health information and care; however, these programs have had some significant challenges. One challenge is that these are...

Data+ Team Introduces Novel Visualization Methods to Understand Contraceptive Trends

August 16, 2018October 14, 2024 by Megan HuchkoNo Comments

Saumya Sao (T ’20, Gender, Feminist and Sexuality; Global Health) and Melanie Lai Wei (Masters’ Candidate, Statistical Science) were proud to share the results of their 10-week Data+ project, Big Data for Reproductive Health, or BD4RH. The pair was just one of 25 teams that spent the summer using data-driven approaches to solve interdisciplinary challenges. The BD4RH team, led by Amy Finnegan and Megan Huchko, sought to build a web-based application that will allow users to visualize and analyze contraceptive calendar data from the DHS. To ground their project, they did a mapping exercise to identify currently available tools, identifying core elements they liked and key areas a new tool could improve. Using this data, and user feedback from various stakeholders in the field, they created a website that hosts four different data visualization methods to interpret trends in contraceptive use from the DHS contraceptive calendar. The site currently uses Kenya data to demonstrate efficacy, but datasets will be added...

Legislation Promoting HPV Vaccine Use Does NOT Increase Risky Sexual Behavior

August 15, 2018October 14, 2024 by Megan HuchkoNo Comments

The relatively low HPV vaccine uptake in the US has been attributed in part to fears that vaccinating against the sexually transmitted virus would encourage early or risky sexual behavior in adolescents. To look at the potential impact of pro-vaccine legislation on behaviors, researchers compared CDC surveillance data on teen sexual activity in states in the US with policies promoting or mandating HPV vaccination among adolescents to states without any specific vaccination policies in a study published in Pediatrics this month. They found no difference in reported sexual activity or risk behavior in states with vaccine legislation. These results support a prior study in which researchers looked at diagnosis of sexually transmitted infection as a marker for sexual activity or increased risk behavior, and found that there was no difference between vaccinated and unvaccinated adolescents over the five year study period. Despite this consistent, reassuring evidence that vaccinating for HPV will not increase sexual activity among adolescents, the US has...

India’s Maternity Benefit (Amendment) Act raises eyebrows, initiating conversations on improving current policy

August 9, 2018October 14, 2024 by Yujung ChoiNo Comments

Last year, India amended its Maternity Benefit Act. While it was praised in “making India proud around the world” and “bringing women in workforce closer to workplace equality” as the amendment increased the paid maternity leave from 12 weeks to 26 weeks, negative consequences also surfaced. With employers being held liable for the entire cost of funding the maternity leave to employees, over a quarter of the small and medium enterprises and startups in a survey indicated that they preferred to hire male employees, rendering the amendment more damaging than helpful for female employees. Several solutions were proposed to remedy this situation and make the Maternity Benfit Act more appealing to the employers: 1) provision of tax: employers provide job-protected leave while the wage replacement is funded through an employee payroll tax; and 2) gender-neutral paid leave: the 26-week leave is split equally between the dad and mom so that no employer bears the entire burden of having its employee...

Still A Long Way To Go: Fighting Gender Disparities in Medicine

August 6, 2018October 14, 2024 by Yujung ChoiNo Comments

A recent report revealed a prestigious Japanese medical school has systematically lowered entrance exam scores of female applicants, preventing women from entering the school for years. Many women quitting medicine after getting married or having children were cited as reasons for altering the exam scores and excluding women. Countries, in which women are steadily becoming a majority of entering medical students such as the US, UK, and Canada, are no exception to encountering these criticisms. Some argue that the changing gender composition of the medical workforce has negative economic and workforce implications because: more female doctors are working part time compared to their male colleagues; more women plan to retire before the age of 65 than men, shortening their working life; women have longer consultations with patients and see fewer patients than male doctors. However, as Yoshiko Maeda, head of the Japan Medical Women's Association, stated in the article, instead of worrying about women quitting jobs, "we need a working...

Multi-Lateral Call to Action to Attain Universal Health Coverage through Sexual and Reproductive Health and Rights that include HIV linkages

August 3, 2018October 14, 2024 by Megan HuchkoNo Comments

Despite the many interconnected risk factors and affected populations, the integration of HIV prevention and treatment services and sexual and reproductive health and rights has not been straightforward. Recently, there has been an increase in the calls for integration from some important global health group. A recent Comment in the Lancet responded to the Guttmacher-Lancet Commission on Sexual and Reproductive Health and Rights (SRHR) report, which highlighted the need for universal access to integrated SRHR packages, including HIV prevention and treatment. The authors set out three main strategies to improve this: 1) Empower women at the individual and community level, 2) Secure accountable leadership, governance and financing from government and international agencies and 3) Improve the coordination and cooperation across various sectors. This was followed by a more specific call to action launched at AIDS 2018. More than 35 international agencies signed on to these 10 key actions necessary to advance both SRHR and HIV treatment, prevention and care. The...

Using GIS Spatial Mapping to Enumerate the Risk of Loss-to-Follow-up for Cervical Cancer Treatment in Western Kenya

August 2, 2018October 14, 2024 by Yujung ChoiNo Comments

By Moreen Njoroge, T-19 Cervical cancer is the second most common cancer in women worldwide and the most common cancer among women in sub-Saharan Africa. The risk for cervical pre-cancer and cancer is increased by the biological effects of co-infection with HIV and HPV, both of which have a higher prevalence in sub-Saharan Africa and especially in Migori, Kenya where the seroprevalence of HIV/AIDS is not uncommon. The social and economic factors in Migori, Kenya make cervical cancer control more difficult to achieve with the established standard of care in developed countries. A major barrier to accessing screening and treatment services for cervical cancer in this region is poor health literacy associated with the lower educational-attainment rates in Kenya, especially for women. Structural barriers associated with increased cervical cancer mortality rates include lack of diagnostic tools for screening, understaffing in clinics and hospitals, a paucity of pathology laboratories and the long waiting times associated with screening-result transmission. The lack of treatment...

Pennsylvania forms maternal mortality committee as the state’s maternal death rate doubles

July 25, 2018October 14, 2024 by Anna KatzNo Comments

Despite being an extremely wealthy nation and leading global power, the United States boasts the highest rate of maternal mortality in the developed world. And while pregnant women face poor outcomes throughout the country, maternal health outcomes vary drastically by state. In Pennsylvania, home to nearly 13 million residents, the maternal death rate has more than doubled since 1994. This dramatic rise in maternal death reflects a troubling trend in the United States--the U.S. is the only developed country where the maternal mortality rate is rising. Half of these deaths are preventable, according to Dr. Amanda Flicker, a Pennsylvania obstetrician. PA Representative Ryan Mackenzie took lead in creating a maternal mortality review committee, which will identify causes of the rising maternal mortality rate and resources that could help reverse the trend, as well as make recommendations for state-wide interventions. Thirty other states have already established similar committees....

South Korean activists call to abolish abortion ban

July 24, 2018October 14, 2024 by Anna KatzNo Comments

Earlier this month, activists rallied and marched in Seoul to demand an end to the laws that criminalized abortion in South Korea. Though the official crowd estimate was 1,500, organizers believe that over 5,000 people participated in the demonstration. Speakers included physicians, clergy, and young women who shared testimonies about their experiences struggling to end unwanted pregnancies or access reproductive information. South Korea's current law, originally passed in 1953, makes receiving abortion punishable by up to one year in prison or a fine of up to 2 million won (about $1,770). Physicians who perform the procedure could face even harsher punishments, serving up to two years in prison or losing their right to practice medicine. Since 1973, another law has allowed for abortion up to 24 weeks of gestation in certain exceptional circumstances, including rape, incest, genetic impairment of the fetus, and endangerment of the health of the women. In addition, women must obtain their husband's consent in order to undergo the...

Receiving an abortion not associated with mental health harms, study confirms

July 19, 2018October 14, 2024 by Anna KatzNo Comments

The notion that abortion causes poor mental health outcomes is often used to defend laws and policies that limit access to the procedure. So-called crisis pregnancy centers--fake health clinics that seek to dissuade women from receiving an abortion, often through manipulation and misinformation--sometimes tell patients that abortion causes depression, anxiety, and regret. They even warn of "post-abortion syndrome," a mythical condition that has been dismissed by scientific authorities. While reviews of scientific literature have found no evidence to suggest that abortion harms mental health, the existing research had limited generalizability. But thanks to the groundbreaking longitudinal Turnaway Study by Advancing New Standards in Reproductive Health (ANSIRH), scientists can conclusively assert that having a wanted abortion is not associated with mental health harms. The study compares the effects of women who have and women who are denied an abortion and follows them for five years. In addition to finding that having a wanted abortion is not associated with poor mental health outcomes, the...

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