The Future (of STI Prevention) is Female

The Future (of STI Prevention) is Female

by kb330@duke.eduNo Comments
Currently, condoms are the only product on the market that provide individuals with dual protection against pregnancy and sexually transmitted infections (STIs), including HIV. The United Nations (UN) Department of Economic and Social Affairs recently reported a worldwide increase in condom use from 1994 to 2015. During this time, the percentage share of male condoms of all contraceptives used globally among married or in-union women aged 15 to 49 increased from 8% to 12%. In addition to condom prevalence, contraceptive use overall has increased rapidly since the creation of various modern methods (such as the pill and IUD) in the 1960s and 1970s. More women are using contraceptives now than ever before. Nonetheless, the UN also reported, “in at least one of out every four countries or areas with data, a single method accounts for 50 per cent or more of all contraceptive use among married or in-union women.” The most commonly used methods included the pill, injectables or IUDs—none of...
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Despite Government Policy, Cervical Cancer Progress Stalls in India

by Amelia CheathamNo Comments
In what might have been a leap forward for reproductive health, the Indian government unveiled an national oral, breast and cervical cancer detection protocol in 2016.  At the time, the initiative was lauded by public health professionals.  However, with little progress to show, the Ministry of Health and Family Welfare is attracting criticism. India leads the world in cervical cancer mortality with over 70,000 deaths per year.  Yet, its women often can't access appropriate screenings, and the government immunization schedule fails to include the HPV vaccine.  This contradicts vaccination recommendations by the WHO and the country's own National Technical Advisory Group on Immunization. It seems India may suffer from misgivings similar to those driving the worldwide anti-vaxxing movement.  A 2009 HPV vaccination trial of 25,000 Indian girls was stopped after the unrelated deaths of seven participants sparked public outcry. Stigma and logistical challenges also complicate cervical cancer screening efforts.  Considering India's "burgeoning youth population that is sexually experimenting at a younger age," this might prove an...
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Nimmi Ramanujam

by kb330@duke.eduNo Comments
Faculty Profile: Nimmi Ramanujam Dr. Nimmi Ramanujam serves as the Robert W. Carr, Jr., Professor of Biomedical Engineering, a Professor of Pharmacology and Cancer Biology, and a Research Professor of Global Health at Duke University. Since arriving at Duke twelve years ago, Dr. Ramanujam has founded the Global Women’s Health Technologies Center and the Tissue Optical Spectroscopy Laboratory, through which she researches cervical and breast cancers, women’s health disparities, and the development of diagnostic tools for implementation in low-resource settings. Her team is currently developing a Point of Care Tampon (POCkeT) Colposcope, which will allow women to screen themselves for cervical cancer.   Dr. Ramanujam took a break from her work to discuss cancer research, technology uptake, and the importance of focusing on the horizon of global health innovation.   How did you decide what technologies to work on?   For Dr. Ramanujam, who had already conducted research on cervical and breast cancers, choosing to concentrate on cervical cancer was about prioritizing the “next generation of problems”...
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Melissa Watt

by Amelia CheathamNo Comments
Faculty Profile: Melissa Watt  With research projects in Tanzania and Ghana, and interests ranging from mother-to-child-transmission of HIV to prevention of fetal alcohol syndrome to family planning to sexual trauma, Associate Professor of the Practice Dr. Melissa Watt is a proficient and passionate force in the field of gender-based health research at Duke.   We sat down with Dr. Watt in her office at the Duke Global Health Institute (DGHI) to learn what sparked her interest in global health, what has defined her time as a Duke faculty member, and what excites her about the future.   How did you become involved in global health and choose reproductive health as a focus for your work?   Referencing a process of self-discovery to which her students might relate, Dr. Watt recalled her undergraduate work in African Studies and Public Policy, which aligned with her passion for “international development and how development can best be transformative for women’s equality and women’s rights.”   After completing her undergraduate program at the...
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Harnessing Culture for Change

Harnessing Culture for Change

by kb330@duke.eduNo Comments
Today is International Day of Zero Tolerance for female genital mutilation (FGM). FGM is comprised of all procedures which alter or injure female genitalia for non-medical reasons. It is internationally recognized as a violation of human rights, and eliminating this practice is one of the Sustainable Development Goals and a key focus area for many governments around the world. It is estimated that at least 200 million women and girls have undergone FGM and almost 40% of girls between the ages of 15 and 19 are currently affected. In order to make lasting change on this issue, more is needed than national legislation. FGM is deeply rooted in culture and religion, and local traditions need to be taken into account and understood to advocate for change. Read the latest editorial from The Lancet addressing this issue, and offering solutions for how we can harness culture for change....
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Ireland to Vote on Abortion Law Reform

Ireland to Vote on Abortion Law Reform

by kb330@duke.eduNo Comments
At the end of May, the Irish government will hold a referendum to decide if their long-standing constitutional ban on abortion should be repealed. Currently, unborn fetuses have a right to life equal to living humans, which has been interpreted as a ban on abortion in almost every single circumstance. If the referendum passes, the Irish Parliament will have the power to enact laws regulating abortion. Read the New York Times article for more information on the potential new regulations and Christine Ryan's blog to learn more about abortion law reform. Photo courtesy of: Clodagh Kilcoyne/Reuters  ...
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Cervical Health Awareness Month

Cervical Health Awareness Month

by kb330@duke.eduNo Comments
People across the U.S. are kicking off 2018 right with health-conscious resolutions. According to Statista, 45% of Americans hope to “lose weight or get in shape” in 2018. But January offers another opportunity to celebrate and jump-start health awareness: it’s Cervical Health Awareness Month. In the U.S. there are between 11,000 and 13,000 new cases of cervical cancer annually, and cervical cancer is the fourth most prevalent form of cancer among women globally. While patients diagnosed with early-stage cervical cancer have 5-year survival rates of up to 91%, the disease becomes far more deadly as cancerous cells spread to other parts of the body. Fortunately, proactive methods like HPV vaccinations and screenings can keep cervical cancer at bay, and mitigate almost all deaths related to cervical cancer. However, access to such healthcare often depends on a woman’s geographic location and socioeconomic status. According to the WHO, “approximately 90% [of] the 270,000 deaths from cervical cancer in 2015 occurred in low- and middle-income countries.” Duke...
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Human Rights, Feminism, and Abortion Law Reform

Human Rights, Feminism, and Abortion Law Reform

by kb330@duke.eduNo Comments
In the seminal international human rights treaties there is no express legal guarantee for abortion rights. Nevertheless, since the 1990s, women’s rights activists have used international human rights forums and mechanisms to advance abortion rights. Cumulatively, human rights law can now be said to call for the decriminalization of abortion and the legalization of abortion in cases where the pregnancy threatens the life or health of the woman, is the result of rape or incest, or there is severe fetal impairment. Despite this promising trajectory, international human rights law does not recognize a woman’s right to decide whether to carry a pregnancy to term as a matter of her autonomy, equality or self-determination. One reason for this is advocates have attempted to follow the path of least resistance for abortion rights and focused instead on the right to health, the right to be free from cruel, inhuman and degrading treatment, and the right to privacy. Recognizing unsafe abortion as a major public...
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The Value of Big Data for Family Planning

The Value of Big Data for Family Planning

by kb330@duke.eduNo Comments
While the use of modern methods of contraception are now commonplace in many countries, one-third of women in developing countries who begin using a modern method of contraception quit within the first year and half quit within two years[i]. Most discontinuation occurs among women who want to avoid pregnancy putting them at risk for unwanted pregnancies, maternal morbidity and mortality[ii]. Traditional measures of contraceptive use are collected retrospectively from population representative surveys conducted only every five years which are not well-suited to measuring contemporary trends in contraceptive discontinuation. This is problematic because advocates and health ministries cannot address concerns in a reasonable amount of time to impact widespread change. "Big Data" can supplement these static sources by providing dynamic, real time tracking of the reasons women discontinue using contraceptives and open up possibilities to prevent discontinuation or help facilitate switching between methods. So what exactly is "Big Data" and how can it supplement traditional reproductive health data? Big data is commonly thought...
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Big Data for Reproductive Health

Big Data for Reproductive Health

by kb330@duke.eduNo Comments
"Curious about contraceptive discontinuation?  Intrigued by intersections of technology and sexual health?  Apply to join the Data+ “Big Data for Reproductive Health” team! This summer, participants will collaborate with Duke Global Health Institute reproductive health investigators, producing a digital resource that repackages basic Demographic and Health Surveys (DHS) information on contraceptive discontinuation as actionable intelligence for family planning organizations. During the 10-week program, students will also seek feedback from RTI researchers and determine appropriate distribution tactics for their social media-integrated platform. Like other Data+ programs, this project is interdisciplinary, combining the fields of computer science, global health, gender, sexuality and feminist studies, public policy and, of course, data.  To find out more and apply, click here."...
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