Notes from the Field: Uganda

Notes from the Field: Uganda

This summer, after a long, solo trip across the world, I arrived in East Africa for the first time. As a Master of Science in Global Health student at Duke University, I spent my first year paired with a mentor, Dr. Megan Huchko, working as a research assistant. During that time we worked together to design a research study which I would conduct the following summer in Kenya. Dr. Huchko and I chose to interview HPV positive women from her ongoing cluster-randomized trial to find ways to reduce the substantial loss to follow up seen with a two-visit screen and treat strategy.  Upon entering this program, I knew I wanted to work in women’s reproductive health. Cervical cancer is the leading cause of cancer in women in Africa, so having the opportunity to have a hand in research being conducted to reduce that burden is a privilege. Our goal was to improve treatment acquisition among HPV positive women, to reduce...
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Contraception offered in Rohingya Camps

Contraception offered in Rohingya Camps

Over 600,000 Rohingya Muslims have fled to Bangladesh to escape persecution in Myanmar, and are currently living in crowded and under-resourced refugee camps. Reproductive health services are often non-existent or severely limited in refugee camps, yet these services are desperately needed by women and girls living in the camps. Bangladesh has begun to offer birth control pills, injectables, and condoms in the camps, and is hiring more staff to offer reproductive health services, including family planning counseling. This is not a service that should be optional in refugee camps, and we hope services continue as long as they are needed....
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#notwithoutrepro

#notwithoutrepro

On Thursday November 2nd, Ivanka Trump traveled to Japan to speak at the World Assembly of Women. In her remarks, Trump commented on the importance of shaping a more realistic picture of women who work (be it in the home, outside, or a combination of both), and that women need to be afforded the same opportunities as their male peers. As she talked about her daughter, she said: "It is my hope that by the time my daughter Arabella grows into a woman, she will not be defined by whether she works inside or outside the home. She will simply be a woman afforded the same opportunities as her male peers and equipped with the education and support she needs to fulfill her unique potential." For her daughter, or girls around the world to do this? They need access to comprehensive reproductive healthcare. Without the ability to decide and control their reproductive futures, girls choices are taken away from them. They will...
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Let’s Talk About Sex: Peer-Led Comprehensive Sexuality Education in Rural Kenya

Let’s Talk About Sex: Peer-Led Comprehensive Sexuality Education in Rural Kenya

What is the function of the clitoris? Before I began teaching comprehensive sexuality education (CSE) at WISER Girls’, a secondary school located in Muhuru Bay, Kenya, I never imagined that this would be the most frequently asked question. Especially among a class of female third-year high school students. When I was first asked, I gave a cursory – and yes, somewhat bashful – reply, explaining the clitoris as the “anatomical source of sexual pleasure in females.” But this answer did not satisfy the students, and they probed for more information. As we engaged in a discussion, I learned that many weren’t familiar with an external representation of the female genitalia – especially one with a “non-reproductive” function. As my answers became more justificatory about the significance of the clitoris, I realized that my attitudes about legitimized female sexuality had begun to leak into my responses. While I tried to remove any bias from my answers, I struggled with leaving my...
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Recap of Women’s Health Symposium

Recap of Women’s Health Symposium

On Friday, October 20th, public health professionals from around the Triangle gathered at Duke to discuss how best to advance women’s health in the current political environment. Keynote speeches were given by Jen Kates, Vice President and Director of Global HIV Policy at the Kaiser Family Foundation, and North Carolina Congressman David Price. Women’s health right now is in an era of uncertainty. Jen Kates focused on this as she outlined many of the questions that remain regarding how the Trump administration will implement many of its proposed changes to global health policy. Unfortunately, this uncertainty extends to women’s health domestically as well. Congressman David Price described expected and potential changes to the Affordable Care Act and the devastating effect these could have on women and girls across the United States. After hearing a broad overview, the afternoon concluded with two panels which honed in on specific impacts current and proposed policies will have. Lindsay Robinson of Planned Parenthood South Atlantic reminded...
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Reflection in Global Health Essay Contest

Reflection in Global Health Essay Contest

The Consortium of Universities for Global Health (CUGH) announced its fifth annual Reflection Essay Contest. The contest is co-sponsored by CUGH, Child Family Health International, University of Pittsburg Center for Global Health and Loyola University Chicago Health Sciences Division. Trainees from undergraduate, graduate and post-graduate levels and Global Health faculty/practitioners are encouraged to submit an essay to the contest. Winners will be invited to attend and read their essays at the CUGH 2018 Annual Conference (March 16-18, 2018) in New York, NY. Submissions are due by midnight EST on November 12, 2017. For more information, please visit the CUGH website....
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We Make Inroads

We Make Inroads

This year, we will host a series of reproductive health talks. These talks are designed to expose audience members to a broad range of reproductive health topics, organizations, researchers, and projects. The first talk of the semester was facilitated by the co-conveners of Inroads. Kati LeTourneau and Katie Gillum gave an engaging presentation on their work and how individuals and organizations are combatting abortion stigma around the world. Rather than being a network of organizations, the Inroads network is comprised of individual members. Gillum and LeTourneau stressed the importance of this, because “we interact with stigma as humans and individuals first” so transforming and dismantling stigma must start on an individual level.  One of their goals is “to transform (stigma) by bringing people together who don’t often get together.” Each member brings their own expertise to the community, provides support to other members, and asks for guidance and feedback from the network. So why stigma? As Kati said, “Stigma is a barrier...
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Free online course from the Lancet Maternal Health Series

Free online course from the Lancet Maternal Health Series

This limited-time, free online course based on the Lancet Maternal Health Series will explore the state of maternal health around the world. Students, researchers and implementers are invited to join to review the latest evidence and learn what is needed to ensure good-quality, woman-centered maternal healthcare for all. You will cover topics that include epidemiology of maternal and neonatal health, patterns in health care delivery, what constitutes quality maternal health care and how it related to respectful care, and challenges and opportunities in the Sustainable Development Goals. Check it out! Link to the online course: https://www.futurelearn.com/courses/maternal-health...
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Can we translate the multilateral strategies for cervical cancer prevention to address other global health disparities?

Can we translate the multilateral strategies for cervical cancer prevention to address other global health disparities?

Cervical cancer is an example of a glaring health disparity between wealthy and poor countries, and remains an immediate health threat to many women in low- and middle-income countries (LMICs). Evidence-based, cost-effective protocols recommended by the World Health Organization have not been widely implemented due to limited health care infrastructure augmented by a lack of funding and political will. Although there are some unique factors contributing to the disparity in cervical cancer outcomes between high and LMICs, there are some common root causes shared across health systems: poor health care infrastructure, lack of awareness of early signs or symptoms, lack of funding prioritization within local governments, and limited operationalization of proven technologies used in high-income countries. These root causes must be addressed through both innovation and adaptation of successful interventions to fit the target community and the priorities of local governments (i.e. be both low-cost and cost-effective). To achieve this, clinicians and researchers need to partner with policy experts and...
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