Insights & Updates – Page 5 – Global Reproductive Health at Duke

A New Mechanism of Non-Hormonal Contraception using Mucoadhesive Polymers

December 4, 2022December 10, 2024 by Logan GlasstetterNo Comments

Effective family planning is critical for women’s empowerment and improvement in child and maternal health, yet nearly half of the world’s pregnancies are unintended(1), representing a clear unmet need for contraception. Hormonal contraceptive regimens offer high efficacy but may induce a systemic side effect profile that reduces compliance. New research into contraceptive development has stagnated since the 1980s, due to the exit of the U.S. pharmaceutical industry from the arena. Consequently, existing pericoital non-hormonal contraceptives, such as spermicides and gels, are unsatisfactory, suffering from high failure rates in typical use as well as high discontinuation rates, which partially stem from vaginal irritation and discomfort. To solve these issues, Schimpf and colleagues, reporting in Science Translational Medicine(2), proposed a novel mechanism that could represent the next generation in contraceptive design. They developed a formulation of chitosan mucoadhesive polymers that can be topically applied to physically reinforce the cervical mucus barrier against sperm penetration. Their vaginal gel formulation decreased average uterine sperm...

OCTOBER 2022 DIRECTOR’S MESSAGE

October 20, 2022December 10, 2024 by Megan HuchkoNo Comments

Be an Outlier for Change Next week marks almost five months since the Supreme Court handed down their decision in Dobbs versus Jackson Women’s Health, overturning the constitutional protection for abortion enshrined by Roe v Wade in 1973. Although the past fifteen years have seen an incredibly successful assault on reproductive rights and access to essential health care for pregnancy, the Dobbs decision led to the enactment of trigger bans in thirteen states, with an additional thirteen states having restrictive or very restrictive laws that are anticipated to lead to bans in the near future. In the first 100 days post-Dobbs, much has been written about the legal climate, how individuals and families have been affected and the legislative victories on both sides of the debate. One of the most striking things I’ve read, however, was a policy analysis by the Guttmacher Institute classifying the US as a global outlier on abortion rights. While the US has often taken pride in...

FACULTY SPOTLIGHT: AN INTERVIEW WITH DR. EMILY HERFEL

October 19, 2022December 10, 2024 by Amber SmithNo Comments

Emily Herfel, DO, Msc-GH, FACOG (Fellow of the American College of Osteopathic Obstetricians and Gynecologists), is an assistant professor at Duke Department of Obstetrics and Gynecology, an affiliate at the Duke Center for Global Reproductive Health, and a volunteer professor at Kilimanjaro Christian Medical Center in Moshi, Tanzania. Dr. Herfel completed her undergraduate work at John Carroll University in Cleveland, Ohio followed by a Doctor of Osteopathy at Heritage College of Osteopathic Medicine in Athens, Ohio. She completed residency at OhioHealth Doctors Hospital in Columbus, Ohio. She then went on to receive her Masters of Science in Global Health through a Women’s Global Health Fellowship at Duke University. During that fellowship, she received an NIH-Fogarty grant to complete her project in Kisumu, Kenya. I had an enriching conversation with Dr. Herfel to learn more about her experiences within the global health sphere and her passion for reproductive health care. “Right in the heart of COVID, in July 2020, I moved to...

REPRODUCTIVE RIGHTS AS HUMAN RIGHTS ACROSS A POST-ROE NATION

September 10, 2022December 10, 2024 by Mohanapriya CumaranNo Comments

Pro-choice vs Pro-life? The conversation surrounding reproductive health has been trampled by the debate between two movements. It has been obscured by debates of when life begins. It has been convoluted with religious beliefs, political beliefs, and complex obscurities that the people have failed to realize the real focus of this discussion: women and their reproductive freedom. With the overturning of Roe vs Wade, the discussion of reproductive rights and women’s rights have become more urgent than ever. This is not a matter of women’s rights but human rights. Due to the constitutional right to an abortion granted by Roe vs Wade, women have had the law the federal government enabling the freedom to reproductive care but stripping this basic human right to healthcare puts them in more dangerous situations than ever [2]. The advent of this new decision has opened new laws that will soon ban abortion access, birth control and other means of contraceptives. This is a mean...

REFLECTION FROM THE FIELD: JULIA’S REFLECTIONS IN NAIROBI

September 10, 2022December 10, 2024 by Julia DavisNo Comments

I recently landed back home in Boston after spending most of my summer in Nairobi, Kenya researching cross-cultural early childhood development with Universal Baby. Universal Baby is a public health, caregiver coaching intervention that creates videos to share current neuroscience and child development information across the globe. Towards the end of my time in Kenya, I visited a Maasai Village in Kajiado South sub-county, about 5-6 hours outside of the Nairobi. The Maasai are one of Kenya’s ethnic tribes, originally from the lower Nile Valley. I embarked on this journey, acutely aware of how the injustice and violence of colonialism has shaped the education systems and subsequent socioeconomic advancements in Kenya. We stopped for the night in the rural town of Bisil before starting off early the following morning for the village, passing giraffes and ostriches on the drive there. Our first stop was Loolkair Primary School, a K-8 school with nearly 400 students and only eight teachers. As we arrived, hundreds of...

Webinar Series

July 29, 2022December 10, 2024 by Megan HuchkoNo Comments

The Center for Global Reproductive Health and the Center for Policy Impact in Global Health recently partnered to convene a webinar on “The unfinished agenda of maternal and child health in Africa and Asia: promising directions to address maternal mortality challenges.” The panel, moderated by Dr. Megan Huchko, included: Dr. Mariam Claeson, former Director of the Global Financing Facility for Every Women Every Child at the World Bank and now at the Karolinska Institute Dr. Qjan Long, Assistant Professor at Duke Kunshan University, formerly worked at the Department of Reproductive Health and Research, WHO Ms. Jacquelyn Caglia, Director of Learning, Communications for Merck for Mothers Experts discussed the historic and current challenges in addressing maternal and child mortality in the region, and brought up some promising innovations and strategies with the potential to effect these disparities in the future. The webinar can be seen here, with a fill description of the background and discussion on the CPIGH website....

The Failures of American Sex-Education

July 25, 2022December 10, 2024 by Vidita ShahNo Comments

As the topic of sexual and reproductive health re-enters the public consciousness in America through the overturning of Roe v. Wade, it becomes increasingly important to access American Sex Education, or rather, the failures of it, and how we teach these topics to our most impressionable population, children. The state of sex-education in this country is in shambles. Though the majority of Americans support sex-education in middle school and in high school, what exactly does that education look like? The first and one of the most important things to note about sex-education in the states is that there is no universal regulation of it. Only thirty nine states, plus DC, even have government mandated sex-education [5]. Within the states with mandated sex-education, only thirteen must provide “medically accurate” sex-education [1]. The content of what is covered in sex-education varies widely from state to state, within states that do have government mandated sex-education, it is often left to individual districts to decide...

Reflection From the Field: Dr. Emily Herfel’s Reflections in Kisumu

July 21, 2022December 10, 2024 by Emily HerfelNo Comments

It is hard to believe I have called Kisumu home for almost a year, with time cut short by the elections set for early August. Our team is busy, skillfully orchestrating multiple studies concurrently. The stigma education study, looking at the impact of a stigma-responsive educational video on cervical cancer screening behavior, is in full swing. The six health facility sites are offering research-supported HPV self-testing as part of their cervical cancer screening program, led by community healthcare volunteers (CHVs). Our three intervention sites are also showing the HPV stigma-responsive education video. The team then visits each site once a week to ask women to participate in a validated HPV/cervical cancer stigma measurement tool. Jeniffer, our study clinician, is leading the project with grace, balancing the day-to-day activities with each facility. Getting positive feedback from the CHVs and women of the community about a cervical cancer screening technique that avoids a speculum helps to keep us motivated. Some of the sites are...

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

July 18, 2022December 10, 2024 by Laya SathyanNo Comments

As we start our eighth and final week in Kisumu, the SRT team is finishing up the last stages of our on-the-ground research, and preparing for our trip back to the US! At this point in time, we are almost finished with our clinic observations. Despite several scheduling changes, we will complete our project with five to six observation sessions at each of the six clinics. Additionally, we have set in motion the plans for the Kisumu team to conduct focus group discussions (FGDs) at the intervention clinics after we leave. The purpose of the FGDs is to understand women’s opinions about our educational intervention, and how they feel about incorporating peer navigation services into the clinics. Unfortunately, we will not be here to witness the FGDs as we originally anticipated, but we’ve been working on setting everything up so that they will run smoothly in our absence. That includes getting participant recruitment up and running, going over our questions and...

Resources for Abortion Access Across a Post-Roe Nation

June 30, 2022December 10, 2024 by Amber SmithNo Comments

Pictured above: People marching in Boulder, Colorado for Reproductive Health Rights in May of 2022 with signs that say “Your right to abortion should not depend on your zip code.” Unfortunately, though, zip codes shaping access to abortions may very much be more of a reality with the overturning of Roe v. Wade. The New York Times reveals how the Supreme Court’s ruling on the Mississippi law could weaken or even overturn Roe v. Wade which could ultimately lead to legal abortion access dramatically decreasing, particularly in the American South and Midwest (Bui et al., 2021). This geographic discrepancy is even more reinforced through social class differences and communities that are “disproportionately Black, Latina, teenagers, uninsured, and undocumented immigrants” (Miller & Sanger-Katz, 2022). Ultimately, leading not only to be a social justice issue and human rights issue, but also a racial justice issue. Bui et al. quotes Caitlin Knowles Myers saying, “A post Roe-United States isn’t one in which abortion isn’t...

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