Insights & Updates – Page 7 – Global Reproductive Health at Duke

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, 2022April 3, 2025 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...

The Heart of the Abortion Debate

June 30, 2022December 10, 2024 by Vidita ShahNo Comments

When having discussions about Roe v. Wade and the consequences of overturning it, it is of the utmost importance that we remember to center the stories and the voices of those that would be most affected by the loss of abortion access. It is often easy to get lost in the big-picture, Constitutional implications of Roe v. Wade being overturned, but the heart of this issue is the people. Some of our most vulnerable and most marginalized populations will feel the impact of Roe being overturned the most, and listening to them and understanding their stories is imperative to movements to preserve abortion access. Through this blogpost, I hope to highlight the stories of real people that need access to abortion services. Adriana was 34 and living in Mexico when she found out that she was pregnant. Abortion was not legal where Adriana was from in Mexico. Adriana knew immediately that she wanted to terminate her pregnancy, but her choices were...

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

June 30, 2022April 3, 2025 by Bentley ChoiNo Comments

First and foremost, we have passed the halfway point of our time in Kenya! Time flies by, and we are discussing what we want to get out of the next four weeks. Insofar, we collected more than 20 observation data to evaluate the workflow of stigma education at the clinic. During this process, we faced multiple hiccups, especially scheduling a visit and clearing up logistics. Three of our observation clinics had a twelve-day-long CHV training, so we had to flip our schedule to ensure we could collect the data we initially planned. We spent the last couple of days creating a contingency plan so that our time in Kenya could contribute to the depth of our data. Listening to what other teammates thought helped us, as a team, solidify the future direction of our study, such as what variables to analyze in observation studies, codes for focus group discussion, and the focus of our manuscript. Besides working on an observational study,...

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

June 15, 2022April 3, 2025 by Haley DionNo Comments

We have made it through week three of our time in Kisumu, Kenya! The weeks are truly flying by because our research is progressing, and we are enjoying our time in the city. The other SRT students and I officially started our workflow analysis observations at each of the six clinics this past week. There are three intervention clinics, at which community health volunteers (CHVs) display an educational video about human-papillomavirus (HPV) self-screening, and three control clinics, where CHVs provide health education talks about HPV and offer the self-screening. Through our observations so far, it is clear that all the CHVs are quick learning, adaptable, and passionate about increasing HPV screening for women in Kisumu! We have enjoyed our first week of observations because of all the positive aspects we have seen with our study. Fortunately, many women are opting into HPV self-screening, and we are able to increase prevention of cervical cancer in many of the Kisumu sub-counties! We...

Maternal Mortality: Why is Race a Factor?

June 11, 2022December 10, 2024 by Mohanapriya CumaranNo Comments

The United States is one of the leading nations in medical advancement and spends a significant portion of expenditures in healthcare and yet, we have the highest rate of maternal mortality (ratio of 57) among developed countries. About 57 mothers die during childbirth per 100,000 birth in a year. Maternal mortality is defined as the death of a mother due to pregnancy and/or childbirth complications [3]. These complications can arise due to a variety of factors including environmental lifestyle, predisposing conditions, risk factors, genetics and socioeconomic factors [1]. Pregnancy complications are likely to arise in women with higher maternal age and those with chronic cardiovascular conditions. Preeclampsia is a condition in which women develop high blood pressure due to preexisting cardiovascular conditions and kidney disease. Black non-Hispanic mothers are 2.5 times more likely to die from pregnancy or labor complications compared to white women and 3.5 times more likely to die than Hispanic women [3]. Why is there a disparity in...

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

June 5, 2022April 3, 2025 by Michelle HuangNo Comments

Sunday marked the first full week that the rest of the students from the Kenyan Reproductive Health SRT team and I have been in Kisumu, Kenya. Our experience thus far has been full of introductions and familiarizations, and we have had an exciting time learning from the field while finding our footing in a new area. After we flew into Kisumu, we were able to get situated in our new living space and learn to make ourselves at home for the next two months, starting to cook for ourselves and establishing new rituals (like bonding through watching Suits together during dinner). We have learned to navigate some parts of the town with the help of our local partners, learning where to buy groceries and hot meals, and we have done a bit of exploring on the weekends and our walks to work. Although moving to an unfamiliar area has been challenging, we have been able to improvise and overcome to...

Myna Mahila Foundation Combats Period Taboo in Urban Indian Communities

May 27, 2022December 10, 2024 by Vidita ShahNo Comments

Although stigma surrounding menstruation exists around the world, this stigma manifests in a way that has a deeply negative effect on the lives of menstruators in some communities in India. In these communities, periods are treated as dirty and impure. Many menstruators are not allowed to pray, go to the temple, or enter the kitchen while on their period. Due to the negative stigma surrounding menstruation, menstruators in these communities do not discuss menstruation. Many men do not even know what menstruation is. Menstruators feel ashamed buying sanitary pads from male workers at health stores and are thus forced to use unsanitary cloth rags during their cycles. As a result of the lack of access to proper menstrual hygiene products and community support, in some Indian communities, young menstruators are forced to end their education after they get their period. Despite how pervasive this taboo is in many Indian communities, there are a variety of efforts to combat this detrimental stigma....

Faculty Spotlight: An Interview with Dr. Jonas Swartz

May 2, 2022December 10, 2024 by Aarushi VenkatakrishnanNo Comments

Jonas Swartz, MD, MPH is an OB/GYN and an Assistant Professor of Obstetrics and Gynecology. He completed his undergrad at Duke University and then his MPH and MD at the University of North Carolina at Chapel Hill. He completed his residency in Obstetrics and Gynecology at the Oregon Health and Science University, followed with a fellowship in Complex Family Planning back at UNC. I had a conversation with Dr. Swartz to understand more about how he became involved in health policy and reproductive health access. “Well, I grew up in North Carolina and did Medical School here, and one of the striking things when I was a medical student was the discrepancy in care during pregnancy for people who were citizens versus non-citizens. And, in particular, thinking about low-income people who use Medicaid.” Swartz described his early medical training and becoming acquainted with the Federal Emergency Medicaid program, which only pays for labor and delivery services for authorized immigrants. He noted that...

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