Roe v. Wade Overturning: A National Approach Evaluation with Resources

Roe v. Wade Overturning: A National Approach Evaluation with Resources

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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The Heart of the Abortion Debate

The Heart of the Abortion Debate

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...
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Maternal Mortality: Why is Race a Factor?

Maternal Mortality: Why is Race a Factor?

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...
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Myna Mahila Foundation Combats Period Taboo in Urban Indian Communities

Myna Mahila Foundation Combats Period Taboo in Urban Indian Communities

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....
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Faculty Spotlight:  An Interview with Dr. Jonas Swartz

Faculty Spotlight: An Interview with Dr. Jonas Swartz

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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SRT Spring 2022 Reflection

SRT Spring 2022 Reflection

This summer, 4 students will join the Center as part of the Student Research Training Program (SRT). Hear their thoughts heading into the program.   Bentley Choi When I first applied to the SRT program, I merely expected to ‘conduct’ research abroad. In reality, I learned more important skills such as writing IRB amendments, scheduling a meeting with teammates, and communicating with a research team in Kisumu. My goal for this summer is to apply what I learned from Dr. Eric Green’s Global Health Research Methods class into a real-life setting, and I believe we are making our way to this goal since the team proposed a new way to evaluate the intervention! I look forward to conducting observational study and focus group discussions. Also, I am hoping to learn how to navigate myself in a new living environment and what are Kenya’s unique cultural factors that influence stigma and perception towards reproductive health since it is also related to my senior thesis...
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BD4RH Spring 2022 Reflection

BD4RH Spring 2022 Reflection

Our Big Data for Reproductive Health Bass Connections team worked on three teams throughout the year and presented their work at the Bass Connections Showcase. Using Natural Language Processing (NLP) Techniques to examine Stigma with Cervical Cancer in Kenya Members: Foxx Hart, Lynne Wang, Alexandra Lawerence, and Neha Shrishail For our project, we utilized topic modeling to identify recurring themes and sentiments in HIV interview data with Kenyan women, as well as develop an understanding of stigma frameworks. This year we were able to learn new technical and project management skills while diving deeper into the emerging interdisciplinary space between quantitative machine learning and qualitative social science research. Due to the many nuances and complexities involved with categorizing stigma, we have concluded that rudimentary NLP is not sufficient for identifying the various forms of stigma in qualitative data. However, we believe that this was a great introduction to applying these methods to an important area in global reproductive health. We hope more research...
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May 2022 Director’s Message

May 2022 Director’s Message

May is a time of growth and excitement, from magnolia blooms and longer, warmer days to the celebrations popping up around campus. Along with the inherent optimism of spring on Duke’s campus, it feels that we are starting to sense what life in a more stable peri-Covid world will look like. For many, getting together in person to celebrate events and achievements, or even just to brainstorm in the same room, is a salve after these past two years. Graduation and summer opportunities provide a blank canvas for new experiences and adventures for students. This year’s graduating class spent much of their time at Duke in conditions altered by the pandemic, and yet most of the ones that I have worked with have not let that hinder their ambition or achievements. Their resilience, flexibility and grace will serve them well. In fact, the confluence of the pandemic and the national reckoning with race and racism that has so profoundly impacted...
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Hybrid GRH

Our paper, “Uptake and correlates of cervical cancer screening among women attending a community-based multi-disease health campaign in Kenya,” is published in the BMC Women’s Health. In this paper, we describe the acceptability and uptake of a model of integrated HPV-based cervical cancer screening as part of a series of multi-disease community health campaigns offered in Kisumu, Kenya. We also describe the prevalence and predictors of both screening and positive HPV results among women attending these campaigns. Although there is an increased risk of cervical cancer among women living with HIV, many HIV-care programs do not offer integrated cervical cancer screening. To address the cervical cancer screening gap in Kenya, we leveraged the community health campaigns facilitated by the Family AIDS Care & Education Services and provided multi-disease testing to achieve a high population coverage for HIV-testing and HPV-based cervical cancer screening in western Kenya, an area with high rates of HIV. In addition to HIV testing, the campaigns provided screening...
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Returning to the Field

Returning to the Field

In March 2022, I was able to return to Kenya to resume my dissertation research. It was wonderful to be back after two years away and to see and work with Kenyan colleagues in person again. I spent part of the time conducting follow-up interviews with sexual and reproductive health NGOs in Kisumu and part of the time preparing to conduct a survey in Migori County later this year. My qualitative work began in February 2020 when I was last in Kenya. I met with several Kisumu-based sexual and reproductive health NGOs to learn about how the US’s global gag rule had impacted their operations, relationships with donors, and relationships with other NGOs. When the pandemic hit and Kenya experienced lockdowns, I along with my undergraduate research assistants Ema Kuczura and Sarah Hubner, conducted semi-structured interviews over zoom with roughly 35 NGOs to understand how they were responding to issues related to the COVID-19 pandemic, including increased demand for their services,...
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