April 2020 Director’s Message

April 2020 Director’s Message

As this very unusual semester comes to an end, the world around us is filled with uncertainty. The Covid-19 crisis has changed our learning, working, and social environments in profound ways that would have seemed unimaginable just a few months ago. The challenges of transitioning to online learning are capped by the disappointment of missing out on the rituals that come with spring at Duke, especially LDOC and graduation activities. We are faced with uncertainty about when we’ll see friends and classmates again, stress associated with working at home while ostensibly caring for and schooling our children, and navigating the continuously changing work demands and structures. On top of this, most of us are worried about the health and safety of loved ones and are wondering when we will get back to normal—and what normal will look like. It may seem that now is not the time to focus on sexual and reproductive health and to prioritize issues directly related...
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An Update on the Rakellz Dream Initiative from Robert Zulu

An Update on the Rakellz Dream Initiative from Robert Zulu

Most cervical cancer is highly preventable and can be cured if diagnosed early, yet women across the world suffer high rates of cervical cancer. One such place is Zambia, where the Rakellz Dream Initiative was founded. After losing his wife to cervical cancer in 2015, Robert Zulu decided to launch a cervical cancer education program in Zambia. Now at 36 years old, he is the the founder and executive director of the Rakellz Dream Initiative, a non-governmental organization with a team of over 50 youth volunteers working to raise awareness around cervical cancer through outreach activities and informational films. The long-term vision of the Rakellz Dream Initiative is to help increase cervical cancer knowledge across Zambia to mitigate and prevent terminal diagnoses by the year 2025. When he spoke about his reasons for forming the Rakellz Dream Initiative, Zulu said he wanted to help reduce the ignorance about cervical cancer among the people of Zambia. “When I was nursing my late wife,...
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ICPD: 25 Years Later

ICPD: 25 Years Later

Article by Diya Chadha The International Conference on Population and Development held in 1994 in Cairo, Egypt, brought 179 countries together behind the common goal of bringing improved reproductive health care and rights to the forefront of international policy and development efforts. Though the call for action primarily dealt with the state of healthcare access in more developing parts of the world, as well as the way women are structurally excluded from such accessibility, the inherent link between health and empowerment was established. Thus, the idea that this access to healthcare is instrumental in achieving women’s empowerment and further gender equality was highlighted. Now 25 years later, the ICPD met in Nairobi, Kenya for ICPD25 to “re-energize” the vision put forward back in Cairo. Specifically, they have resolved to end “all maternal deaths, unmet need for family planning and gender-based violence and harmful practices against women and girls by 2030.” The price tag for this task? $264 billion. Public sector civil organizations,...
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New York Passes Anti-Discrimination Laws on Basis of Reproductive Healthcare History

New York Passes Anti-Discrimination Laws on Basis of Reproductive Healthcare History

Article by Diya Chadha In the wake of attacks on reproductive health rights over the past year, a number of states have taken countering actions by passing pieces of statewide legislation that protect such rights. This has manifested in different ways. Earlier this year, parts of New York listed sexual and reproductive health rights as protected under the New York City Human Rights Law, with coverage ranging from being able to use birth control and contraception to having access to an abortion. New Jersey has been looking towards allocating nearly $9 million worth of state funds to organizations like Planned Parenthood to cover the gap in their funding caused by the defunding of Title X. These are just a few examples among many across the country. Just this past week, New York has again added to this set of protections by passing an antidiscrimination law protecting laborers from discrimination because of their reproductive health decision-making histories. There are three overarching sections:...
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The American Anti-Abortion Strategy

The American Anti-Abortion Strategy

Article By: Diya Chadha Over the past year, a series of restrictive anti-abortion legislation have been passed in states like Georgia, Kentucky, and Alabama. Courts have blocked their constitutionality, with the last case (Alabama) struck down this past month. Passage of such legislation would have resulted in a reversal of Roe v. Wade as many have called for six-week bans, which for many women, would limit their opportunity to get an abortion to a timeline before they may even realize they are pregnant. In other cases, states have called for outright bans on abortion at any stage of pregnancy, with no exceptions for rape and incest. The actions that are taking place “behind the scenes” of this more publicized series of events is equally as problematic. What’s worse is that they receive far less recognition as a relevant force in the anti-abortion effort. These “incremental” laws are state-by-state restrictions that impose what may seem to be minor restraints on the capabilities...
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Sexual Reproductive Rights – The Case of Social Exclusion

Sexual Reproductive Rights – The Case of Social Exclusion

Article by Sandra Y. Oketch Globally, access to sexual reproductive health rights (SRHR services) have been greatly hampered by social exclusion, more so in Africa. In November 2019, Kenya was privileged to host the United Nations summit -  International Conference on Population and Development (ICPD 25) - which focused on diversity, abortion care, ending gender based violence, elimination of female genital mutilation, FGM, ending unmet need for family planning, comprehensive sexuality education, mental health and psychosocial support, HIV prevention for adolescent girls and women. Women and other minority groups experience social exclusion when women and girls get abortions, when girls fail to undergo traditional practices of some communities, like the FGM, and are considered outcasts, and when individuals identify as Lesbian, Gay, Bisexual, or Transgender, LGBT. There exists high maternal morbidity and mortality in women due to unsafe abortion practices. In Kenya, abortion is illegal and only legalized in instances where the health care provider assesses that the life or health of the...
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Sensitization meeting on RMNCAH and immunization budgeting in Kisumu County

Sensitization meeting on RMNCAH and immunization budgeting in Kisumu County

By: Sandra Y. Oketch The Duke Center for Global reproductive health Kenya team had an interactive session on October 29, 2019 with the Ministry of Health and CSOs to discuss on Reproductive Maternal Neonatal Child and Adolescent Health (RMNCAH) and Immunization advocacy to ensure proper budgeting and sustainability. The discussions revolved around the critical pillars in budgeting that include: transparency and accountability; public participation and strategic planning. Some of the gaps in the Kisumu County Annual Development Plan (ADP) included: The lack of clear cut priorities for the FY 2019/20 and the public participation is not prioritized nor costed. All members present acknowledged the need for advocacy on the key stages in budgeting that include budget formulation, approval, implementation and Auditing. It was an exciting 1st advocacy collaborations to push for more transparent budget cycle on RMNCAH + Immunization with the CSO roles revolving around providing support in dissemination of the National County RMNCAH + Immunization policies and guidelines; Organize and conduct sensitization...
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Dr. Elizabeth Bukusi’s Work on HIV Prevention and Care

Dr. Elizabeth Bukusi’s Work on HIV Prevention and Care

To commemorate World AIDS Day held each year on December 1, we are highlighting Dr. Elizabeth Bukusi’s HIV research in Kenya! Dr. Bukusi is one of the foremost advocates for HIV care. She has conducted various studies in evaluating treatment options for high-risk populations. In one of her recent studies, she explored the value of post-exposure prophylaxis (PEP) and the antibiotic doxycylcine (dPEP) as an STI prevention strategy in African women taking PrEP, PrEP, or HIV pre-exposure prophylaxis, has been used over the past decade to prevent against HIV, however, there has also been a rising incidence of curable STIs in populations taking PrEP. The disproportionate risk that African women face from overlapping HIV-STI epidemics makes them an essential study population. dPEP is beneficial because it can be "woman-controlled," meaning that the effectiveness is not determined by partner participation, and that it's been shown to be safe for women. Dr. Bukusi predicts that dPEP will lead to a substantial reduction in the amount of...
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Pro-Life Obria Medical Clinic Chain Receives Title X Funding

Pro-Life Obria Medical Clinic Chain Receives Title X Funding

Article by Jackie Vicksman Earlier in 2019, the Trump Administration granted $1.7 million in Title X funds to a group of healthcare facilities in and around California, called Obria Medical Clinics. Title X was designed to provide funds for family-planning resources in lower income populations. Obria is a “Christian medical chain” which claims to provide reproductive healthcare services and is seeking to replace Planned Parenthood as a go-to service provider. Although Obria’s website makes no mention of a religious background, it does illustrate the chain’s emphasis on holistic care and “well-woman” services. Additionally, the woman that runs the organization, Kathleen Eaton Bravo, has been open about her pro-life views. The clinic itself does not perform abortion care services, nor does it provide condoms or hormonal birth control options for patients. Instead, the clinic focuses on more “natural” methods of family planning that consist of timing menstrual cycles and an emphasis on abstinence-only sex education. Critics fear that the government-funded group’s misleading...
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Planned Parenthood Opens New Clinic in Illinois Near Missouri Border

Planned Parenthood Opens New Clinic in Illinois Near Missouri Border

Article by Jackie Vicksman On October 2, 2019, Planned Parenthood of the St. Louis Region and Southwest Missouri announced that it is planning on opening a new facility in Illinois, near the Missouri border, in order to increase access to reproductive healthcare (specifically family-planning and abrotion services) for women in this region. The large facility will replace a smaller one in the region and will expand care to provide both medical and surgical abortion services. This plan comes after several restrictive abortion laws have been passed in Missouri, where state legislature officials also attempted to make abortion after eight weeks illegal. This move failed in court but other restrictions such as a 72 hour waiting period and parental consent for minors, are currently in place to reduce women’s access to abortion and abortion care services. There is currently one facility that provides abortion services in Missouri, and Planned Parenthood officials believe that this new “mega-facility” will address access issues for women living...
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