Winter 2019 Director’s Message

The end of the semester and calendar lend themselves to reflections on the progress and challenges of the past year, and global health is no exception. In fact, last year we highlighted some of the year’s ups and downs in reproductive health. Both myself and Konyin Adewumi, DGHI MSc ’17, concluded that despite some setbacks, 2018 left us optimistic about progress toward reproductive and sexual health, reflected in a global call toward cervical cancer elimination, a historic decision on abortion rights in Ireland and a record number of women seeking (and achieving) government office in the United States and around the world. This year, the 25th anniversary of the International Conference on Population and Development (ICPD) facilitates reflections on not just the past year, but the past 25 years of achievements in global reproductive health. The momentous discussion at the ICPD in Cairo, Egypt and the resultant 20-year Programme of Action were pivotal in shaping the agenda in women’s health around...
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The Nairobi Summit on the International Conference on Population and Development (ICPD25)

The Nairobi Summit on the International Conference on Population and Development (ICPD25)

From November 10-12, Kenya hosted an international conference with over 9,500 participants from more than 170 countries with a single shared purpose: to achieve the ICPD25 goals. These goals were termed “the three zeroes” - zero maternal mortality, zero unmet needs for family planning and zero tolerance towards gender-based violence. The conference seemed to be a massive success, generating over 1,250 commitments by governments, donors, businesses, non-governmental organizations, civil society and other actors to support work towards the three zeroes. This summit marks the 25th anniversary of the first International Conference on Population and Development held in Cairo. It sought to ensure the continuation of the global promise to prioritize women made at that first conference, where the world agreed that sexual and reproductive health is a human right. Although the support initiated by the conference is promising, there are some challenges to meeting these ambitious goals. According to Dr. Joia Crear Perry, President of the National Birth Equity collaborative in the...
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Global Health Security Agenda Annual Report

Global Health Security Agenda Annual Report

Article by Diya Ginjupalli In May of 2019, the White House released the first U.S. Global Health Security Strategy. This document outlined the United States Government’s approach to preventing and responding to infectious diseases both domestically and globally. In November of 2019, the White House released the annual report "Advancing the Global Health Security Agenda: Results and Impacts of U.S. Government Investments," which illustrated their continued efforts towards global health. The report specified the current strategies used by the United States Government to ensure global health security. The United States is currently partnering with 32 countries and has pledged over one billion dollars in funding for these countries. The focus for the upcoming year falls in eleven "Global Health Security Action Packages": antimicrobial resistance, zoonotic diseases, biosafety & biosecurity, immunization, national laboratory system, real-time surveillance, reporting, workforce development, emergency operations centers, linking public health with law enforcement & multisectoral rapid response, and medical countermeasures & personnel development. These action packages span...
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Hurricane Maria’s Effect on Abortion Care in Puerto Rico

Hurricane Maria’s Effect on Abortion Care in Puerto Rico

Article by Jackie Vicksman In 2017, two weeks after Hurricane Irma, Hurricane Maria hit the already-struggling Caribbean. Hurricane Maria was a category 5 storm that affected several islands, including Puerto Rico. After a natural disaster, births rates normally rise due in part to increased sexual activity, but more-so a lack of access to adequate contraceptives and other reproductive services. With pharmacies, hospitals, and free clinics closed down, women have very limited options when it comes to family planning after a natural disaster. This includes abortion services. In the case of Puerto Rico, only one of six abortion clinics was still open after the hurricane hit. Vale Moreno, the director of the clinic, explained that the biggest challenge for women seeking abortions in the aftermath of the hurricane was transportation. The journey to the clinic from more rural areas was uncertain, as road conditions were often poor, which made getting an abortion much more difficult. Additionally, women were realizing that they were...
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“Husbands Schools” in the Sahel Region of Africa

“Husbands Schools” in the Sahel Region of Africa

Article by Jackie Vicksman Since 2008, the UNFPA has been supporting “husbands schools,” where facilitators lead conversations and lessons with men in local communities in order to improve their general understanding of women’s unique experiences and hardships. Lessons focus on women’s health risks, empowerment, and human rights. The schools serve as a component of the Sahel Women’s Empowerment and Demographic Dividend project (SWEDD), a region-wide program financed by the World Bank and implemented in seven of the countries that make up the African Sahel region. Its objective is to reduce intimate partner violence, expand girls’ education, and generally improve the social standing of women and girls. One such school in the Mamboué village of Burkina Faso has had strong results. The school meets weekly, with 16 men and 2 facilitators. One woman whose husband participates in the program spoke of how his work improved their relationship. She explained that prior to his participation, “there was discord in [her] household,” and after,...
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NGO Population Council to Develop Medication that Combines Contraception and HIV Therapy

NGO Population Council to Develop Medication that Combines Contraception and HIV Therapy

Article by Jackie Vicksman Population Council, a research-oriented NGO based in New York, has been pioneering research behind contraceptive multipurpose prevention technologies (cMPTs). Most recently, researchers have been developing a single product that combines contraception and Pre-Exposure Prophylaxis (PrEP) in order to reduce the risk of unintended pregnancy and HIV infection among young women in low and middle-income countries (LMICs). This product could contribute to both family planning initiatives and HIV prevention efforts. This project began in 2018 and is currently ongoing, yet researchers are unsure of when the product will be available to be tested and distributed. The team is particularly excited because one pill would make it easier for women to have control over their own reproduction and sexual health. The NGO is confident that this work will “confirm cMPT acceptability among young women and adolescent girls,” and will “explore the possibility of combining existing products into a single tablet and identify a clear pathway toward regulatory approval.”...
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The Language of “Abortion”: Why The Word Matters

The Language of “Abortion”: Why The Word Matters

Article by Diya Chadha This election cycle’s candidates are comprised of a diverse group, with representation of people from different racial/ethnic groups, sexual identities, religious backgrounds, geographic backgrounds, and more. They fall into different categories when it comes to where they stand on the democratic “spectrum” as well. More than ever before though, we’ve seen a strong contingent of very liberal, democratic socialist candidates for the presidency, in addition to politics in general. Because of the increasingly leftist policies that they’re proposing (especially when compared to the current state of U.S. politics), it has been interesting to see just how the candidates opt to speak about abortion and reproductive healthcare access, both as a women’s rights issue and a healthcare one. Interestingly, as progressive of a group as the candidates seem to be, they’re really failing when it comes to the way they talk about abortion in the explicit sense. At the last democratic debate, only two of the eight candidates asked...
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Looking to 2020 and The Future of Roe v. Wade

Looking to 2020 and The Future of Roe v. Wade

Article by: Diya Chadha Abortion and reproductive healthcare access at large have definitely been key areas of contention and policy focus under the Trump administration. Notably, the reform of Title X under the domestic gag rule and the passing of “heartbeat bills” in nearly 15 states have imposed serious limitations on women’s access to healthcare in the country. And, as much as we hail Supreme Court decisions to function as laws of the land, working to remedy some of the outdatedness of the Constitution, it is simply unreasonable to throw complete faith into the institution given how unorthodox politics have become. As can be seen with those aforementioned policy changes, it is clear that the legislative climate has become increasingly restrictive and less progressive, arguably working in the opposite direction of how it traditionally changes over time. Naturally, the interested portion of the public has been looking towards the 2020 candidates to see how they aim to combat the seemingly growing...
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Pilot Study: Use of mSaada Application to Address Cervical Cancer in Kenya

Pilot Study: Use of mSaada Application to Address Cervical Cancer in Kenya

Article by: Emmy Duerr At the DGRH Think Global Talk on October 15, Jacob Stocks presented his work on the mSaada mobile application platform. Prior to his pilot study, Stocks developed mSaada (meaning “support” in Swahili), an application designed to be a support tool for community-based cervical cancer screening for low-income communities. The app was intended to provide counseling/decision support for community health volunteers as well as patient and specimen tracking to better ensure follow up and patient retention. Stocks implemented a small (n = 19) 5-week pilot study in Migori and Kisumu between July and August of 2019. The pilot study consisted of six iterative feedback sessions with the goal of refining the mSaada platform. The first week of the study involved three group sessions with four participants in each session, using a mixed methods approach of a combination of qualitative in-depth interviews and quantitative usability surveys. Weeks 2-4 provided app developers time for feedback integration, and allowed them to implement...
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Reproductive Health Panel Hosted by PPGA, Empower Her Voice, and NARAL-NC

Reproductive Health Panel Hosted by PPGA, Empower Her Voice, and NARAL-NC

Article by: Diya Chadha On Monday, October 14, two women empowerment and health-focused student groups, Planned Parenthood Generation Action and Empower Her Voice, partnered with NARAL-NC, a pro-choice advocacy group to host a reproductive health panel on campus at the Freeman Center. Lynne Walter from NARAL-NC, Dr. Jonas Schwartz from Duke University Hospital, Gloria de los Santos from The Action Network, and Dani Hoffpauir from Planned Parenthood answered a series of moderated questions on the topics of the Hyde Amendment and the rising influence of pregnancy crisis centers/clinics in North Carolina. Two specific points that they brought attention to were the amount of funding directed from the state towards such emergency clinics and the subsequent negative impact that the clinics have on the healthcare options available to women, as well as the evolving narrative around the idea of abortion and healthcare access in the changing domestic political climate. In the state of North Carolina, crisis pregnancy centers receive nearly $1.3 million in state...
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