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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Michele O’Shea and her recruitment observations in Kenya

By: Michele O'Shea During October to November 2021, I spent 6 weeks Kisumu Kenya working with our collaborators at Jaramogi Oginga Odinga Teaching and Referral Hospital. Our specific project is aimed at evaluating a new set of illustrations to assess for symptomatic pelvic organ prolapse and urinary incontinence. It is an early step in the process of understanding the burden of pelvic floor disorders in Kenya and informing strategies to better diagnose and treat patients with these conditions. As part of the study, we are asking patients presenting for outpatient care to tell us whether they have the symptoms represented in different illustrations of prolapse, urgency urinary incontinence and stress urinary incontinence. Then, to determine whether the patient clinically has symptomatic prolapse or urinary incontinence, we speak with the patient about her symptoms and perform a brief pelvic exam. From the study’s start, we were plagued by slow recruitment, primarily related to patients declining to undergo a pelvic exam. My co-investigators, Dr....
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Jacob Stocks and his experience working on mSaada

Jacob Stocks and his experience working on mSaada

Duke MsGH ’20, Jacob Stocks, talks about his experience working on an mHealth app to support cervical cancer screening in western Kenya.  The app was developed by four Duke seniors (‘T20) as part of their Computer Science Capstone course. Stocks’ experience co-designing the app with end-users, clinicians and community health volunteers in Kenya, was published recently in JMIR Formative Research. In 2019, I worked alongside members of the Center for Global Reproductive Health to develop and pilot test mSaada, a mobile phone app for use by lay-providers during cervical cancer screening. This experience was an exercise in self-reflection, flexibility, and perseverance, as the study team had to acknowledge the gaps in our intervention and work effectively and efficiently to address them while adapting to additional challenges as they arose. Our team, working face-to-face with local collaborators as well as virtually with app developers, conducted feedback sessions with community health volunteers and clinicians in Kisumu and Migori, Kenya. The main findings of this...
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From Dormmates to Research Collaborators

From Dormmates to Research Collaborators

In fall 2019, when Rachel Mundaden and Ramya Ginjupalli (T’22) applied to spend the following summer in Kisumu, Kenya, as part of the Center’s Student Research Training program, no one could have predicted the COVID-19 pandemic, and the resultant global disruptions in almost every aspect of people’s lives.  Travel and fieldwork were soon out of the question, but these two were able to pivot to develop the content expertise and skills in qualitative methods necessary to carry out an analysis of focus groups discussions designed to better understand stigma related to cervical cancer and human papillomavirus in Kenya.  They spoke to DGHI about their experience and how it felt to have a published manuscript resulting from this work. Check it out here: https://globalhealth.duke.edu/news/dormmates-research-collaborators    ...
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International Women’s Day 2022

International Women’s Day 2022

Today, March 8, marks International Women’s Day which is also the fourth anniversary of the Center for Global Reproductive Health at Duke.  This year’s theme for IWD is #BreaktheBias, challenging people to celebrate women’s achievement, raise awareness against bias and take action for equality. The United Nations is convening a series of events to highlight the link between gender, social equity and climate change, and call for more women’s voices to call for gender transformative solutions to the climate crisis.  The UN published a series of articles and resources about this year’s theme, and ways in which people everywhere can get involved and have their voices heard. The Economist has compiled a series of articles on women around the world, Twitter is alight with stories about how organizations are working toward equity and celebrated women, and Duke highlighted the work of leading women around campus. Happy International Women’s Day—add your own voice to this important day!...
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Director’s Blog February 2022

Director’s Blog February 2022

The new year often inspires us to reflect on our goals and priorities, an endeavor supported by a series of opportunities to recognize, learn about and celebrate different events and people. January was Cervical Cancer Awareness Month, February is Black History Month and March is Women’s History Month, including International Women’s Day on March 8. This year’s International Women’s Day theme is #BreaktheBias, offering to challenge various the biases people face around the world, including gender and race. The subjects explored over these months are all central to the work of the Center, and among other things, illustrate the impact of marginalization and discrimination on health outcomes. The intersection of race, gender and reproductive health is perhaps best shown by the experience of Henrietta Lacks, the Black woman whose cervical cancer cells gave rise to the immortal “HeLa” cell line. HeLa cells have played an extraordinary role in scientific research, underlying multiple Nobel Prize-winning discoveries and enabling medical advances for...
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Faculty Spotlight: An Interview with Dr. Sumedha Ariely

Dr. Sumedha Gupta Ariely is an associate Professor in the Global Health department and teaches courses such as Research methods in Global Health (GLHLTH371) and Global Health Ethics (GLHLTH373). She is also a faculty lead for Duke Global Health Institute’s Durham Research and Service work, demonstrating her commitment to the “Local-is-Global” approach in global health endeavors. She has mentored a variety of undergraduate and graduate students through Bass Connections and DukeEngage projects. In her research, she investigates maternal, child, and adolescent health across international contexts. Notable, she has worked extensively with Uganda, Kenya, and India across her time at Duke. Using her background in developmental psychology, she examines how cultural and social factors relate to a community’s health behaviors and outcomes. To explore more of Dr. Ariely’s revolutionary work, I interviewed her on her experiences and initiatives in the global health field during her time at Duke to see how they have informed her research. 1. You’ve led initiatives in the “Global Is...
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