Economic Sanctions and Maternal Mortality

Economic Sanctions and Maternal Mortality

As this academic year comes to a close, so does my two-year tenure as the Duke Global Health Institute Doctoral Scholar working with the Center for Global Reproductive Health. I have been so fortunate to be mentored by Dr. Huchko and the staff both here in Durham and in Kisumu. A true highlight has been collaborating with community partners as well as undergrads and grad students here at Duke. Pei-Yu Wei, another PhD student and I started a project investigating the impact of economic sanctions on women’s rights and maternal mortality, which we recently had the opportunity to present at a national conference and two academic workshops. Economic sanctions are policy instruments used to influence the behavior of another international actor. While generally a less harmful method for countries to settle disputes compared to military force, sanctions still have the ability to adversely affect the civilian population in the targeted state. Much research has been done on the negative consequences of...
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Director’s Blog May 2021

Director’s Blog May 2021

Amid the familiar bursts of color and warm breezes that call us back outdoors for another glorious North Carolina spring, there are signs of a return to a pre-pandemic way of life. In light of increasing vaccinations and decreasing case numbers, Governor Cooper lifted the mask mandate at the beginning of May, with a plan to end most of the Covid-related restrictions in June. Duke was able to hold an in-person graduation, and is committed to having all students back on campus in the fall. So, while there is still a long road ahead of us, it’s reassuring to see some tangible plans for a return to normalcy. As we start to recover from the pandemic, this quarter’s newsletter focuses on what true healing looks like. Although everyone’s experience was unique, the pandemic undoubtedly brought some loss to all of us, whether in the form of isolation, missed opportunities, or, for too many of us, the loss of family or loved...
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How male reproductive health is impacted by location

In recent research conducted by researchers at the University of Nottingham, evidence has been found that suggests that the places where men live have the ability to affect their reproductive health. The study was conducted using dogs as a sentinel species, based upon their common proximity to humans and popularity as pets. The study analyzed the testes of dogs, searching for and evaluating levels of pathologies and irregularities present. Anthropogenic chemicals, those derived from environmental pollutants, have been hypothesized to be associated with an increased risk and prevalence of testicular cancer as well as with declines in semen quality in male reproductive health. Samples for this study were taken from different regions throughout the United Kingdom, [from the West Midlands, East Midlands and South East] as well as from Denmark and Finland for comparison. It was discovered that the samples from the different locations demonstrated varying levels of pathologies, indicating that certain populations were more at risk for experiencing negative effects...
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The Implications of the Newest Wave of Pre-Implantation Genetic Diagnosis and Testing on Global Inequality

In 1997, the film Gattaca was released and while it was not a commercial success, it did raise questions about the future of genetic technology. The movie predicted a dystopian future in which eugenics dictate the futures of humankind – those who are genetically “superior” rule over those who have less desirable genetic traits. In the movie this is done through a procedure where parents pick their embryos based on their genes prior to implantation (Maslin).  In reality, Pre-Implantation Genetic Diagnosis and Testing (PGD/T) has been around for almost 40 years. It involves the testing of genetic material from the blastula of a developing embryo that is external to the body (to be later implanted using embryo transfer). It is an extra step during the process of In-Vitro Fertilization (IVF), which begins with egg retrieval and sperm retrieval from both parents, and then fertilization occurs external to the womb to create an embryo. After the embryo reaches a certain size, a small number of cells are...
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Faculty Spotlight: Sara LeGrand or Liz Turner selected as part of WomenLift Health’s 2021 Global Leadership Journey cohort

Faculty Spotlight: Sara LeGrand or Liz Turner selected as part of WomenLift Health’s 2021 Global Leadership Journey cohort

Sara LeGrand Serving as an Associate Research Professor of Global Health and as the co-director of the Duke Sexual and Gender Minority Health Program, Sara LeGrand has done incredible work in exploring health care disparities worldwide through her research and her teaching. Across her 10 years at Duke, Dr. LeGrand’s research has investigated HIV prevention & disparities among sexual and gender minorities and developed digital health interventions to improve antiretroviral adherence. Her research on sexual and gender minorities also explores social determinants of health that affect mental, physical, and social health outcomes globally. Recently, Dr. LeGrand has recently been published in the International Journal of Transgender Health in the study “Mental health and challenges of transgender women: A qualitative study in Brazil and India”, exploring the lived experiences of transgender women in low - and middle - income countries with high rates of transphobia and gender-based violence.   Elizabeth Turner In her work as the Director of Duke Global Health Institute’s Research and Design...
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Cervical cancer screening and women’s empowerment in rural Kenya:  Identifying mechanisms for promoting empowerment and assessing resiliency in the wake of the COVID-19 pandemic

Cervical cancer screening and women’s empowerment in rural Kenya: Identifying mechanisms for promoting empowerment and assessing resiliency in the wake of the COVID-19 pandemic

The empowerment of women and girls in low and middle-income countries has long been recognized as a cornerstone of sustainable development. Yet despite billions in foreign aid spent on development projects annually, the international community is falling short on meeting the sustainable development goal (SDG) to achieve gender equality. The gendered impacts of the COVID-19 pandemic have provided further setbacks for women. However, incorporating mechanisms aimed at increasing women’s empowerment into existing and future development projects is one potential solution to close the gender gap. Indeed, interdependencies of the SDGs can encourage positive spillovers or downstream effects; efforts targeted at one SDG can also impact another. Following this assumption, it is possible for interventions aimed at SDG 3 (ensure healthy lives and promote well-being for all at all ages) to, for example, impact SDG 5 (achieve gender equality and empowerment of all women and girls). My dissertation project leverages these interdependencies and exploits an external health intervention targeted at women...
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Director’s Blog March 2021

Director’s Blog March 2021

Today, March 8, is the International Women’s Day (IWD) a global day to celebrate the social, economic, cultural and political achievements of women. It’s also the date that the Duke Center for Global Reproductive Health launched three years ago. This year’s theme for IWD is #choosetochallenge. Reflecting not only the immense challenges of the past year, but many of the longstanding gender and other biases that impact our world, the organizers have called on people around the world to challenge and call out gender bias and inequality while seeking out and celebrating women’s achievements. You can join the challenge here. Gender bias alone is not the only challenge impacting women’s health, health equity and equal participation in the workforce. February and March are Black history and Women’s history months, respectively. This past February, twenty leading health organizations released a statement designating February 28 and March 1 as dates to acknowledge the three enslaved women, Betsey, Lucy and Anarcha, who were experimented...
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Launch of the Kisumu Cervical Cancer Alliance Website

Launch of the Kisumu Cervical Cancer Alliance Website

On Thursday, January 14, the Kisumu Cervical Cancer Alliance held a Zoom meeting to review current plans and status of cervical cancer prevention in the region, and to launch their new website: www.kisumucanceralliance.org. The KCCA was started approximately three years ago to harmonize and increase the impact of cervical cancer prevention efforts among health care systems, non-profit organizations and government programs. Their mission is to “create an alliance of partners and stakeholder working to improve cancer screening, treatment and rehabilitation services in Kisumu County.” The website will serve as a resource for people interested in learning more about screening and vaccination and for women diagnosed with cervical cancer. Partners working in cervical cancer can share their work, and learn more about what control efforts in the region. The Kisumu first lady, Dorothy Nyongo, who has been a powerful advocate in cancer control for the region, was in attendance. She lauded the work, stating that “despite Covid, she is proud that...
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Abortion Rights, Global Aid, & COVID-19: How Do They all Tie Together?

Abortion Rights, Global Aid, & COVID-19: How Do They all Tie Together?

Ethiopian health clinics supporting teenagers have been shut down. Decades worth of HIV care integration and family planning progress have completely unraveled in Kenya (Henderson, 2020). The duties of government workers dedicated to traveling the Himalayas to share health related information have been stopped (Henderson, 2020). These are some of the effects from the implementation of President Trump’s 2017 global aid policy, “Protecting Life in Global Health Assistance.”  The “Protecting Life in Global Health Assistance,” also referred to as the “The Global Gag Rule,” has made lasting impacts under the Trump administration (Kaiser Family Foundation, 2020). This policy requires non-governmental organizations to refrain from using funds from U.S. and non-U.S. sources to promote or provide abortion care as a form of family planning (Kaiser Family Foundation, 2020). This policy is an extension of the Mexico City Policy which was first announced in 1984 at an international conference under President Reagan's administration and the policy has been in and out of effect...
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Challenges to Maternal Mental Health During the COVID-19 Crisis

Challenges to Maternal Mental Health During the COVID-19 Crisis

The current SARS-CoV-2 pandemic has devastated communities across the United States since early this spring and continues to do so on a global scale. The impact on maternal health and welfare, and by extension child health has not been lost on mothers across the world. Hospitals have closed their doors to visitors and accompanying loved ones for those seeking healthcare – victims of COVID-19 fight alone and too often succumb to the illness without their primary emotional support systems, but rather in isolated rooms with little human contact. In the case of pregnant and expectant mothers, this means potentially giving birth alone. These women are now also kept in isolation rooms, away from their families and loved ones, and surrounded by healthcare workers masked in personal protective equipment – a far cry from the societal norms previously established and long withstanding (Hermann, Fitelson, & Bergink, 2020). This newfound isolation and the impact of the pandemic extends to reaching antenatal care and...
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