community health – Global Reproductive Health at Duke

Links Between Hormone Replacement Therapies and Increased Risk of Breast Cancer

September 2, 2019December 10, 2024 by Emily WoodrowNo Comments

Hormone replacement therapies (HRT) are often prescribed to women facing menopause to help relieve harsh symptoms like hot flashes and dryness. The transition of menopause often begins for women around the ages 45 and 55 and is caused by a shift in the body’s sex hormone production. Estrogen and progesterone are two of the most commonly used hormones and there are currently around 12 million users of HRT. A study recently published in the journal The Lancet based on an analysis of data from 58 other studies on HRT, revealed that the longer a woman uses HRT, the greater the risk she has of developing breast cancer. It also concluded that in comparison to women who use estrogen-only hormone therapies, women who use estrogen-progestogen hormone therapies have greater risks for breast cancer. This research is important for both doctors and women to take into consideration before deciding to begin hormone replacement therapy and Dr. Janice Rymer, gynecologist and vice president...

Federal Funded Family Planning Program New Rule

August 15, 2019December 9, 2024 by Emily WoodrowNo Comments

Title X is a federally funded family planning program for birth control and reproductive healthcare and it is particularly aimed at people with low incomes. Enacted in 1970 as part of the Public Health Service Act, Title X helps more than 4 million Americans each year. Under the Trump administration, a new rule would mandate providers receiving Title X funds to be separate from any providers that perform or refer to abortions. In regards to Planned Parenthood, this rule would prohibit all Planned Parenthood health centers from receiving Title X funds if any Planned Parenthood health center counseled on abortions or performed abortions. Legal challenges to this rule have led to injunctions; however, Planned Parenthood released a statement saying it will formally withdraw from the Title X program on August 19 unless a federal court intervenes. Officials from Planned Parenthood believe it is wrong to keep complete medical abortion information from clients, which the rule would require, and acting president...

Three Ground-Breaking HIV Studies

July 27, 2019December 9, 2024 by Emily WoodrowNo Comments

Three ground-breaking studies published in the New England Journal a few weeks ago reveal the benefits of door-to-door health workers, mobile clinics, and whole community testing in reducing the rate of new HIV infections in African Countries. The first study, the Ya T’sie trial, provided HIV testing, linkage to care, and early antiretroviral treatment to communities of Botswana; the second study, Search, focused on universal HIV treatment for communities in Uganda and Kenya; and the third study, PopART, implemented combination prevention intervention with ART in communities of Zambia and South Africa. The conclusion of these workings points to a 30 percent decrease in HIV incidence proving the success of these testing and treatment efforts. The key to the success is the idea of the “warm handoff” implemented in all three studies in which the health care workers ensured anyone who tested positive for HIV followed up at a clinic and did not forget. These studies are so important considering that...

Healthcare in the West African nation of Mali

July 14, 2019December 9, 2024 by Emily WoodrowNo Comments

The West African nation of Mali is one of the world’s poorest countries and has extremely high rates of maternal and child mortality. The WHO has approximated that costs of healthcare are a force pushing 100 million people across the globe into extreme poverty every year. So, in the area of Yirimadio during 2008, the community implemented a free door-to-door health-care plan sponsored by the government in order to ensure wellness and combat health ailments. After 7 years of the trial, the University of California collected data from the region and discovered that child mortality in the region dropped by 95%—marking the program as extremely successful. After this news, the President of Malawi announced the goal for the entire country by 2020 to have localized, free health care for pregnant women and children under the age of 5 to fight maternal and child mortality. This program will focus on training community health care workers, providing door-to-door services, and...

Important New Study Regarding Injectable Contraceptives

June 23, 2019December 9, 2024 by Emily WoodrowNo Comments

There is an unmet need affecting 47% of women in Africa who want modern contraception in order to prevent pregnancy. During the last few years, there has been an increase in the use of injectable contraceptives, such as Depo-Provera, across the continent specifically in Mali, Sierra Leone, Chad, Ethiopia, Kenya, and Uganda. Many African women rely on these types of shots because they are more easily concealable compared to other forms of contraception such as a daily birth control pill. Also, in some health clinics, these shots are the only method of contraception offered. Many women need secret protection due to men refusing condoms and the women wanting to avoid any social, physical, and mental consequences they may endure if they are found trying to keep away from pregnancy. A specialist in HIV at Britain’s Medical Research Council, Dr. Sheena McCormack, stated that African women’s, “husbands or partners, and their families, often want them to have children.” Along with the...

Stakeholders Meeting on Palliative Care and Treatment of Cervical Cancer

June 23, 2019December 9, 2024 by Jacob StocksNo Comments

By: Jacob B. Stocks & Sandra Yvonne Oketch - June 18th, 2019 On May 23rd, 2019, a stakeholders meeting on palliative care and treatment of cervical cancer for partners in Kisumu County was hosted at the KMET Complex in Kisumu. The main objectives of the meeting were 1) to share experiences on palliative care and cervical cancer services in Kisumu County and 2) to identify opportunities for networking and collaboration among partners. The 7-hour meeting began with a discussion of structural barriers to effective referral and treatment of cervical cancer in Kisumu County. The presenter, Brenda Otieno, discussed barriers such as the complexity of intra-facility referrals and client tracking, the lack of centrally located data on cancer patients (i.e. lack of a county-level cancer registry), and the lack of financial protection for clients seeking treatment. Following this session, Dr. Chemtai Mungo, an OB/GYN from UCSF, presented the evidence for cervical cancer screening via HPV testing by citing multiple studies discussing the cost-effectiveness...

OMEGA FOUNDATION MEETING WITH HARUN KODIAGA – HEAD OF PROGRAMS

June 4, 2019December 6, 2024 by Faith OtewaNo Comments

I had the opportunity to meet with Harun, the Head of Programs at the Omega Foundation (OF) at the Kisumu Office. The OF mission is, “to strengthen the capacity of communities to live meaningful lives through integrated health and innovative livelihood solutions” across 12 counties in Kenya: Kisumu, Siaya, Migori, Homa Bay, Busia, Bungoma, Nandi, Uasin-Gishu, Kakamega, Vihiga, and Bomet. OF undertakes various projects including Sexual and Reproductive Health Service Delivery and Advocacy projects funded by Planned Parenthood Global. The projects are being implemented in Kisumu, Siaya, and Homa Bay counties respectively with an objective to increase awareness of, access to, and use of quality family planning (FP) and Post Abortion Care (PAC) services. Twenty facilities in Kisumu are supported in delivery of the services and focus on strengthening the capacity of partners to provide facility-based FP and PAC services and advocate for expansion of Sexual and Reproductive Health (SRH) rights and services. To achieve their goals, the OF supports provision of...

Kisumu Nurse Spotlight: Everline Oruko

April 30, 2019December 6, 2024 by Faith OtewaNo Comments

Everline Oruko is a nurse at Migosi sub-County Hospital, one of three sites in Kisumu, Kenya, that offers cervical cancer screening and treatment. As the Nursing Officer in Charge, Everline leads a team of nurses and staff to improve uptake of cervical cancer screening and cryotherapy treatment for those who test positive. Despite many fits and starts, Everline has remained a constant in the effort to reduce cervical cancer among women in Kisumu. Our Kisumu site coordinator, Faith Otewa, sat down with Everline to talk about her job and her commitment to her work in cervical cancer prevention: Everline was first employed by the Ministry of Health at Ahero Health Facility after she graduated in 1993 with a Diploma in Nursing. She further enrolled for certificate courses in Counseling and HIV Testing Services (HTS) because she felt these would make her service delivery better. Everline then became sponsored for a course in counseling supervision because of her commitment at work. Upon...

South Korea Poses Amendment for Anti-Abortion Law

April 14, 2019December 6, 2024 by Emily WoodrowNo Comments

South Korea has fostered an anti-abortion law for 66 years which names abortion a crime with repercussions of heavy fines and women facing up to a year in jail and doctors facing up to two years. Last Thursday, South Korea’s Constitutional Court ruled this law unconstitutional and concluded that Parliament must revise the law by 2020 or else it will become invalid. There are a few exceptions to the law which allow for abortions under the situations of pregnancy from rape or incest, pregnancy which poses great risk to the mother’s health, or pregnancy that will result in a child with a serious deformity. However, a study does prove that since the law has been enacted, there have been huge amounts of illegal abortions—49,7000 abortions took place in 2017 and an estimated 94% of those were performed illegally. There also seems to be a general shift in trends of what South Koreans think of abortion because a poll shows that...

Introducing the New mSaada Mobile App for Community Health Volunteers

March 26, 2019December 6, 2024 by Stacey DixsonNo Comments

Guest Blog by Catie Grasse Meaning "help" in Swahili, the mobile "saada" application aims to improve the efficacy and efficiency of community health volunteers screening patients for cervical cancer in Kisumu, Kenya. This project is the extension of a previous project for the Duke class CS408: Delivering Software to Client, which pairs student developers and designers with a client team to build a specialized application. The mSaada developer team is composed of four Duke seniors: Our designer, Rachel Settle is a Computer Science major, Visual Media Studies minor, and pursuing the Information Science certificate. Working on the user experience is Carly Levi, a senior studying Computer Science and Global Health who is particularly interested in women's and reproductive health and hopes to use her background in technology to come up with effective interventions around the world. Focusing on the back-end database design is Catie Grasse, a senior majoring in Computer Science and minoring in Visual Media Studies. Also working on the...