Megan Justine Huchko

Primary Theme: Information, Society & Culture

One-third of women who begin using a modern method of contraception in low-income countries discontinue within the first year, and half within the first two years, putting them at risk for unintended pregnancies as well as maternal morbidity and mortality. The current method of measuring contraceptive discontinuation (quitting, switching and method failure) relies on household surveys collected in five-year intervals through a retrospective monthly contraceptive calendar. This measurement provides a broad overview of discontinuation, but does not show the granular details often needed to develop programs to effect change.

Primary Theme: Global Health

Invasive cervical cancer affects 500,000 women worldwide each year. Unlike most cancers, it is highly preventable through the screening, diagnosis and treatment of cervical precursor lesions. Colposcopy with biopsy is the gold standard for diagnosis of precancerous lesions. However, colposcopes are expensive, and require referral to a facility that can house this machine as well as a trained colposcopist who can interpret the images. These factors make colposcopy inaccessible to the many women in low- and middle-income countries who are at greatest risk for developing cervical cancer. To address this limitation, Duke researchers have developed a device called the Pocket Colposcope. It is more than an order of magnitude less expensive and lighter than commercial colposcopes. The first year of this Bass Connections project in 2016-17 was dedicated to performing a global value chain analysis in order to identify leverage points that can increase the likelihood of adoption of the Pocket Colposcope in Peru. In 2017-18, team members focused on launching a community health provider program to implement the Pocket Colposcope at the primary care setting in Peru.