Browsing by Author "Beauclair, Roxanne"

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    Adverse outcomes associated with timing of antenatal care initiation a retrospective cohort study of pregnancies in Cape Town, South Africa
    (2012) Beauclair, Roxanne; Myer, Landon
    The medical community tends to advocate for early initiation of antenatal care (ANC) for the prevention of adverse birth outcomes. Despite this suggestion, the population impact of early ANC remains unclear. To this end, we have undertaken a retrospective cohort study of pregnant women using public perinatal services in Cape Town, South Africa. The study includes all women (n=35,473) from the CRADLE database who gave birth between 01 January 2007 and 31 December 2009 and had a booking examination between 01 April 2006 and 31 March 2009.
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    The association between timing of initiation of antenatal care and stillbirths: a retrospective cohort study of pregnant women in Cape Town, South Africa
    (BioMed Central, 2014-06-13) Beauclair, Roxanne; Petro, Greg; Myer, Landon
    Background: There is renewed interest in stillbirth prevention for lower-middle income countries. Early initiation of and properly timed antenatal care (ANC) is thought to reduce the risk of many adverse birth outcomes. To this end we examined if timing of the first ANC visit influences the risk of stillbirth. Methods: We conducted an analysis of a retrospective cohort of women (n = 34,671) with singleton births in a public perinatal service in Cape Town, South Africa. The main exposure was the gestational age at the first ANC visit. Bivariable analyses examining maternal characteristics by stillbirth status and gestational age at the first ANC visit, were conducted. Logistic regression, adjusting for maternal characteristics, was conducted to determine the risk of stillbirth. Results: Of the 34,671 women who initiated ANC, 27,713 women (80%) were retained until delivery. The population stillbirth rate was 4.3 per 1000 births. The adjusted models indicated there was no effect of gestational age at first ANC visit on stillbirth outcomes when analyzed as a continuous variable (aOR 1.01; 95% CI: 0.99-1.04) or in trimesters (2nd Trimester aOR 0.78, 95% CI: 0.39-1.59; 3rd Trimester OR 1.03, 95% CI: 0.50-2.13, both with 1st Trimester as reference category). The findings were unchanged in sensitivity analyses of unobserved outcomes in non-retained women. Conclusion: The timing of a woman’s first ANC visit may not be an important determinant of stillbirths in isolation. Further research is required to examine how quality of care, incorporating established, effective biomedical interventions, influences outcomes in this setting.
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    Development and disappointment : an ethnographic study of Kosovo informal settlement's water and sanitation system upgrade
    (2010) Beauclair, Roxanne; Spiegel, Andrew
    In the context of rapid urbanisation and growing numbers of informal settlements in peri-urban areas of Cape Town, South Africa, a development project was undertaken by the municipality, to provide Kosovo Informal Settlement with a new communal water and sanitation system that uses vacuum sewerage technology. This ethnographic study sought to establish the level of social acceptability of the new infrastructure postupgrade; to monitor how residents used the new and old water and sanitation systems; and to identify any other social or institutional barriers to providing water and sanitation services in similar contexts. It was found that the development project was a complete failure. This dissertation describes the ways in which the municipality engaged with residents and other stakeholders and shows how they contributed to the project's failure.