Table 2.
Multilevel logistic regression models assessing the relationship of delivery through caesarean section with health facility-, individual-, household-, and community-level factors (N = 4954).
| Characteristics | Null model | Health facility-level model, AOR (95% CI) | Health facility-, individual- and household-level model, AOR (95% CI) | Health facility-, individual-, household-, and community-level model, AOR (95% CI) |
|---|---|---|---|---|
| General health service readiness | ||||
| Health facility management system | 1.18 (0.98–1.36) | 1.16 (0.96–1.40) | 1.13 (0.91–1.42) | |
| Health facility infrastructure | 1.88 (1.08–2.18)∗∗ | 1.83 (1.05–2.08)∗∗ | 1.83 (1.04–2.07)∗∗ | |
| Comprehensive obstetric care availability in health facility | 3.17 (1.20–5.20)∗ | 3.13 (1.34–5.13)∗ | 3.14 (1.40–5.12)∗ | |
| Health facility readiness to provide comprehensive obstetric care | 2.76 (2.14–3.18)∗∗ | 2.24 (1.14–3.28)∗∗ | 2.18 (1.15–3.28)∗∗ | |
| Average distance to the nearest health facility | 0.84 (0.78–0.98)∗∗ | 0.78 (0.44–0.98)∗∗ | 0.72 (0.42–0.94)∗∗ | |
| Women's age | ||||
| ≤19 (ref) | 1.00 | 1.00 | ||
| 20–34 | 1.44 (1.20–1.71)∗∗ | 1.44 (1.21–1.72)∗∗ | ||
| ≥35 | 1.81 (1.20–2.73)∗∗ | 1.75 (1.16–2.64)∗∗ | ||
| Women's educational attainment | ||||
| No education (Ref) | 1.00 | 1.00 | ||
| Primary | 0.95 (0.65–1.38) | 0.94 (0.65–1.38) | ||
| Secondary | 1.42 (0.98–2.08) | 1.40 (0.96–2.05) | ||
| Higher | 2.12 (1.39–3.23)∗∗ | 2.11 (1.38–3.22)∗∗ | ||
| Women's employment status | ||||
| Not employed (ref) | 1.00 | 1.00 | ||
| Employed | 0.74 (0.63–0.86)∗∗ | 0.69 (0.58–0.80)∗∗ | ||
| Husbands' educational attainment | ||||
| No formal education (ref) | 1.00 | 1.00 | ||
| Primary | 1.07 (0.82–1.39) | 1.08 (0.83–1.41) | ||
| Secondary | 1.32 (1.01–1.74)∗ | 1.35 (1.03–1.77)∗ | ||
| Higher | 2.04 (1.47–2.83)∗∗ | 1.98 (1.42–2.75)∗∗ | ||
| Husbands' occupation status | ||||
| Agricultural worker (ref) | 1.00 | 1.00 | ||
| Physical worker | 1.09 (0.88–1.35) | 1.13 (0.91–1.39) | ||
| Services | 1.52 (1.05–2.21)∗ | 1.59 (1.10–2.30) | ||
| Business | 1.12 (0.88–1.43) | 1.17 (0.92–1.49) | ||
| Other | 0.53 (0.09–3.28) | 0.57 (0.09–3.49) | ||
| Total children ever born | ||||
| 1–2 (ref) | 1.00 | 1.00 | ||
| >2 | 0.64 (0.53–0.79)∗∗ | 0.67 (0.56–0.82)∗∗ | ||
| Intervals between the two most recent live births | ||||
| ≤2 years | 1.00 | 1.00 | ||
| 3–4 years | 1.11 (0.78–1.56) | 1.10 (0.78–1.55) | ||
| >4 years | 1.67 (1.23–2.27)∗∗ | 1.57 (1.15–2.14)∗∗ | ||
| Family types | ||||
| Nuclear (ref) | 1.00 | 1.00 | ||
| Joint | 0.90 (0.77–1.05) | 0.94 (0.80–1.10) | ||
| Household wealth status | ||||
| Richest (ref) | 2.37 (1.88–2.99)∗∗ | 1.00 | ||
| Richer | 1.12 (0.90–1.39) | 2.43 (1.90–3.11)∗∗ | ||
| Middle | 1.00 | 1.13 (0.91–1.41) | ||
| Poorer | 0.76 (0.60–0.95)∗∗ | 0.75 (0.60–0.95)∗∗ | ||
| Poorest | 0.48 (0.37–0.63)∗∗ | 0.49 (0.38–0.64)∗∗ | ||
| Type of residential place | ||||
| Urban (ref) | 1.00 | |||
| Rural | 1.00 (0.83–1.21) | |||
| Region of residence | ||||
| Barishal (ref) | 1.00 | |||
| Chattogram | 0.75 (0.54–1.05) | |||
| Dhaka | 1.40 (1.01–1.95)∗ | |||
| Khulna | 1.93 (1.37–2.72)∗∗ | |||
| Mymensingh | 1.19 (0.84–1.69) | |||
| Rajshahi | 1.64 (1.16–2.32)∗∗ | |||
| Rangpur | 1.35 (0.95–1.91) | |||
| Sylhet | 0.86 (0.60–1.22) | |||
| Random effects (Measures of variation for short birth interval) | ||||
| Community level variance (SE) | 0.91 (0.11)∗∗ | 0.59 (0.06)∗∗ | 0.51 (0.07)∗∗ | 0.42 (0.06)∗∗ |
| ICC | 0.216 | 0.095 | 0.073 | 0.050 |
| PCV | Reference | 35.16% | 43.95% | 53.85% |
| Median odds ratio | 2.48 | 1.75 | 1.63 | 1.44 |
| Model fit statistics | ||||
| AIC | 6126.08 | 5244.86 | 5208.38 | 4436.93 |
| BIC | 6139.11 | 5394.19 | 5409.66 | 4564.98 |
Note: Model 1 is the null model, a baseline model without any determinant variables. Model 2 is adjusted for health facility-level factors. Model 3 is adjusted for health facility-, individual- and household-level factors. Model 4 is adjusted for health facility-, individual-, household- and community-level factors. AIC: Akaike's Information Criteria, BIC: Bayesian Information Criteria, PCV: Percentage Change in Variance. ∗∗p < 0.01, ∗p < 0.05.