Table 5.
Multilevel analysis of factors associated with the effective coverage of antenatal care among pregnant women in Tanzania.
| Variables | Received Quality ANC care | COR (95% CI) | Model 1 AOR (95% CI) (With level one variables) | Model 2 AOR (95% CI) (With level two variables) | Model 3 AOR (95% CI) (With level one and two variables) | |
|---|---|---|---|---|---|---|
| Yes n (%) | No n (%) | |||||
| Individual level variables | ||||||
| Women's age (in years) | ||||||
| 15–19 | 135 (34.15) | 260 (65.85) | 1 | 1 | 1 | |
| 20–24 | 350 (32.96) | 711 (67.04) | 0.89 (0.66, 1.21) | 0.89 (0.61, 1.29) | 0.86 (0.6, 1.25) | |
| 25–29 | 450 (46.2) | 525 (53.8) | 1.57 (1.16, 2.13) | 1.57 (1.05, 2.35) | 1.46 (0.97, 2.18) | |
| 30–34 | 262 (37.95) | 429 (62.05) | 1.15 (0.84, 1.58) | 1.4 (0.88, 2.21) | 1.25 (0.79, 1.99) | |
| 35–39 | 227 (44.42) | 284 (55.59) | 1.54 (1.1, 2.16) | 2.13 (1.29, 3.54) | 1.77 (1.07, 2.95)* | |
| 40–44 | 94 (44.42) | 118 (55.58) | 1.63 (1.07, 2.47) | 2.66 (1.48, 4.77) | 2.14 (1.19, 3.85)* | |
| 45–49 | 10 (21.78) | 35 (78.22) | 0.56 (0.24, 1.33) | 0.97 (0.34, 2.75) | 0.77 (0.27, 2.18) | |
| Women's educational status | ||||||
| No education | 186 (24.17) | 585 (75.83) | 1 | 1 | 1 | |
| Primary education | 786 (37) | 1,339 (63) | 1.46 (1.16, 1.83) | 1.31 (1.01, 1.71) | 1.25 (0.96, 1.63) | |
| Secondary education | 513 (54.39) | 430 (45.61) | 2.5 (1.92, 3.28) | 1.65 (1.18, 2.32) | 1.46 (1.03, 2.06)* | |
| Higher education | 42 (83.26) | 9 (16.74) | 15.24 (6.42, 36.18) | 5.57 (2.05, 15.12) | 4.72 (1.74, 12.8)** | |
| Husbands’/partners’ educational level (n = 3,208) | ||||||
| No education | 118 (26.28) | 329 (73.72) | 1 | 1 | 1 | |
| Primary education | 677 (35.54) | 1,229 (64.46) | 1.07 (0.8, 1.43) | 0.88 (0.65, 1.19) | 0.86 (0.64, 1.17) | |
| Secondary education | 386 (52.75) | 345 (47.25) | 2.01 (1.44, 2.81) | 1.13 (0.78,1.64) | 1.12 (0.77, 1.62) | |
| Higher education | 77 (61.9) | 47 (38.1) | 3.09 (1.83, 5.25) | 0.85 (0.47, 1.55) | 0.97 (0.53, 1.76) | |
| Husbands’/partners’ occupation (n = 7,799) | ||||||
| Not employed | 68 (26.88) | 185 (73.12) | 1 | 1 | 1 | |
| Employed | 1,189 (40.25) | 1,766 (59.75) | 1.92 (1.35, 2.75) | 1.71 (1.18, 2.46) | 1.59 (1.1, 2.3)* | |
| Wealth index | ||||||
| Poorest | 211 (25.05) | 631 (74.95) | 1 | 1 | 1 | |
| Poorer | 208 (27.09) | 559 (72.91) | 1.09 (0.83, 1.42) | 1.03 (0.76, 1.39) | 1.01 (0.74, 1.36) | |
| Middle | 254 (33.63) | 501 (66.37) | 1.42 (1.08, 1.86) | 0.99 (0.72, 1.36) | 0.83 (0.6, 1.16) | |
| Richer | 372 (47.81) | 406 (52.19) | 2.68 (2.02, 3.56) | 1.63 (1.16, 2.29) | 1.2 (0.83, 1.75) | |
| Richest | 484 (64.61) | 265 (35.39) | 5.07 (3.74, 6.88) | 2.76 (1.87, 4.08) | 1.72 (1.09, 2.71)* | |
| Distance to a health facility | ||||||
| Big problem | 373 (28.66) | 929 (71.34) | 1 | 1 | 1 | |
| Not a big problem | 1,155 (44.63) | 1,433 (55.37) | 1.73 (1.42, 2.1) | 1.29 (1.03, 1.6) | 1.23 (0.76, 1.65) | |
| Parity | ||||||
| Low parity | 730 (41.55) | 1,026 (58.45) | 1.14 (0.93, 1.41) | 1.29 (0.88, 1.89) | 1.12 (0.76, 1.65) | |
| Multiparous | 505 (42.24) | 690 (57.76) | 1.28 (1.03, 1.6) | 1.32 (0.98, 1.76) | 1.19 (0.89, 1.6) | |
| Grand multiparous | 294 (31.27) | 645 (68.73) | 1 | 1 | 1 | |
| Number of ANC visits | ||||||
| Less than four visits | 274 (25.62) | 795 (74.38) | 1 | 1 | 1 | |
| Four visits and above | 1,254 (44.46) | 1,567 (55.54) | 1.97 (1.63, 2.39) | 1.6 (1.25, 2.05) | 1.58 (1.23, 2.03)** | |
| Timing of first ANC in months | ||||||
| Less than 4 months | 694 (46.61) | 795 (53.39) | 1 | 1 | 1 | |
| 4- 6 months | 775 (36.23) | 1,364 (63.77) | 0.75 (0.63, 0.89) | 1.01 (0.83, 1.23) | 1.01 (0.82, 1.23) | |
| 7 months and above | 59 (22.61) | 203 (77.39) | 0.44 (0.3, 0.63) | 0.78 (0.49, 1.25) | 0.8 (0.5, 1.28) | |
| Number of under five children | ||||||
| 0–1 | 727 (46.74) | 829 (53.26) | 1.64 (1.15, 2.35) | 1.38 (0.91, 2.09) | 1.09 (0.71, 1.66) | |
| 2–3 | 720 (35.12) | 1,329 (64.88) | 1.12 (0.79, 1.58) | 0.96 (0.64, 1.44) | 0.82 (0.54, 1.23) | |
| Four and above | 81 (28.45) | 204 (71.57) | 1 | 1 | 1 | |
| Community level variables | ||||||
| Administrative zones | ||||||
| Western | 64 (17.24) | 307 (82.76) | 1 | 1 | 1 | |
| Northern | 180 (49.24) | 186 (50.76) | 5.6 (3.09, 10.16) | 4.95 (2.87, 8.53) | 4.3 (2.38, 7.77)** | |
| Central | 148 (35.49) | 269 (64.51) | 2.61 (1.44, 4.73) | 2.74 (1.59, 4.71) | 2.5 (1.39, 4.49)** | |
| Southern highlands | 145 (69.63) | 63 (30.37) | 14.58 (7.59, 27.99) | 12.05 (6.57, 22.09) | 11.7 (5.94, 23.1)** | |
| Southern | 87 (50.73) | 85 (49.27) | 6.42 (3.23, 12.76) | 6.54 (3.48, 12.03) | 5.14 (2.52, 10.46)** | |
| South West highlands | 121 (34.57) | 229 (65.43) | 2.43 (1.35, 4.4) | 2.14 (1.24, 3.69) | 2.17 (1.2, 3.92)* | |
| Lake | 428 (31.89) | 914 (68.11) | 1.93 (0.1.14, 3.26) | 1.73 (1.07, 2.8) | 1.74 (1.03, 2.91)* | |
| Eastern | 281 (51.88) | 260 (48.12) | 6.49 (3.68, 11.47) | 3.59 (2.11, 6.11) | 3.29 (1.84, 5.88)** | |
| Zanzibar | 75 (59.88) | 50 (40.12) | 8.59 (4.42, 16.7) | 7.1 (3.81, 13.26) | 4.41 (2.22, 8.75)** | |
| Community level media exposure | ||||||
| Yes | 815 (49.5) | 832 (50.5) | 1.69 (1.42, 2.01) | 1.47 (1.23, 1.74) | 1.1 (0.89, 1.36) | |
| No | 713 (31.78) | 1,530 (68.22) | 1 | 1 | 1 | |
| Residence | ||||||
| Urban | 630 (57.5) | 466 (42.5) | 3.75 (2.85, 4.94) | 3.08 (2.36, 4.02) | 1.93 (1.37, 2.73)** | |
| Rural | 898 (32.13) | 1,896 (67.87) | 1 | 1 | 1 | |
| Measures of variation | ||||||
| Null model | Model 1 | Model 2 | Model 3 | |||
| Variance | 1.48 | 1.04 | 0.83 | 0.82 | ||
| ICC | 0.31 | 0.24 | 0.20 | 0.19 | ||
| AIC | 4873.46 | 3660.6 | 4482.98 | 3581.57 | ||
| BIC | 4885.97 | 3824.58 | 4558.06 | 3806.27 | ||
| PCV | Ref. | 29.73% | 43.92% | 44.59% | ||
| MOR 2.38 [95% CI: 2.06, 2.69] | ||||||
| Model fitness (Goodness of fit) | ||||||
| LLR | −2434.73 | −1803.3 | −2229.49 | −1753.78 | ||
| Deviance (− 2LLR) | 4869.46 | 3606.6 | 4458.98 | 3507.56 | ||
| LR-test | 368.58 | 217.58 | 261.9 | 175.33 | ||
AIC, Akaike information criteria; AOR, adjusted odds ratio; BIC, Bayesian information criteria; ICC, intra-class correlation coefficient; LLR, log-likelihood ratio; LR, likelihood ratio; MOR, median odds ratio; PCV, proportionate change in variance.
*
P-value <0.05.
**
P-value <0.01.