Table 5.
Multilevel Mixed-Effects Generalized Linear Regression Analysis for Receipt of Respectful Care—Kigoma Region, Tanzania, April–July 2016 (Clients n = 935, Providers n = 249)
| Respectful Maternity Care Dimension 1: Friendliness, Comfort, and Attention | Respectful Maternity Care Dimension 2: Information and Consent | Respectful Maternity Care Dimension 3: Non-abuse and Kindness | ||||
|---|---|---|---|---|---|---|
| Fixed Effects - Client Level Variables | Adjusted Coefficient (95% CI) | P-value | Adjusted Coefficient (95% CI) | P-value | Adjusted Coefficient (95% CI) | P-value |
| Client age in years | ||||||
| 15 to 19 (reference) | ||||||
| 20 to 29 | 0.29 (−0.14−0.71) | 0.185 | −0.20 (−0.45−0.06) | 0.131 | 0.01 (−0.27−0.29) | 0.927 |
| 30 to 39 | 0.63 (0.14−1.13) | 0.012 | −0.17 (−0.52−0.19) | 0.361 | −0.02 (−0.30−0.27) | 0.910 |
| 40 to 49 | 0.79 (0.18−1.39) | 0.011 | −0.22 (−0.90−0.45) | 0.516 | −0.20 (−0.67−0.27) | 0.393 |
| Don’t know | 0.51 (−0.09−1.10) | 0.094 | 0.29 (−0.12−0.70) | 0.165 | −0.85 (−1.87−0.17) | 0.103 |
| Highest education attended | ||||||
| No education (reference) | ||||||
| Primary | NA | −0.19 (−0.43−0.05) | 0.128 | NA | ||
| Secondary | NA | 0.20 (−0.27−0.68) | 0.402 | NA | ||
| College or University | NA | −0.24 (−0.78−0.30) | 0.385 | NA | ||
| Total live births | ||||||
| 0 to 2 (reference) | ||||||
| 3 or more | −0.14 (−0.45−0.17) | 0.363 | −0.13 (−0.39−0.14) | 0.350 | NA | |
| Socioeconomic status | ||||||
| Low wealth (reference) | ||||||
| Low middle wealth | NA | −0.12 (−0.47−0.22) | 0.486 | NA | ||
| Middle wealth | NA | −0.02 (−0.31−0.26) | 0.872 | NA | ||
| High middle wealth | NA | −0.24 (−0.51−0.04) | 0.089 | NA | ||
| High wealth | NA | −0.12 (−0.49−0.26) | 0.540 | NA | ||
| Frequency of attendance at religious services | ||||||
| Attends less often than weekly (reference) | ||||||
| Attends at least weekly | NA | −0.31 (−0.60−[−0.02]) | 0.035 | NA | ||
| Marital status | ||||||
| Not in a union (reference) | ||||||
| In a union | NA | NA | 0.27 (−0.10−0.64) | 0.159 | ||
| Companionship in labor | ||||||
| No (reference) | ||||||
| Yes | NA | 0.37 (0.06−0.68) | 0.020 | 0.12 (−0.08−0.31) | 0.253 | |
| Companionship at time of delivery | ||||||
| No (reference) | ||||||
| Yes | NA | 0.10 (−0.32−0.52) | 0.635 | NA | ||
| Self-reported delivery complications | ||||||
| No (reference) | ||||||
| Yes | −0.41 (−0.72−[−0.10]) | 0.010 | NA | −0.29 (−0.60−0.02) | 0.071 | |
| Fixed effects - Provider-level variables | ||||||
| Provider age in years | ||||||
| 20−29 (reference) | ||||||
| 30−39 | NA | −0.34 (−0.63−[−0.05]) | 0.023 | 0.14 (−0.06−0.34) | 0.178 | |
| 40−49 | NA | −0.58 (−0.86−[−0.29]) | 0.000 | 0.03 (−0.20−0.27) | 0.777 | |
| 50+ | NA | −0.09 (−0.41−0.23) | 0.585 | 0.34 (0.09−0.58) | 0.007 | |
| Cadre | ||||||
| Clinician (reference) | ||||||
| Nurse/midwife | −0.46 (−0.89−[−0.03]) | 0.038 | NA | −0.02 (−0.27−0.24) | 0.881 | |
| Other staff | 0.33 (−0.27−0.92) | 0.287 | NA | −0.10 (−0.45−0.25) | 0.560 | |
| Training and practice | ||||||
| Delivery ever-training summative index, possible range 0 to 25 | 0.03 (−0.04−0.09) | 0.402 | NA | 0.01 (−0.01−0.03) | 0.356 | |
| Delivery pre-service summative index, possible range 0 to 25 | 0.01 (−0.04−0.06) | 0.730 | NA | NA | ||
| Delivery in-service summative index, possible range 0 to 25 | NA | NA | 0.00 (−0.01−0.02) | 0.550 | ||
| Recent delivery practice summative index (in last 3 months), possible range 0 to 25 | −0.02 (−0.07−0.02) | 0.333 | NA | NA | ||
| Number of deliveries attended in last month | ||||||
| 1 to 10 | ||||||
| 11 to 20 | −0.35 (−0.67−[−0.02]) | 0.035 | −0.30 (−0.61−0.01) | 0.059 | −0.02 (−0.22−0.19) | 0.872 |
| 21 to 30 | 0.03 (−0.82−0.87) | 0.947 | −0.14 (−0.69−0.40) | 0.599 | −0.01 (−0.25−0.24) | 0.953 |
| More than 30 | 0.00 (−0.88−0.89) | 0.994 | 0.40 (−0.30−1.11) | 0.261 | −0.43 (−0.89−0.03) | 0.066 |
| Don’t know | 0.37 (−0.53−1.27) | 0.420 | −0.07 (−0.61−0.46) | 0.792 | −0.01 (−0.33−0.32) | 0.971 |
| Types of complications dealt with in last 1 month summative index | ||||||
| 0 of 4 types of complications dealt with - postpartum hemorrhage, eclampsia, obstructed labor, puerperal sepsis (reference) | ||||||
| 1 of 4 | 0.06 (−0.24−0.37) | 0.692 | NA | NA | ||
| 2 of 4 | −0.57 (−1.28−0.15) | 0.122 | NA | NA | ||
| 3 of 4 | −0.09 (−0.73−0.56) | 0.794 | NA | NA | ||
| 4 of 4 | −0.67 (−1.55−0.22) | 0.139 | NA | NA | ||
| Access to electronic mentoring opportunities | ||||||
| Access to 0 of 3 types of electronic mentoring - emergency call system, e-learning, teleconference (reference) | ||||||
| Access to 1 type | −0.08 (−0.64−0.48) | 0.775 | 0.02 (−0.37−0.40) | 0.938 | 0.10 (−0.10−0.29) | 0.334 |
| Access to 2 types | −0.17 (−0.85−0.51) | 0.621 | −0.05 (−0.48−0.38) | 0.827 | 0.36 (0.07−0.65) | 0.014 |
| Access to 3 types | −0.74 (−1.49−0.01) | 0.054 | 0.14 (−0.43−0.71) | 0.631 | 0.25 (−0.08−0.59) | 0.134 |
| Work environment | ||||||
| Perception paid fairly for job duties | 0.46 (0.04−0.88) | 0.032 | 0.37 (0.06−0.68) | 0.019 | NA | |
| Perception in-service training has helped job performance | −0.31 (−0.74−0.12) | 0.156 | NA | NA | ||
| Work hours per week | NA | 0.01 (0.00−0.02) | 0.022 | NA | ||
| Random effects | ||||||
| Provider-level variance (SE) | 0.86 (0.29) | 0.57 (0.11) | 0.04 (0.04) | |||
| Provider-level variance partition coefficient | 0.18 | 0.24 | 0.03 | |||
| Level 1 units | 935 | 935 | 935 | |||
| Level 2 units | 249 | 249 | 249 | |||
| Log likelihood | −2032.0704 | −1685.2573 | −1492.6216 | |||
NOTE: CI Confidence Intervals, NA Not Applicable, SE Standard Error