Table 3.
Comparison of three-level mixed-effect models for fixed and random-effect estimates for DPT3 immunization among children between 12-59 months in two districts of Uttar Pradesh, India.
| Fixed effects | COR | M1 |
M2 |
M3 |
M4 |
M5 |
M6 |
M7 |
95% CI |
|---|---|---|---|---|---|---|---|---|---|
| AOR | AOR | AOR | AOR | AOR | AOR | AOR | |||
| Child's characteristics | |||||||||
| Age categories (Ref- 48 to 59 months) | |||||||||
| 12–23 months | 5.05*** | 4.87*** | 3.94*** | 3.97*** | 4.00*** | 4.61*** | 4.50*** | [2.65, 7.64] | |
| 24–35 months | 3.73*** | 3.66*** | 3.26*** | 3.25*** | 3.26*** | 3.77*** | 3.79*** | [2.36, 6.08] | |
| 36–47 months | 1.90** | 1.87** | 1.78** | 1.79** | 1.80** | 1.96** | 1.99** | [1.32, 3.00] | |
| Birth order (Ref- Firstborn) | |||||||||
| Not firstborn (second or third) | 2.26*** | 1.04 | 1.13 | 1.13 | 1.13 | 1.07 | 1.08 | [0.72, 1.63] | |
| Gender (Ref- Boy) | |||||||||
| Girl | 0.95 | ||||||||
| Facility for vaccination (Ref- AWC/VHND) | |||||||||
| Sub-centers | 0.92 | ||||||||
| PHC, CHC or Hospital | 0.71 | ||||||||
| Mother's characteristics | |||||||||
| Age categories (40–49 years) | |||||||||
| 15–19 year | 6.12** | 2.62 | 2.72 | 2.40 | 2.49 | 2.57 | [0.64, 10.32] | ||
| 20–29 years | 4.22*** | 2.27* | 2.36* | 2.18* | 2.32* | 2.35* | [1.10, 5.01] | ||
| 30-30 years | 2.42* | 1.76 | 1.78 | 1.69 | 1.72 | 1.77 | [0.83, 3.78] | ||
| Education (Ref-Illiterate) | |||||||||
| Up to primary | 1.86*** | 1.65* | 1.66* | 1.64* | 1.69** | 1.66* | [1.12, 2.46] | ||
| Above primary | 3.32*** | 2.60*** | 2.57*** | 2.53*** | 2.58*** | 2.59*** | [1.66, 4.02] | ||
| Occupation (Ref-Unemployed) | |||||||||
| Employed | 0.86 | ||||||||
| Knowledge of immunization | 1.51*** | 1.47*** | 1.47*** | 1.46*** | 1.43*** | 1.42*** | [1.19, 1.69] | ||
| Regular communication with FLWs (Ref- No) | |||||||||
| Yes | 1.74*** | 1.41* | 1.35 | 1.33 | 0.99 | 1.00 | [0.69, 1.45] | ||
| Knew about incurring VHNDs (Ref- No) | |||||||||
| Yes | 1.44* | 1.18 | 1.18 | 1.17 | 1.20 | 1.23 | [0.89, 1.70] | ||
| Freedom of decision making (Ref- No freedom at all) | |||||||||
| Freedom in very few decisions | 1.66* | 1.56 | 1.53 | 1.47 | 1.37 | 1.29 | [0.78, 2.14] | ||
| Freedom in some decisions | 1.63* | 1.61 | 1.62* | 1.58 | 1.42 | 1.35 | [0.84, 2.18] | ||
| Freedom in most decisions | 1.04 | 1.09 | 1.06 | 1.00 | 0.89 | 0.84 | [0.50, 1.42] | ||
| Freedom in all decisions | 1.26 | 1.06 | 1.02 | 0.97 | 0.93 | 0.87 | [0.49, 1.55] | ||
| Mother's Individual social capital | |||||||||
| Organizational participation | 1.02 | ||||||||
| Social support | 0.99 | ||||||||
| Trust | 1.13ᵃ | 1.27 | 1.26 | 1.24 | 1.09 | [0.77, 1.54] | |||
| Social cohesion | 1.11ᵃ | 0.90 | 0.91 | 0.93 | 1.02 | [0.74, 1.40] | |||
| Household Head's characteristics | |||||||||
| Gender (Ref: Male) | |||||||||
| Female | 0.86 | ||||||||
| Age categories (18–29 years) | |||||||||
| 30–39 years | 0.89 | ||||||||
| 40–49 years | 1.38 | ||||||||
| 50–59 years | 1.23 | ||||||||
| 60–69 years | 0.93 | ||||||||
| More than 70 years | 1.07 | ||||||||
| Occupation (Ref- Cultivator) | |||||||||
| Wage laborer | 0.80 | ||||||||
| Salaried worker | 1.16 | ||||||||
| Unemployed/Student/Housewife | 0.94 | ||||||||
| Education (Ref- Illiterate) | |||||||||
| Up to primary | 0.99 | ||||||||
| Above primary | 1.16 | ||||||||
| Knowledge of immunization | 1.09ᵃ | 1.03 | 1.03 | 1.03 | 1.02 | 1.02 | [0.9, 1.16] | ||
| Household Head's Individual social capital | |||||||||
| Organizational participation | 1.02 | ||||||||
| Social support | 1.04 | ||||||||
| Trust | 0.87ᵃ | 0.91 | 0.92 | 0.94 | 1.01 | [0.70, 1.47] | |||
| Social cohesion | 0.88ᵃ | 0.95 | 0.93 | 0.94 | 0.90 | [0.63, 1.29] | |||
| Household's characteristics | |||||||||
| Household Size (Member Number) | 0.95ᵃ | 0.96 | 0.95 | 0.95 | [0.88, 1.02] | ||||
| Religion (Ref- Hindu) | |||||||||
| Muslim and Others | 1.15 | ||||||||
| Caste (Ref- General) | |||||||||
| Scheduled Caste/Scheduled Tribe | 0.92 | ||||||||
| Other backward caste and others | 0.83 | ||||||||
| Household wealth (Ref- Quintile 1) | |||||||||
| Quintile 2 | 1.71* | 1.51 | 1.49 | 1.50 | [0.85, 2.65] | ||||
| Quintile 3 | 1.46ᵃ | 1.51 | 1.45 | 1.44 | [0.84, 2.44] | ||||
| Quintile 4 | 1.15 | 1.09 | 1.08 | 1.07 | [0.64, 1.78] | ||||
| Quintile 5 | 1.66* | 1.70* | 1.69* | 1.67* | [1.00, 2.77] | ||||
| Household financial stability (Ref- Worsen) | |||||||||
| Stable or Improved | 1.19 | ||||||||
| Community characteristics | |||||||||
| Census Block (Ref- Behadar) | |||||||||
| Kachhauna | 1.10 | ||||||||
| Kothwan | 0.70 | ||||||||
| Kasmanda | 0.75 | ||||||||
| Machhrehta | 1.29 | ||||||||
| Sidhauli | 0.86 | ||||||||
| Community size (Ref- Small) | |||||||||
| Medium | 0.71 | 0.69 | 0.67 | [0.43, 1.06] | |||||
| Large | 0.67ᵃ | 0.58* | 0.56* | [0.35, 0.89] | |||||
| Community-level scheduled caste population (Ref: Low) | |||||||||
| Medium | 1.18 | ||||||||
| High | 1.20 | ||||||||
| Community wealth | 1.37*** | 1.39** | 1.34** | [1.09, 1.64] | |||||
| Community average age of children (Months) | 1.03ᵃ | 1.06** | 1.05** | [1.02, 1.09] | |||||
| Community average mothers' education | 1.69* | 0.76 | 0.77 | [0.46, 1.29] | |||||
| Community average knowledge of immunization | 1.25** | 1.10 | 1.11 | [0.93, 1.34] | |||||
| Communities contact with the FLWs | 4.05*** | 4.80*** | 4.74*** | [2.12, 10.58] | |||||
| Improvement of the health service (Ref- No) | |||||||||
| Yes | 1.02 | ||||||||
| Presence of active VHSNC (Ref- No) | |||||||||
| Yes | 1.66** | 1.58* | 1.58* | [1.08, 2.32] | |||||
| Mothers' community-level social capital | |||||||||
| Organizational participation | 1.03 | ||||||||
| Social support | 0.86ᵃ | 0.84 | [0.67, 1.05] | ||||||
| Trust | 0.85ᵃ | 0.89 | [0.71, 1.11] | ||||||
| Social cohesion | 1.18ᵃ | 1.25* | [1.12, 1.54] | ||||||
| Household Head's community-level social capital | |||||||||
| Organizational participation | 1.02 | ||||||||
| Social support | 0.96 | ||||||||
| Trust | 0.88ᵃ | 0.86 | [0.7, 1.05] | ||||||
| Social cohesion | 0.98 | ||||||||
| Random effects | |||||||||
| Level 3: Community level variation (variance) | 1.16*** | 1.58*** | 1.39*** | 1.31*** | 1.34*** | 0.93*** | 0.88*** | [0.49, 1.59] | |
| ICC | 0.17 | 0.19 | 0.18 | 0.17 | 0.18 | 0.13 | 0.13 | [0.08, 0.20] | |
| Level 2: Household level variation (Variance) | 2.20*** | 3.42*** | 3.03*** | 2.97*** | 2.79*** | 2.94*** | 2.89*** | [1.62, 5.17] | |
| ICC |
0.51 |
0.60 |
0.57 |
0.57 |
0.56 |
0.54 |
0.53 |
[0.41, 0.66] |
|
| Observations | 2161 | 2161 | 2161 | 2161 | 2161 | 2161 | 2161 | ||
| Log-likelihood (LL) | -1407.59 | -1370.16 | -1323.65 | -1320.41 | -1316.25 | -1292.51 | -1288.06 | ||
| Akaike information criterion (AIC) | 2821.2 | 2754.3 | 2687.3 | 2688.8 | 2690.5 | 2659.0 | 2658.1 | ||
Note: *** = p < 0.001, ** = p < 0.01, * = p < 0.05, ᵃ = p < 0.2.
Regressions include data from 2161children of 12–59 months from 1705 households within 346 Gram Panchayats (PSU).
AOR = Adjusted odds ratio, AWC = Anganwadi Center, CHC = Community Healthcare Center, COR = Crud odds ratio, FLW = Front Line Health Workers, ICC = intra-class correlation, PHC = Primary Healthcare Center, VHND = Village Health and Nutrition Day, VHSNC = Village Health Sanitation and Nutrition Committee.