Table 3.
Results of linear mixed models of observed competent and respectful labour and delivery care in Malawi, 2013–2014 (standard errors clustered by facilities)
| Competent care (N = 474) | Respectful care (N = 473) | |||||
|---|---|---|---|---|---|---|
| Coeff † | LCL‡ | UCL | Coeff † | LCL‡ | UCL | |
| Patient | ||||||
| Time of day | ||||||
| Evening and night (18pm–6am) | ref | ref | ||||
| Afternoon (12pm–17pm) | 0.31 | −6.02 | 6.65 | 4.51 | −3.13 | 12.14 |
| Morning (7am–11am) | 0.31 | −5.99 | 6.61 | 4.20 | −3.00 | 11.41 |
| Age of the woman | ||||||
| 35+ | ref | ref | ||||
| 20–35 | 6.89*** | 2.52 | 11.27 | 5.24 | −1.75 | 12.24 |
| 19 or less | 6.18** | 2.71 | 9.66 | 3.38 | −4.60 | 11.36 |
| First childbirth | ||||||
| No | ref | ref | ||||
| Yes | 1.39 | −1.63 | 4.40 | 4.91* | 0.20 | 9.62 |
| HIV positive | ||||||
| No | ref | ref | ||||
| Yes | 4.48* | 0.10 | 8.86 | 4.45 | −2.05 | 10.96 |
| Provider | ||||||
| Gender | ||||||
| Male | ref | ref | ||||
| Female | 2.97 | −0.83 | 6.77 | 4.00 | −1.49 | 9.48 |
| Cadre | ||||||
| Lower§ | ref | ref | ||||
| Higher¶ | 3.72 | −0.05 | 7.49 | −2.50 | −8.17 | 3.17 |
| Facility | ||||||
| Location | ||||||
| Rural | ref | ref | ||||
| Urban | 3.59 | −0.60 | 7.77 | 1.29 | −4.92 | 7.51 |
| Type | ||||||
| Public health centre | ref | ref | ||||
| Private health centre, maternity or clinic | 2.64 | −2.11 | 7.40 | −2.52 | −8.72 | 3.68 |
| Public hospital | 0.54 | −4.17 | 5.25 | −6.03 | −12.37 | 0.31 |
| Private hospital | 7.35** | 2.67 | 12.03 | 0.19 | −6.50 | 6.87 |
| Clinical staff per maternity bed | ||||||
| Less than 3 | ref | ref | ||||
| 3 or more | 7.65** | 1.81 | 13.49 | 11.36* | 2.57 | 20.16 |
| Zones | ||||||
| Central east | ref | ref | ||||
| Central west | 0.46 | −4.64 | 5.57 | 1.19 | −6.33 | 8.71 |
| Northern | 0.90 | −4.44 | 6.24 | 0.65 | −8.05 | 9.35 |
| South east | 2.02 | −3.37 | 7.41 | 3.97 | −3.87 | 11.81 |
| South west | 2.59 | −2.56 | 7.74 | 0.94 | −7.48 | 9.35 |
| Intercept | 48.49 | 39.55 | 57.44 | 52.51 | 40.39 | 64.64 |
| Total variance | 173.86 | 374.47 | ||||
| Provider variance | 80.66 | 54.21 | 120.00 | 105.14 | 61.79 | 178.93 |
| Residual variance | 93.20 | 69.92 | 124.24 | 269.33 | 213.84 | 339.21 |
| Proportion of variance explained | 13.8% | 6.5% | ||||
A total of 474 deliveries were observed in Malawi but one woman was missing all nine respectful care indicators, leading to analytical samples of 474 and 473 respectively for each outcome.
The coefficient is the expected difference in visit quality (scale 0 to 100) given a 1 unit difference in the exposure, holding all other covariates constant.
Lower and upper confidence limits
Lower cadres include enrolled nurses and midwives, community health nurses and nurse aides.
Higher cadres include MDs, clinical technicians, medical assistants, BScN nurses and midwives and registered nurses and midwives.
*P ≤ 0.05, **P ≤ 0.01, ***P ≤ 0.001.