Table 3. Multilevel logistic regression of individual and contextual factors associated with barriers to healthcare among women in SSA.
| Variables | Model I | Model II AOR [95%CI] |
Model III AOR [95%CI] |
Model IV AOR [95%CI] |
|---|---|---|---|---|
| Individual level factors | ||||
| Age | ||||
| 15–19 | 1.099*** | 0.986 | ||
| [1.053–1.147] | [0.944–1.030] | |||
| 20–24 | 1.096*** | 1.014 | ||
| [1.054–1.139] | [0.975–1.055] | |||
| 25–29 | 1.031 | 0.986 | ||
| [0.994–1.069] | [0.950–1.023] | |||
| 30–34 | 0.972 | 0.953** | ||
| [0.938–1.007] | [0.920–0.988] | |||
| 35–39 | 0.951** | 0.945** | ||
| [0.917–0.986] | [0.911–0.980] | |||
| 40–44 | 0.978 | 0.972 | ||
| [0.941–1.016] | [0.935–1.011] | |||
| 45–49 | Ref | Ref | ||
| Marital status | ||||
| Never married | 0.836*** | 0.834*** | ||
| [0.790–0.885] | [0.787–0.883] | |||
| Married | 0.690*** | 0.694*** | ||
| [0.656–0.726] | [0.658–0.732] | |||
| Cohabiting | 0.958 | 0.928* | ||
| [0.906–1.014] | [0.876–0.984] | |||
| Widowed | Ref | Ref | ||
| Divorced | 0.969 | 0.966 | ||
| [0.913–1.028] | [0.910–1.026] | |||
| Education | ||||
| No education | 2.265*** | 1.803*** | ||
| [2.161–2.374] | [1.718–1.891] | |||
| Primary | 1.988*** | 1.676*** | ||
| [1.900–2.080] | [1.601–1.756] | |||
| Secondary | 1.570*** | 1.438*** | ||
| [1.504–1.638] | [1.378–1.501] | |||
| Higher | Ref | Ref | ||
| Employment | ||||
| Not working | 1.552*** | 1.449*** | ||
| [1.429–1.685] | [1.334–1.573] | |||
| Managerial | 1.186*** | 1.156** | ||
| [1.086–1.295] | [1.058–1.263] | |||
| Clerical | Ref | Ref | ||
| Sales | 1.323*** | 1.280*** | ||
| [1.218–1.438] | [1.178–1.391] | |||
| House/domestic | 1.403*** | 1.409*** | ||
| [1.273–1.547] | [1.278–1.553] | |||
| Agricultural | 2.275*** | 1.909*** | ||
| [2.093–2.473] | [1.755–2.075] | |||
| Services | 1.537*** | 1.420*** | ||
| [1.411–1.674] | [1.303–1.548] | |||
| Manual | 1.588*** | 1.551*** | ||
| [1.458–1.729] | [1.424–1.689] | |||
| Parity | ||||
| None | Ref | Ref | ||
| 1–3 | 1.075*** | 1.016 | ||
| [1.044–1.106] | [0.987–1.046] | |||
| 4+ | 1.343*** | 1.211*** | ||
| [1.296–1.391] | [1.169–1.255] | |||
| Health insurance coverage | ||||
| No | 1.251*** | 1.284*** | ||
| [1.216–1.287] | [1.248–1.322] | |||
| Yes | Ref | Ref | ||
| Frequency of listening to radio | ||||
| Not at all | 1.433*** | 1.399*** | ||
| [1.365–1.506] | [1.331–1.470] | |||
| Less than once a week | 1.278*** | 1.296*** | ||
| [1.215–1.344] | [1.231–1.364] | |||
| At least once a week | 1.155*** | 1.174*** | ||
| [1.100–1.214] | [1.117–1.234] | |||
| Almost every day | Ref | Ref | ||
| Frequency of reading newspaper or magazine | ||||
| Not at all | 1.034 | 1.03 | ||
| [0.942–1.135] | [0.937–1.132] | |||
| Less than once a week | 0.893* | 0.896* | ||
| [0.813–0.982] | [0.814–0.986] | |||
| At least once a week | 0.880** | 0.893* | ||
| [0.800–0.968] | [0.811–0.983] | |||
| Almost every day | Ref | Ref | ||
| Frequency of watching television | ||||
| Not at all | 1.151*** | 0.907*** | ||
| [1.101–1.204] | [0.866–0.950] | |||
| Less than once a week | 0.778*** | 0.706*** | ||
| [0.741–0.816] | [0.673–0.742] | |||
| At least once a week | 0.577*** | 0.598*** | ||
| [0.551–0.604] | [0.571–0.626] | |||
| Almost every day | Ref | Ref | ||
| Contextual factors | ||||
| Sex of household head | ||||
| Male | 0.990 | 1.000 | ||
| [0.973–1.007] | [0.981–1.020] | |||
| Female | Ref | Ref | ||
| Wealth status | ||||
| Poorest | Ref | Ref | ||
| Poorer | 0.730*** | 0.785*** | ||
| [0.710–0.749] | [0.764–0.806] | |||
| Middle | 0.567*** | 0.658*** | ||
| [0.552–0.582] | [0.641–0.676] | |||
| Richer | 0.435*** | 0.570*** | ||
| [0.424–0.447] | [0.554–0.586] | |||
| Richest | 0.274*** | 0.457*** | ||
| [0.266–0.282] | [0.443–0.472] | |||
| Place of residence | ||||
| Urban | Ref | Ref | ||
| Rural | 1.499*** | 1.235*** | ||
| [1.458–1.262] | [1.209–1.262 | |||
| N | 307,611 | 307,611 | 307,611 | |
| Parameters | ||||
| Community-level variance (SE) | 0.43(0.022) | 0.29(0.017) | 0.34(0.019) | 0.27(0.175) |
| ICC (%) | 11.7% | 8.1% | 9.6% | 8.2% |
| Log-likelihood | -201775.6 | -189152.7 | 191013.06 | -186503.04 |
| LR Test | 5866.45 (p<0.001) | 3772.84 (p<0.001) | 4522.01 (p<0.001) | 3839.23 (p<0.001) |
| AIC | 403555.2 | 378367.5 | 382042.1 | 373086.1 |
| BIC | 403576.5 | 378697.2 | 382127.2 | 373511.5 |
Exponentiated coefficients; 95% confidence intervals in brackets.
* p < 0.05
** p < 0.01
*** p < 0.001.
SE = Standard Error; ICC = Intra-Class Correlation; LR Test = Likelihood ratio Test; AIC = Akaike’s Information Criterion; BIC = Schwarz’s Bayesian Information Criteria.
Model I is the null model, a baseline model without any determinant variable.
Model II = individual level variables.
Model III = Contextual level variables.
Model IV is the final model adjusted for individual and Contextual level variables.