Table 3.
Multilevel results of individual-level, community-level and country-level predictors of intermittent preventive treatment of malaria during pregnancy with sulphadoxine-pyrimethamine uptake in sub-Saharan Africa
| Model 1 | Model 2 | Model 3 | Model 4 | ||||
| Empty model | aOR | (95% Crl) | aOR | (95% Crl) | aOR | (95% Crl) | |
| Fixed effects | |||||||
| Individual-level factors | |||||||
| Knowledge | 1 | (1 to 1) | 1 | (1 to 1) | 1 | (1 to 1) | |
| Low | |||||||
| Medium | 1.109** | (1.025 to 1.188) | 1.107** | (1.035 to 1.184) | 1.108** | (1.036 to 1.186) | |
| High | 1.296*** | (1.200 to 1.402) | 1.297*** | (1.202 to 1.400) | 1.298*** | (1.206 to 1.398) | |
| Acceptance of wife beating | |||||||
| Low | 1 | (1 to 1) | 1 | (1 to 1) | 1 | (1 to 1) | |
| Medium | 0.950 | (0.887 to 1.017) | 0.947 | (0.886 to 1.012) | 0.952 | (0.891 to 1.015) | |
| High | 0.941 | (0.877 to 1.008) | 0.937 | (0.869 to 1.010) | 0.941 | (0.874 to 1.012) | |
| Decision-making capacity | |||||||
| Low | 1 | (1 to 1) | 1 | (1 to 1) | 1 | (1 to 1) | |
| Medium | 0.943 | (0.864 to 1.030) | 0.938 | (0.861 to 1.021) | 0.939 | (0.862 to 1.022) | |
| High | 0.942 | (0.884 to 1.005) | 0.937 | (0.875 to 1.003) | 0.941 | (0.882 to 1.002) | |
| Labour force participation | |||||||
| Not working | 1 | (1 to 1) | 1 | (1 to 1) | 1 | (1 to 1) | |
| Working | 1.122* | (1.005 to 1.252) | 1.139* | (1.015 to 1.278) | 1.114 | (0.990 to 1.254) | |
| Age | |||||||
| 15–19 | 0.894 | (0.712 to 1.123) | 0.919 | (0.725 to 1.165) | 0.889 | (0.725 to 1.089) | |
| 20–24 | 1.050 | (0.878 to 1.255) | 1.082 | (0.892 to 1.313) | 1.046 | (0.886 to 1.234) | |
| 25–29 | 1.009 | (0.849 to 1.200) | 1.039 | (0.867 to 1.245) | 1.006 | (0.859 to 1.178) | |
| 30–34 | 1.042 | (0.879 to 1.234) | 1.071 | (0.896 to 1.280) | 1.037 | (0.887 to 1.213) | |
| 35–39 | 1.067 | (0.901 to 1.263) | 1.097 | (0.913 to 1.319) | 1.063 | (0.907 to 1.244) | |
| 40–44 | 1.108 | (0.927 to 1.327) | 1.137 | (0.937 to 1.380) | 1.103 | (0.932 to 1.306) | |
| 45–49 | 1 | (1 to 1) | 1 | (1 to 1) | 1 | (1 to 1) | |
| Wealth quintile | |||||||
| Poor | 1 | (1 to 1) | 1 | (1 to 1) | 1 | (1 to 1) | |
| Middle | 0.931 | (0.858 to 1.029) | 0.931 | (0.853 to 1.021) | 0.911 | (0.882 to 1.034) | |
| Rich | 0.941 | (0.858 to 1.057) | 0.933 | (0.843 to 1.015) | 0.915 | (0.841 to 1.077) | |
| Marital status | |||||||
| Married | 1 | (1 to 1) | 1 | (1 to 1) | 1 | (1 to 1) | |
| Not married | 1.095 | (0.812 to 1.254) | 1.322 | (0.893 to 1.801) | 1.081 | (0.739 to 2.06) | |
| Gravidity | |||||||
| 1 | 1.191*** | (1.082 to 1.311) | 1.180*** | (1.070 to 1.300) | 1.179*** | (1.073 to 1.295) | |
| 2 | 1.060 | (0.983 to 1.144) | 1.050 | (0.971 to 1.135) | 1.050 | (0.974 to 1.131) | |
| 3 | 1 | (1 to 1) | 1 | (1 to 1) | 1 | (1 to 1) | |
| ANC visit | |||||||
| No visit | 1 | (1 to 1) | 1 | (1 to 1) | 1 | (1 to 1) | |
| <4 | 0.927 | (0.918 to 1.051) | 0.950 | (0.802 to 1.125) | 0.918 | (0.800 to 1.052) | |
| ≥4 | 1.288*** | (1.101 to 1.491) | 1.313** | (1.101 to 1.564) | 1.267** | (1.099 to 1.773) | |
| Have insecticide treated net | |||||||
| No | 1 | (1 to 1) | 1 | (1 to 1) | 1 | (1 to 1) | |
| Yes | 1.059 | (0.990 to 1.132) | 1.065 | (0.995 to 1.141) | 1.071 | (0.999 to 1.127) | |
| Health insurance | |||||||
| No | 1.032 | (0.921 to 1.155) | 1.036 | (0.916 to 1.173) | 1.018 | (0.932 to 1.135) | |
| Yes | 1 | (1 to 1) | 1 | (1 to 1) | 1 | (1 to 1) | |
| Community-level factors | |||||||
| Residence | |||||||
| Urban | 1 | (1 to 1) | 1 | (1 to 1) | |||
| Rural | 0.783** | (0.610 to 0.862) | 0.829** | (0.732 to 0.908) | |||
| Socioeconomic disadvantage | |||||||
| Tertile 1 (least disadvantage) | 1.024 | (0.936 to 1.120) | 1.027 | (0.940 to 1.123) | |||
| Tertile 2 | 0.990 | (0.907 to 1.080) | 0.992 | (0.913 to 1.077) | |||
| Tertile 3 (most disadvantaged) | 1 | (1 to 1) | 1 | (1 to 1) | |||
| Country-level factor | |||||||
| Income level | |||||||
| Low (<US$1036) | 1 | (1 to 1) | |||||
| Lower middle (US$1036–4045) | 1.723*** | (1.386 to 2.353) | |||||
| Upper middle income (US$4046–12 535) | 3.268*** | (2.392 to 4.098) | |||||
| Random effect | |||||||
| Country level | |||||||
| Variance (SE) | 1.853 (1.213,2.83) | 1.994 | (1.200 to 3.311) | 1.970 | (1.211 to 3.206) | 2.167 | (1.221 to 3.844) |
| ICC, % | 25.9 (21.7,33.) | 27.0 | (18.6 to 37.4) | 26.7 | (18.7 to 36.5) | 28.6 | (18.9 to 40.8) |
| MOR | 3.66 (2.86,4.9) | 3.85 | (2.84 to 5.67) | 3.81 | (2.86 to 5.52) | 4.07 | (2.87 to 6.49) |
| Explained variation | Ref | 18.0 | (15.22 to 21.51) | 19.42 | (14.88 to 23.00) | 20.01 | (15.92 to 25.01) |
| Community level | |||||||
| Variance (SE) | 1.999 (1.088 to 2.23) | 2.098 | (1.952 to 2.256) | 2.119 | (1.958 to 2.293) | 2.118 | (1.960 to 2.288) |
| ICC, % | 53.9 (41.1 to 60.) | 55.4 | (48.9 to 62.8) | 55.4 | (49.0 to 62.5) | 56.5 | (49.1 to 65.1) |
| MOR | 3.85 (2.70 to 4.1) | 3.98 | (3.79 to 4.19) | 4.01 | (3.80 to 4.24) | 4.01 | (3.80 to 4.23) |
| Explained variation | Ref | 24.51 | (19.41 to 31.11) | 23.16 | (17.21 to 28.44) | 22.99 | (19.21 to 28.66) |
| Model fit statistics | |||||||
| DIC | 104 168 | 11 522 | 10 982 | 11 211 | |||
| Sample | |||||||
| Country | 20 | 20 | 20 | 20 | 20 | 20 | 20 |
| Community | 10 478 | 10 478 | 10 478 | 10 478 | 10 478 | 10 478 | 10 478 |
| Individual | 96 765 | 96 765 | 96 765 | 96 765 | 96 765 | 96 765 | 96 765 |
Exponentiated coefficients; 95% CIs in brackets *p <0.05, **p <0.01, ***p <0.001.
ANC, antenatal care; DIC, deviation information criterion; ICC, intracluster correlation; MOR, median OR.