Table 2.
Multilevel logistic regression of individual and contextual factors associated with barriers to healthcare among women in Papua New Guinea (fixed effects results)
| Getting permission to go to hospital | Getting money needed for treatment | Distance to health facility | Not wanting to go alone | At least one barriers | |
|---|---|---|---|---|---|
| Variable | AOR (95% CI) | AOR (95% CI) | AOR (95% CI) | AOR (95% CI) | AOR (95% CI) |
| Age, y | |||||
| 15–19 | 1.23 (0.98 to 1.52) | 1.51*** (1.22 to 1.87) | 1.48*** (1.18 to 1.86) | ||
| 20–24 | 0.99 (0.81 to 1.21) | 1.17 (0.97 to 1.42) | 1.39** (1.13 to 1.69) | ||
| 25–29 | 1.04 (0.86 to 1.26) | 1.06 (0.88 to 1.28) | 1.22* (1.01 to 1.48) | ||
| 30–34 | 0.96 (0.79 to 1.15) | 1.00 (0.84 to 1.20) | 1.09 (0.90 to 1.32) | ||
| 35–39 | 0.88 (0.73 to 1.06) | 0.93 (0.78 to 1.12) | 1.06 (0.88 to 1.28) | ||
| 40–44 | 0.90 (0.74 to 1.10) | 0.83 (0.68 to 1.00) | 1.04 (0.86 to 1.27) | ||
| 45–49 | Ref. | Ref. | Ref. | ||
| Marital status | |||||
| Never married | 1.50* (1.09 to 2.07) | 0.86 (0.64 to 1.15) | 1.00 (0.74 to 1.36) | 1.42* (1.06 to 1.91) | 0.90 (0.65 to 1.23) |
| Married/living together | 1.37* (1.03 to 1.81) | 0.67** (0.52 to 0.87) | 0.88 (0.67 to 1.16) | 0.96 (0.74 to 1.23) | 0.76 (0.57 to 1.00) |
| Married but not together | 1.19 (0.85 to 1.67) | 0.85 (0.63 to 1.16) | 0.88 (0.63 to 1.22) | 0.79 (0.58 to 1.08) | 0.83 (0.59 to 1.15) |
| Widowed/divorced | Ref. | Ref. | Ref. | Ref. | Ref. |
| Educational level | |||||
| Primary | 0.93 (0.82 to 1.05) | 0.85* (0.75 to 0.97) | 0.86* (0.75 to 0.99) | 0.75*** (0.66 to 0.85) | 0.89 (0.77 to 1.04) |
| Secondary or higher | 0.75*** (0.64 to 0.89) | 0.67*** (0.56 to 0.77) | 0.64*** (0.54 to 0.76) | 0.65*** (0.55 to 0.76) | 0.68*** (0.57 to 0.81) |
| No education | Ref. | Ref. | Ref. | Ref. | Ref. |
| Occupation | |||||
| Unemployed | 0.89 (0.54 to 1.48) | 1.00 (0.65 to 1.54) | 1.00 (0.62 to 1.62) | 1.00 (0.63 to 1.59) | 1.14 (0.72 to 1.81) |
| Managerial | 0.94 (0.54 to 1.62) | 0.49** (0.30 to 0.78) | 0.94 (0.56 to 1.57) | 0.90 (0.54 to 1.49) | 0.69 (0.42 to 1.13) |
| Clerical/agric. | 1.09 (0.66 to 1.81) | 0.98 (0.63 to 1.51) | 0.94 (0.58 to 1.52) | 1.01 (0.63 to 1.61) | 1.03 (0.65 to 1.64) |
| Manual | Ref. | Ref. | Ref. | Ref. | Ref. |
| Religion | |||||
| Orthodox | 0.97 (0.85 to 1.11) | 1.01 (0.88 to 1.14) | 1.05 (0.91 to 1.22) | 1.03 (0.90 to 1.17) | 0.98 (0.85 to 1.13) |
| Protestant | 0.83** (0.74 to 0.94) | 0.94 (0.84 to 1.05) | 0.97 (0.85 to 1.10) | 0.93 (0.83 to 1.05) | 0.92 (0.81 to 1.04) |
| Other | Ref. | Ref. | Ref. | Ref. | Ref. |
| Number of children | |||||
| 0 | 1.12 (0.93 to 1.36) | 0.93 (0.79 to 1.09) | 0.92 (0.77 to 1.10) | 1.07 (0.89 to 1.28) | 0.92 (0.76 to 1.12) |
| 1–4 | 1.05 (0.92 to 1.20) | 0.97 (0.86 to 1.08) | 0.98 (0.87 to 1.11) | 0.92 (0.81 to 1.04) | 0.89 (0.78 to 1.02) |
| ≥5 | Ref. | Ref. | Ref. | Ref. | Ref. |
| Covered by health insurance | |||||
| No | 0.88 (0.68 to 1.13) | 1.30* (1.05 to 1.61) | 0.94 (0.73 to 1.20) | 0.85 (0.67 to 1.07) | 1.06 (0.87 to 1.30) |
| Yes | Ref. | Ref. | Ref. | Ref. | Ref. |
| Frequency of reading newspaper or magazine | |||||
| Not at all | 1.30*** (1.12 to 1.51) | 1.22** (1.07 to 1.38) | 1.23** (1.06 to 1.42) | 1.10 (0.96 to 1.27) | 1.19* (1.03 to 1.36) |
| Less than once a week | 1.22* (1.05 to 1.43) | 1.08 (0.95 to 1.23) | 1.07 (0.92 to 1.25) | 1.16* (1.00 to 1.34) | 1.12 (0.98 to 1.29) |
| At least once a week | Ref. | Ref. | Ref. | Ref. | Ref. |
| Frequency of listening to radio | |||||
| Not at all | 0.95 (0.83 to 1.09) | 0.90 (0.79 to 1.01) | 0.96 (0.84 to 1.10) | 0.89 (0.79 to 1.02) | 0.93 (0.81 to 1.06) |
| At least once a week | 0.82* (0.70 to 0.97) | 0.85* (0.74 to 0.97) | 0.89 (0.76 to 1.04) | 0.81** (0.70 to 0.94) | 0.86 (0.75 to 1.00) |
| Less than once a week | Ref. | Ref. | Ref. | Ref. | Ref. |
| Frequency of watching television | |||||
| Not at all | 1.00 (0.85 to 1.18) | 1.12 (0.97 to 1.29) | 1.06 (0.90 to 1.24) | 1.14 (0.97 to 1.33) | 1.20* (1.03 to 1.40) |
| At least once a week | 0.95 (0.78 to 1.15) | 0.95 (0.81 to 1.12) | 0.93 (0.77 to 1.12) | 1.11 (0.92 to 1.32) | 1.02 (0.86 to 1.21) |
| Less than once a week | Ref. | Ref. | Ref. | Ref. | Ref. |
| Gender of head of household | |||||
| Male | 1.01 (0.90 to 1.14) | 1.05 (0.95 to 1.17) | 1.09 (0.97 to 1.23) | 1.09 (0.98 to 1.22) | 1.11 (0.99 to 1.24) |
| Female | Ref. | Ref. | Ref. | Ref. | Ref. |
| Wealth | |||||
| Richest | 0.58*** (0.46 to 0.72) | 0.31*** (0.25 to 0.39) | 0.42*** (0.33 to 0.53) | 0.50*** (0.40 to 0.62) | 0.36*** (0.28 to 0.46) |
| Richer | 0.69*** (0.57 to 0.82) | 0.49*** (0.41 to 0.59) | 0.54*** (0.44 to 0.65) | 0.58*** (0.48 to 0.69) | 0.50*** (0.40 to 0.62) |
| Middle | 0.75*** (0.64 to 0.88) | 0.66*** (0.55 to 0.78) | 0.66*** (0.55 to 0.80) | 0.75*** (0.63 to 0.88) | 0.64*** (0.52 to 0.79) |
| Poorer | 0.91 (0.78 to 1.05) | 0.77** (0.64 to 0.92) | 0.76** (0.63 to 0.91) | 0.83* (0.71 to 0.97) | 0.71** (0.58 to 0.88) |
| Poorest | Ref. | Ref. | Ref. | Ref. | Ref. |
| Residence | |||||
| Rural | 1.55* (1.04 to 2.30) | 1.39 (0.98 to 1.98) | 4.10*** (2.72 to 6.18) | 1.75** (1.15 to 2.65) | 1.87** (1.27 to 2.77) |
| Urban | Ref. | Ref. | Ref. | Ref. | Ref. |
| Region | |||||
| Southern | 0.69 (0.42 to 1.14) | 0.79 (0.50 to 1.24) | 0.89 (0.56 to 1.42) | 1.12 (0.66 to 1.89) | 0.79 (0.48 to 1.30) |
| Highlands | 0.63 (0.39 to 1.04) | 0.90 (0.58 to 1.41) | 0.37*** (0.23 to 0.59) | 0.64 (0.38 to 1.07) | 0.617 (0.38 to 1.01) |
| Islands | 0.96 (0.57 to 1.61) | 1.00 (0.62 to 1.60) | 0.94 (0.57 to 1.54) | 1.12 (0.65 to 1.93) | 0.97 (0.58 to 1.64) |
| Momase | Ref. | Ref. | Ref. | Ref. | Ref. |
| Community level socioeconomic status | |||||
| Tertile 1 (least disadvantaged) | 0.91 (0.66 to 1.27) | 0.56*** (0.42 to 0.74) | 0.22*** (0.15 to 0.33) | 0.40*** (0.28 to 0.56) | 0.46*** (0.33 to 0.64) |
| Tertile 2 (middle disadvantaged) | 0.71** (0.55 to 0.90) | 0.55*** (0.44 to 0.68) | 0.29*** (0.21 to 0.39) | 0.41*** (0.32 to 0.53) | 0.45*** (0.34 to 0.58) |
| Tertile 3 (most disadvantaged) | Ref. | Ref. | Ref. | Ref. | Ref. |
| N | 14 653 | 14 653 | 14 653 | 14 653 | 14 653 |
AIC, Akaike's information criterion; ICC, intraclass correlation; PSU; primary sampling units; Ref., Reference.
Exponentiated coefficients; 95% CIs in brackets.
*p<0.05, **p< 0.01, ***p< 0.001.
Model 0 is the null model, a baseline model without any determinant variable.
Model 1 = individual level variables.
Model 2 = community level variables.
Model 3 is the final model adjusted for individual and household/community level variables.