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Table 3 Binomial logistic regression for the determinants of utilisation of better technical quality of routine MNH services in Nepal, 2015

From: Utilisation of quality antenatal, delivery and postnatal care services in Nepal: An analysis of Service Provision Assessment

Pregnant women attended HFs for their first ANC visit (N = 523) Postpartum women discharged from HFs (N = 309)
Determinants Categories cOR (95% CI) aOR (95% CI) Determinants Categories cOR (95% CI) aOR (95%CI)
Structural     Structural    
 Ethnicity (women) Brahmin/Chhetri 1.00   Ethnicity (women) Brahmin/Chhetri 1.00  
Janajatis 0.46(0.22,0.94) *    Janajatis 1.07(0.57, 2.03)  
Madhesi 0.33(0.16,0.69) **    Madhesi 0.23(0.10, 0.51) ***  
Dalit 0.43(0.20,0.94) *    Dalit 0.51(0.21, 1.26)  
Muslims 0.20(0.08,0.53) **   Managed by Public 1.00 1.00
 Education No schooling 1.00    Private 4.64(2.05, 10.48) *** 2.63(1.14, 6.08) *
Up to 10 grades 2.21(1.20,4.08) *   Intermediary    
SLC and above 1.86(0.99,3.50)   Province One 1.00 1.00
 Managed by Public 1.00    Two 0.17(0.04, 0.67) * 0.15(0.03, 0.63) *
Private 0.50(0.28,0.87) *    Three 3.03(0.83,11.08) 2.04(0.57, 7.31)
Intermediary      Four 1.19(0.29, 4.85) 0.94(0.21, 4.21)
 Province One 1.00 1.00   Five 1.89(0.46, 7.70) 1.58(0.36, 7.00)
Two 0.72(0.26,1.94) 0.52(0.19,1.38)   Six 1.71(0.47, 6.20) 2.94(0.68, 12.69)
Three 1.82(0.72,4.60) 2.11(0.84, 5.32)   Seven 0.49(0.13, 1.91) 0.59(0.15, 2.33)
Four 4.55(1.58,13.08) ** 4.03(1.56, 10.40) ** Women’s age (years) 15–19 1.00  
Five 2.32(0.88,6.08) 1.60(0.63, 4.04)   20–24 0.80(0.39, 1.61)  
Six 4.01(1.14,14.11) * 3.28(0.90,12.01)   25–29 1.73(0.78, 3.86)  
Seven 3.88(1.43,10.49) ** 2.77(0.94, 8.16)   ≥30 2.67(0.96, 7.38)  
 Waiting time Immediately 1.00   Delivery Companion No 1.00  
Up to 30 min 1.22(0.70,2.10)    Yes 0.73(0.39, 1.37)  
> 30 min 0.98(0.50,1.92)      
 Region Terai 1.00   Health system    
Mountain 1.95(0.48,7.89)   HF capacity Low 1.00  
Hill 1.84(1.08, 3.15) *    Medium 0.56(0.23, 1.32)  
 Women’s age (years) 15–19 1.00    High 0.46(0.20, 1.05)  
20–24 1.42(0.69,2.90)   Supervision of staff No 1.00  
25–29 1.13(0.58,2.21)    Yes 0.33(0.14, 0.78) *  
≥30 1.14(0.44,2.99)   HF Meeting Never 1.00  
 Facility types PHCCs and hospitals 1.00    Sometimes 1.06 (0.20, 5.72)  
HPs and clinics 0.78(0.43, 1.39)    Monthly 0.80(0.35, 1.85)  
Health system     Feedback collection Yes 1.00  
 HF capacity Low 1.00 1.00   No 0.32(0.16, 0.64) **  
Medium 2.21 (1.07, 4.56) * 2.12(1.03, 4.35) * QA activities No 1.00  
High 1.41(0.67, 2.97) 1.27(0.55, 2.94)   Yes 1.85(0.85, 4.02)  
 Supervision of staff No 1.00   Aama program No 1.00  
Yes 1.79(0.91,3.52)    Yes 0.37(0.14, 1.02)  
 HF meeting Never 1.00   Decision No 1.00  
Sometimes 0.74(0.22,2.47)    Timely 0.63(0.21, 1.89)  
Monthly 1.04(0.43,2.53)   Providers Nurse 1.00  
 Feedback collection Yes 1.00    Doctors 2.26(1.27, 4.04) **  
No 0.75(0.41,1.37)      
 Quality assurance No 1.00      
Yes 1.04(0.55,1.97)   PNC Mothers Nurses 1.00  
 Waiting area No 1.00    Doctor 2.44(1.29, 4.62) **  
Yes 1.39(0.53,3.66)   PNC Newborn Nurses 1.00 1.00
 HWs category GP/Specialists 1.00 1.00   Doctor 2.79(1.44, 5.42) ** 2.14(1.13, 4.04) *
MBBS 0.85(0.18,4.07) 1.00 (0.23, 4.35) First baby No 1.00  
Nursing 2.06(1.07,3.94) * 2.89(1.33, 6.29) **   Yes 0.88 (0.55, 1.40)  
Paramedics 0.91(0.21,3.96) 0.89(0.21, 3.74) Delivery Normal 1.00  
 Staff supervision No 1.00 1.00   Assisted 1.88(1.00, 3.52) *  
Yes 1.71(0.96,3.03) 1.71(1.01,2.92) *     
 Problem felt (clients) No 1.00      
Yes 0.70(0.42,1.14)      
 Need to pay Yes 1.00      
No 1.19 (0.71,1.99)      
  1. Significance at ** p < 0.01, * p < 0.05. Variables which had p < 0.2 included in the final model for each outcome variable. For each outcome variable, independent binomial logistic regression analysis was consudcted adjusting for covariates listed in the respective column. Goodness of fit test (Hosmer Lemeshow test) for utilisation of technical quality for ANC services (p = 0.896). Goodness of fit test (Hosmer Lemeshow test) for utilisation of technical quality of delivery and PNC services (p = 0.793). These figures show that our models are the best fit.