Introduction
Methods
Study area
Source of data and study sample size
Outcome variable
Individual-level variables
Community-level variables
Community mean distance to a health facility
Community socioeconomic status
Community ethnicity diversity
Community media saturation
Statistical methods
Statistical analysis
Spatial analysis
Results
Individual and community-level characteristics of the respondents
Variables | Number (weighted N, %)N=9590 | Not used PNC (Weighted %) | Used PNC (Weighted %) | P-value |
---|---|---|---|---|
INDIVIDUAL VARIABLES | ||||
Age at last birth | 0.029 | |||
<=19 | 1305 (13.68) | 40.80 | 59.20 | |
20-29 | 5074 (53.32) | 40.49 | 59.51 | |
30-39 | 2695 (27.65) | 43.85 | 56.15 | |
40+ | 516 (5.34) | 45.81 | 54.19 | |
Marital Status | 0.003 | |||
Single | 552 (5.80) | 34.47 | 65.53 | |
Married | 4078(40.44) | 40.57 | 59.43 | |
Living together | 3793 (40.84) | 43.22 | 56.78 | |
Previous married | 1167 (12.92) | 44.00 | 56.00 | |
Household Head | 0.014 | |||
Male | 7006 (73.10) | 42.62 | 57.38 | |
Female | 2584 (26.90) | 39.36 | 60.64 | |
Parity | 0.000 | |||
1 | 1882(20.20) | 33.37 | 66.63 | |
2-3 | 3195 (33.88) | 40.00 | 60.00 | |
4+ | 4513(45.92) | 46.71 | 53.29 | |
Family Size | 0.006 | |||
<=4 | 3105 (33.36) | 39.11 | 60.89 | |
5-6 | 2986(30.95) | 42.53 | 57.47 | |
7+ | 3499 (35.69) | 43.53 | 56.47 | |
Level of Education | 0.000 | |||
No education | 1208 (10.42) | 47.39 | 52.61 | |
Primary | 5869 (60.00) | 47.57 | 52.43 | |
Secondary or Higher | 2513 (29.58) | 27.94 | 72.06 | |
Place of Residence | 0.000 | |||
Urban | 1985(23.38) | 29.33 | 70.67 | |
Rural | 7605 (76.62) | 45.53 | 54.47 | |
Wealth Index | 0.000 | |||
Poor | 4494 (41.35) | 47.99 | 52.01 | |
Middle | 1773(18.84) | 47.49 | 52.51 | |
Rich | 3323 (39.82) | 32.54 | 67.46 | |
Religion | 0.000 | |||
Anglican | 3034 (31.17) | 44.60 | 55.40 | |
Catholic | 3975(39.43) | 41.47 | 58.53 | |
Muslim | 1099(13.77) | 33.68 | 66.32 | |
Other’s | 1482 (15.63) | 43.86 | 56.14 | |
Employment Status | 0.220 | |||
Unemployed | 1893 (20.92) | 43.44 | 56.56 | |
Employed | 7697 (79.08) | 41.30 | 58.70 | |
Quality of ANC content | 0.000 | |||
Low | 7150 (73.89) | 47.24 | 52.76 | |
High | 2440 (26.11) | 26.19 | 73.81 | |
COMMUNITY VARIABLES | ||||
Community Distance to Health Facility | 0.400 | |||
Inaccessible | 6615(72.12) | 48.66 | 51.34 | |
Accessible | 2829 (27.87) | 32.05 | 67.95 | |
Community Socioeconomic Status | 0.000 | |||
Low | 5496 (50.39) | 47.00 | 53.00 | |
High | 4094(49.61) | 36.41 | 63.59 | |
Community Ethnicity Diversity Index | 0.709 | |||
Less Diverse | 7535(79.61) | 43.34 | 56.66 | |
More Diverse | 2055 (20.39) | 39.64 | 60.36 | |
Community Media Saturation | 0.000 | |||
Less Saturated | 5321(51.54) | 48.28 | 51.72 | |
Saturated | 4269(48.46) | 35.09 | 64.91 | |
Total | 9590 (100) | 41.74 | 58.26 |
Prevalence of postnatal care service utilization across the explanatory variables
Factors associated with PNC utilization among women in Uganda
Random effects (measures of variation)
Variables | Model 1 | Model 2 | Model 3 | Model 4 |
---|---|---|---|---|
Empty Model | Individual level | Community level | Individual/Community level | |
COR (95% CI) | COR (95% CI) | COR (95% CI) | AOR (95% CI) | |
INDIVIDUAL VARIABLES | ||||
Age at last birth | ||||
<=19 | 1.00 | 1.00 | ||
20-29 | 1.18 (0. 97-1.43) | 1.22*(1.01-1.47) | ||
30-39 | 1.31* (1.04-1.67) | 1.39**(1.10-1.75) | ||
40+ | 1.21 (0.88-1.67) | 1.29(0.94-1.77) | ||
Marital Status | ||||
Single | 1.00 | |||
Married | 1.10 (0.83-1.44) | |||
Living together | 1.05 (0.80-1.37) | |||
Previous married | 0.93 (0.69-1.24) | |||
Household Head | ||||
Male | 1.00 | |||
Female | 1.02(0.90-1.17) | |||
Parity | ||||
1 | 1.00 | 1.00 | ||
2-3 | 0.69***(0.57-0.84) | 0.70*** (0.58-0.85) | ||
4+ | 0.59*** (0.47-0.73) | 0.58*** (0.47- 0.72) | ||
Family Size | ||||
<=4 | 1.00 | 1.00 | ||
5-6 | 1.05(0.91-1.21) | 1.04 (0.90-1.19) | ||
7+ | 1.04(0.89-1.21) | 1.01 (0.87-1.17) | ||
Level of Education | ||||
No education | 1.00 | 1.00 | ||
Primary | 0.98(0.82-1.18) | 1.00(0.84-1.20) | ||
Secondary or Higher | 1.55*** (1.25-1.91) | 1.66***(1.34-2.05) | ||
Place of Residence | ||||
Urban | 1.00 | 1.00 | ||
Rural | 0.70**(0.56-0.87) | 0.69***(0.54-0.90) | ||
Wealth Index | ||||
Poor | 1.00 | 1.00 | ||
Middle | 1.18 (0.99-1.41) | 1.19* (1.01-1.42) | ||
Rich | 1.29** (1.09-1.52) | 1.32**(1.12-2.56) | ||
Religion | ||||
Anglican | 1.00 | 1.00 | ||
Catholic | 1.06 (0.92-1.21) | 1.06 (0.92-1.21) | ||
Muslim | 1.19 (0.95-1.50) | 1.23 (0.97-1.55) | ||
Other’s | 0.99 (0.84-1.17) | 0.99 (0.84-1.16) | ||
Employment Status | ||||
Unemployed | 1.00 | 1.00 | ||
Employed | 1.29** (1.11-1.50) | 1.32***(1.34-1.54) | ||
Quality of content of ANC | ||||
Low | 1.00 | 1.00 | ||
High | 2.04***(1.81-2.49) | 2.05***(1.78-2.36) | ||
COMMUNITY VARIABLES | ||||
Community Socioeconomic status | ||||
Advantaged | 1.00 | 1.00 | ||
Disadvantaged | 1.39**(1.09-1.78) | 0.92 (0.71-1.19) | ||
Community Media Saturation | ||||
Less Saturated | 1.00 | 1.00 | ||
Saturated | 1.58*** (1.24-2.02) | 1.29*(1.01-1.65) | ||
Random effect results: | ||||
PSU Variance (95% CI) | 0.95(0.78-1.15) | 1.96(0.63-0.92) | 0.84(0.69-1.02) | 0.76(0.63-0.92) |
ICC | 0.22 | 0.19 | 0.20 | 0.19 |
Wild chi-square and p-value | Ref | χ2=262.37, p<0.000 | χ2= 40.85, p<0.000 | χ2=208.12, p<0.000 |
Model fitness: | ||||
Log-likelihood | -2254979 | -2182476.9 | -2250233.4 | -2210640.5 |
AIC | 4509962 | 4365000 | 4500475 | 4421321 |
PSU | 649 | 649 | 649 | 649 |
N | 9,590 | 9,590 | 9,590 | 9,590 |
Measure of association (fixed effects) results
Spatial analysis
Spatial autocorrelation
Hotspot analysis of postnatal care service utilization
Interpolation of postnatal care service utilization
SaTScan analysis of postnatal care services utilization
EA (enumeration Area) | Regions | Coordinate or Radius | RR | LLR | P-value |
---|---|---|---|---|---|
90, 188, 191, 219, 189, 237, 218, 193, 231, 232, 234, 233, 225, 228, 197, 198, 235, 236, 258, 194, 224, 196, 184, 195, 200, 192, 201, 226, 220, 223, 227, 238, 257, 239, 217, 202, 256, 216, 255, 222, 229, 254, 215, 199, 185, 240, 241, 214, 247, 187, 230, 173, 206, 176, 245, 246, 213, 242, 182, 145, 203, 149, 244, 174, 262, 259, 205, 248, 243, 151, 263, 208, 186, 175, 183, 250, 152, 261, 249, 207, 264, 266, 150, 297, 204, 221, 144, 212, 265, 153, 209, 260, 665, 211, 670, 267, 155, 210, 268, 177, 251, 668, 171, 269, 298, 156, 148, 147, 154, 272, 678, 252, 253, 672, 673, 669, 676, 679, 674, 677, 146, 681, 271, 680, 172, 685, 682, 161, 683, 675, 162, 671, 168, 658, 165, 684, 169, 160, 276, 277, 270, 660, 294, 167, 158, 178, 667, 157, 663, 666, 283, 180, 179, 308, 164, 142, 143, 657, 275, 303, 159, 664, 181, 166, 291, 274, 299, 300, 281, 282, 331, 301, 163, 656, 279, 123, 131, 295, 280, 304, 288, 310, 289, 170, 306, 662, 124, 273, 302, 122, 128, 141, 659, 121, 278, 284, 287, 307, 661, 285, 296, 126, 292, 129, 127, 130, 286, 311, 138, 125, 293, 290, 140, 139, 118, 378, 655, 89, 117, 91, 92, 654, 90, 305, 79, 43, 309, 40, 44, 42, 371, 26, 372, 27, 39, 41, 38, 369, 45, 5, 9, 2, 370, 37, 10, 36, 30, 29, 32, 28, 7, 13, 35, 6, 33, 119, 80, 12, 1, 34, 8, 98, 4, 23, 96, 312, 31, 11, 652, 3, 97, 17, 24, 88, 99, 341, 25, 16, 20, 137, 94, 14, 21, 18, 19, 373, 15, 93, 336, 22, 77, 313, 95, 314, 344, 78, 74, 120, 102, 343, 132, 87, 653, 73, 71, 76, 332, 75, 364, 100, 72, 318, 101, 316, 330, 337, 374, 339, 350, 317, 70, 315, 342, 329, 362, 346, 363, 375, 69, 86, 338, 85, 376, 347, 365, 334, 379, 348, 340, 335, 353, 328, 352, 366, 380, 646, 116, 377, 351, 367, 368, 136, 645, 105, 349, 650, 651, 135, 358, 326, 641, 345, 642, 410, 68, 113, 355, 356, 333, 115, 381, 106, 67, 114, 354, 643, 327, 644, 361, 647, 465, 383, 392, 325 | Central, Eastern and Northern Uganda. | (0.765256 N, 34.198923 E) / 261.49 km | 2.39 | 44.68 | 0.000 |