Health insurance coverage and timely antenatal care attendance in sub-Saharan Africa

Aboagye, Richard Gyan; Okyere, Joshua; Ahinkorah, Bright Opoku; Seidu, Abdul-Aziz; Zegeye, Betregiorgis; Amu, Hubert; Yaya, Sanni

doi:10.1186/s12913-022-07601-6

BMC Health Services Research

Table 3 Fixed and random effect analysis of association between health insurance and timely ANC among pregnant women in sub-Saharan Africa

From: Health insurance coverage and timely antenatal care attendance in sub-Saharan Africa

Variable	Model 0	Model I aOR [95% CI]	Model II aOR [95% CI]	Model III aOR [95% CI]
Fixed effect results
Covered by health insurance
No		1 [1.00,1.00]		1 [1.00,1.00]
Yes		1.51^*** [1.40,1.64]		1.21^*** [1.11,1.31]
Maternal age
15-19		1 [1.00,1.00]		1 [1.00,1.00]
20-24		1.23^*** [1.15,1.31]		1.22^*** [1.14,1.30]
25-29		1.42^*** [1.32,1.54]		1.34^*** [1.24,1.46]
30-34		1.50^*** [1.38,1.63]		1.42^*** [1.30,1.54]
35-39		1.56^*** [1.43,1.70]		1.46^*** [1.33,1.60]
40-44		1.51^*** [1.37,1.67]		1.43^*** [1.29,1.58]
45-49		1.44^*** [1.28,1.64]		1.39^*** [1.22,1.59]
Maternal educational level
No education		1 [1.00,1.00]		1 [1.00,1.00]
Primary		0.90^*** [0.86,0.94]		1.17^*** [1.13,1.23]
Secondary		0.97 [0.92,1.02]		1.18^*** [1.12,1.24]
Higher		1.14^** [1.04,1.25]		1.56^*** [1.41,1.72]
Marital status
Never married		1 [1.00,1.00]		1 [1.00,1.00]
Married		0.96 [0.89,1.03]		1.34^*** [1.25,1.45]
Cohabiting		1.16^*** [1.07,1.25]		1.25^*** [1.15,1.36]
Widowed		0.99 [0.86,1.14]		1.35^*** [1.17,1.56]
Divorced		0.82^** [0.72,0.93]		1.32^*** [1.16,1.51]
Separated		1.02 [0.92,1.14]		1.35^*** [1.22,1.49]
Religion
Others		1 [1.00,1.00]		1 [1.00,1.00]
Christianity		0.90 [0.72,1.12]		1.01 [0.81,1.25]
Islamic		0.77^* [0.61,0.96]		0.84 [0.67,1.06]
African Traditional		1.30 [0.98,1.72]		0.82 [0.62,1.09]
No religion		0.85 [0.65,1.11]		0.77^* [0.59,1.00]
Maternal current working status
No		1 [1.00,1.00]		1 [1.00,1.00]
Yes		1.05^* [1.01,1.09]		1.00 [0.96,1.04]
Parity
1		1 [1.00,1.00]		1 [1.00,1.00]
2		0.88^*** [0.83,0.92]		0.86^*** [0.82,0.91]
3		0.79^*** [0.75,0.84]		0.79^*** [0.74,0.84]
4 or more		0.66^*** [0.62,0.70]		0.68^*** [0.64,0.73]
Getting medical help for self: Getting money for treatment
Not a big problem		1 [1.00,1.00]		1 [1.00,1.00]
Big problem		1.00 [0.96,1.04]		0.96 [0.93,1.00]
Getting medical help for self: Distance to health facility
Not a big problem		1 [1.00,1.00]		1 [1.00,1.00]
Big problem		0.92^*** [0.89,0.96]		0.98 [0.94,1.02]
Frequency of reading newspaper/magazine
Not at all		1 [1.00,1.00]		1 [1.00,1.00]
Less than once a week		0.97 [0.92,1.03]		1.07^* [1.01,1.13]
At least once a week		1.07 [0.98,1.17]		1.14^** [1.05,1.24]
Almost every day		1.42^* [1.06,1.91]		1.31 [1.00,1.74]
Frequency of listening to radio
Not at all		1 [1.00,1.00]		1 [1.00,1.00]
Less than once a week		1.04 [0.99,1.09]		1.02 [0.97,1.07]
At least once a week		1.01 [0.97,1.05]		1.02 [0.98,1.07]
Almost every day		1.25^** [1.09,1.43]		1.21^** [1.06,1.38]
Frequency of watching television
Not at all		1 [1.00,1.00]		1 [1.00,1.00]
Less than once a week		1.13^*** [1.07,1.19]		1.06^* [1.00,1.12]
At least once a week		1.23^*** [1.17,1.30]		1.11^*** [1.05,1.18]
Almost every day		1.28^*** [1.14,1.44]		1.07 [0.95,1.21]
Wealth index
Poorest			1 [1.00,1.00]	1 [1.00,1.00]
Poorer			1.02 [0.97,1.07]	0.98 [0.93,1.03]
Middle			1.05^* [1.00,1.11]	0.97 [0.92,1.02]
Richer			1.22^*** [1.15,1.29]	1.05 [0.99,1.12]
Richest			1.85^*** [1.73,1.98]	1.36^*** [1.26,1.47]
Sex of household head
Male			1 [1.00,1.00]	1 [1.00,1.00]
Female			1.03 [0.99,1.07]	1.03 [0.99,1.08]
Age of household head (years)
Below 25			1 [1.00,1.00]	1 [1.00,1.00]
25-34			1.01 [0.95,1.09]	1.02 [0.95,1.10]
35-44			0.95 [0.89,1.01]	1.00 [0.93,1.07]
45 and above			0.92^* [0.86,0.99]	0.99 [0.91,1.06]
Residence
Urban			1 [1.00,1.00]	1 [1.00,1.00]
Rural			1.14^*** [1.08,1.20]	1.18^*** [1.12,1.25]
Countries
Angola			1 [1.00,1.00]	1 [1.00,1.00]
Benin			1.38^*** [1.24,1.54]	1.58^*** [1.41,1.78]
Burundi			0.90 [0.80,1.02]	0.91 [0.80,1.03]
Cameroon			0.94 [0.83,1.07]	0.96 [0.84,1.09]
Ethiopia			0.47^*** [0.41,0.55]	0.50^*** [0.43,0.58]
Gambia			0.86^* [0.74,0.99]	0.94 [0.80,1.10]
Guinea			0.51^*** [0.44,0.60]	0.63^*** [0.53,0.74]
Liberia			2.86^*** [2.50,3.28]	3.15^** [2.74,3.62]
Mali			0.82^** [0.73,0.94]	0.99 [0.86,1.14]
Malawi			0.32^*** [0.28,0.36]	0.31^*** [0.28,0.35]
Nigeria			0.31^*** [0.28,0.35]	0.31^*** [0.28,0.35]
Sierra Leone			0.86^* [0.76,0.97]	1.02 [0.89,1.17]
Chad			0.79^** [0.68,0.91]	0.95 [0.82,1.11]
Uganda			0.42^*** [0.38,0.47]	0.42^*** [0.37,0.47]
Zambia			0.62^*** [0.55,0.70]	0.56^*** [0.50,0.64]
Zimbabwe			0.70^*** [0.62,0.79]	0.61^*** [0.53,0.69]
Random effects
PSU variance (95% CI)	0.196 [0.165, 0.232]	0.188 [0.159, 0.224]	0.089 [0.072, 0.110]	0.080 [0.066, 0.098]
ICC	0.056	0.054	0 .026	0.024
Wald chi-square	Reference	782.93 (<0.001)	2788.42 (<0.001)	3568.39 (<0.001)
Model fitness
Log-likelihood	-75547.51	-74627.774	-71913.807	-71399.091
AIC	151099	149327.5	143879.6	142918.2
N	113918	113918	113918	113918
Number of clusters	1,397	1,397	1,397	1,397

Exponentiated coefficients, 95% confidence intervals in brackets, aOR adjusted odds ratios, CI Confidence Interval, * p < 0.05, ** p < 0.01, *** p < 0.001, 1 Reference, category PSU Primary Sampling Unit, ICC Intra-Class Correlation, AIC Akaike’s Information Criterion

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