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Table 3 Social determinants of access to quality 4+ ANC visits in Nepal, 2016 (N = 1401)

From: High coverage but low quality of maternal and newborn health services in the coverage cascade: who is benefitted and left behind in accessing better quality health services in Nepal?

Determinants Categories Frequency (n = 1401) % p 4+ ANC visits
Crude OR (95% CI)
4+ ANC visits
Adjusted OR (95% CI)
Structural
Wealth rank Lower 539 61.5 0.242 1.00  
Upper 862 65.6   1.19 (0.89,1.60)  
Ethnicity Disadvantaged 903 55.2 < 0.001 1.00 1.00
Advantaged 498 80.1   3.26 (2.39, 4.45)*** 1.68 (1.16, 2.43)**
Religion Others 186 59.3 0.333 1.00  
Hindu 1215 64.8   1. 26 (0.79–2.02)  
Occupation Not working 622 58.8 0.003 1.00  
Agriculture 596 65.7   1.35 (1.03,1.77)*  
Working paid 183 76.4   2.27 (1.38, 3.74)**  
Maternal education Illiterate 305 47.9 < 0.001 1.00  
Primary 249 58.7   1.55 (1.03, 2.34)*  
Secondary higher 847 71.4   2.72 (1.92, 3.86)***  
Decision-making Yes 486 70.7 0.003 1.00  
No 915 60.5   0.63 (0.47, 0.85)**  
Intermediary
Language Nepali 673 76.2 < 0.001 1.00 1.00
Maithili 244 31.7   0.14 (0.10, 0.22)*** 0.42 (0.20, 0.88) *
Bhojpuri 121 55.5   0.39 (0.23, 0.64)*** 1.01 (0.48, 2.14)
Others 363 65.9   0.60 (0.42, 0.87)** 0.82 (0.53, 1.25)
Residence Urban 802 68.4 0.009 1.00  
Rural 599 58.1   0.64 (0.46, 0.90)**  
Province One 266 59.7 < 0.001 1.00 1.00
Two 298 36.9   0.39 (0.24, 0.65)*** 0.74 (0.37,1.49)
Bagmati 236 76.4   2.18 (1.31, 3.63)** 1.65 (0.97, 2.80)
Gandaki 124 78.1   2.41 (1.36, 4.28)** 1.69 (1.02, 2.79)*
Lumbini 272 71.9   1.72 (1.02, 2.92)* 1.47 (0.88, 2.46)
Karnali 66 68.7   1.48 (0.86, 2.56) 1.37 (0.77, 2.43)
Sudurpaschim 139 79.2   2.56 (1.57, 4.17)*** 2.41 (1.46, 3.97)***
Region Mountain 94 62.4 < 0.01 1.00  
Hill 579 74.8   0.56 (0.30, 1.06)  
Terai 728 55.7   0.42 (0.31, 0.58)***  
Maternal age (years) 15–19 216 54.5 0.003 1.00  
20–34 1120 66.4   1.65 (1.24, 2.21)***  
35 +  66 54.9   1.02 (0.55, 1.88)  
Birth order  < 4 1260 66.0 < 0.001 1.00 1.00
 ≥ 4 142 46.6   0.45 (0.31, 0.65)*** 0.54 (0.35, 0.85) **
Sex of child (index child) Male 756 65.3 0.337 1.00  
Female 645 62.5   0.89 (0.69, 1.13)  
Access to bank account No 904 57.1 < 0.001 1.00 1.00
Yes 498 76.6   2.47 (1.83, 3.32)*** 1.48 (1.08, 2.03) *
Media exposure Yes 855 69.4 < 0.001 1.00  
No 546 55.6   0.55 (0.42, 0.73)***  
Last birth (index child) Wanted 1149 64.9 0.229 1.00  
Unwanted 252 60.1   0.81 (0.58, 1.14)  
Distance to health facilities as a perceived problem No problem 588 71.6 < 0.001 1.00  
Problem 814 58.6   0.56 (0.42, 0.75)***  
Health system
Perceived problem not having female providers No problem 438 79.6 < 0.001   
Problem 963 57.0   0.34 (0.24, 0.48)***  
Awareness of health mothers' group in the community Yes 497 71.6 < 0.001 1.00  
No 904 59.9   0.59 (0.44, 0.80)***  
C-section delivery Yes 497 71.6 0.023 1.00  
No 1235 62.8   0.62 (0.41, 0.94)*  
  1. Significance at ***p < 0.001, **p < 0.01, *p < 0.05. Hosmer Lemeshow test for the model fitness (p = 0.575)