Table 4 Social determinants of access to quality institutional delivery in Nepal, 2016 (N = 1270)
Determinants | Categories | Frequency (N = 1270) | % | p | Institutional delivery cOR (95% CI) | Institutional delivery aOR (95% CI) |
|---|---|---|---|---|---|---|
Structural | ||||||
Wealth rank | Lower | 405 | 42.1 | 0.692 | 0.95 (0.72, 1.24) | |
Upper | 865 | 43.4 | 1.00 | |||
Ethnicity | Disadvantaged | 819 | 41.0 | 0.078 | 0.79 (0.61, 1.03) | |
Advantaged | 451 | 46.6 | 1.00 | |||
Religion | Others | 193 | 45.2 | 0.591 | 1.00 | |
Hindu | 1,076 | 42.6 | 0.90 (0.62, 1.32) | |||
Occupation | Not working | 636 | 41.5 | 0.082 | 1.00 (0.76, 1.30) | |
Agriculture | 460 | 41.6 | 1.00 | |||
Working paid | 174 | 51.9 | 1.51 (1.00, 2.29)* | |||
Maternal education | Illiterate | 270 | 38.5 | 0.278 | 0.76 (0.51, 1.15) | |
Primary | 208 | 40.5 | 1.00 | |||
Secondary higher | 792 | 45.2 | 0.83 (0.58, 1.17) | |||
Decision-making | Yes | 439 | 49.3 | 0.013 | 1.00 | |
No | 830 | 39.7 | 0.68 (0.50, 0.92)* | |||
Intermediary | ||||||
Language | Nepali | 589 | 47.2 | 0.073 | 1.00 | |
Maithili | 204 | 37.2 | 0.66 (0.43,1.02) | |||
Bhojpuri | 141 | 36.5 | 0.64 (0.47, 0.89)** | |||
Others | 336 | 41.9 | 0.81 (0.57, 1.14) | |||
Residence | Urban | 781 | 43.9 | 0.449 | 1.00 | |
Rural | 489 | 41.6 | 0.91 (0.70, 1.19) | |||
Province | One | 223 | 41.0 | 0.037 | 1.00 | |
Two | 280 | 36.8 | 0.84 (0.52, 1.35) | |||
Bagmati | 226 | 50.6 | 1.47 (0.89, 2.45) | |||
Gandaki | 121 | 50.4 | 1.47 (0.85, 2.53) | |||
Lumbini | 239 | 46.0 | 1.23 (0.79, 1.91) | |||
Karnali | 53 | 37.7 | 0.87 (0.49, 1.55) | |||
Sudurpaschim | 128 | 36.2 | 0.82 (0.50, 1.33) | |||
Region | Mountain | 59 | 30.0 | 0.015 | 1.00 | |
Hill | 514 | 47.1 | 0.48 (0.33, 0.71)*** | |||
Terai | 697 | 41.1 | 0.78 (0.60, 1.03) | |||
Maternal age (years) | 15–19 | 206 | 41.2 | 0.322 | 1.00 | |
20–34 | 1007 | 43.9 | 1.12 (0.78, 1.61) | |||
35+ | 57 | 32.3 | 0.68 (0.32, 1.43) | |||
Birth order | < 4 | 1153 | 44.0 | 0.081 | 1.00 | |
≥ 4 | 117 | 33.4 | 0.64 (0.39, 1.06) | |||
Sex of child (index child) | Male | 698 | 44.3 | 0.330 | 1.00 | |
Female | 572 | 41.3 | 0.88 (0.69, 1.13) | |||
Access to bank account | No | 798 | 40.9 | 0.120 | 0.80 (0.60, 1.06) | |
Yes | 472 | 46.5 | 1.00 | |||
Media exposure | Yes | 807 | 44.4 | 0.184 | 1.00 | |
No | 463 | 40.6 | 0.86 (0.68, 1.08) | |||
Last birth (index child) | Wanted | 1027 | 43.4 | 0.678 | 1.00 | |
Unwanted | 243 | 41.3 | 0.92 (0.62, 1.36) | |||
Distance to health facilities as a perceived problem | No problem | 581 | 45.3 | 0.174 | 1.00 | |
Problem | 689 | 41.0 | 0.84 (0.65, 1.08) | |||
Health system | ||||||
Perceived problem not having female providers | No problem | 419 | 47.2 | 0.057 | 1.00 | |
problem | 851 | 40.9 | 0.77 (0.59, 1.01) | |||
Awareness of health mothers’ group in the community | Yes | 426 | 44.2 | 0.562 | 1.00 | |
No | 844 | 42.4 | 0.93 (0.72, 1.19) | |||
C-section delivery | Yes | 198 | 34.0 | 1.00 | 0.54 (0.37, 0.80)** | |
No | 1072 | 44.7 | 0.016 | 1.57 (1.09, 2.26)* | 1.00 | |
Quality of 4+ ANC visits | Poor | 547 | 33.2 | < 0.001 | 1.00 | 1.00 |
Optimal | 723 | 50.4 | 2.05 (1.60, 2.63)*** | 1.78 (1.33, 2.38)*** | ||