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Table 2 Multilevel logistic regression of individual and contextual factors associated with barriers to healthcare among women in Ghana (Fixed effects results)

From: Barriers to accessing healthcare among women in Ghana: a multilevel modelling

Variable

Permission

Money

Distance

Alone

At least one barrier

AOR [95%CI]

AOR [95%CI]

AOR [95%CI]

AOR [95%CI]

AOR [95%CI]

Age

 15–19

Ref

Ref

Ref

Ref

Ref

 20–24

0.941 [0.70,1.27]

1.00 [0.73,1.05]

0.915 [0.75,1.12]

0.613***[0.49,0.77]

0.820*[0.68,0.98]

 25–29

0.7 [0.51,1.11]

0.727** [0.58,0.91]

0.823 [0.64,1.05]

0.592***[0.45,0.78]

0.67***[0.54,0.83]

 30–34

1.00 [0.56,1.33]

0.90 [0.69,1.12]

0.887 [0.67,1.17]

0.614**[0.45,0.84]

0.729*[0.57,0.93]

 35–39

0.939 [0.60,1.48]

1.00 [0.65,1.09]

0.877 [0.66,1.17]

0.576**[0.41,0.80]

0.716*[0.55,0.93]

 40–44

0.70 [0.42,1.13]

0.863 [0.66,1.14]

0.893 [0.66,1.21]

0.547***[0.38,0.78]

0.750*[0.57,0.99]

 45–49

1.00 [0.40,1.15]

0.745*[0.56,0.99]

0.805 [0.59,1.11]

0.555** [0.39,0.80]

0.65**[0.49,0.86]

Marital status

 Never married

Ref

Ref

Ref

Ref

Ref

 Married

0.70 [0.52,1.07]

0.604***[0.49,0.74]

0.854 [0.67,1.08]

1.05 [0.80,1.38]

0.71**[0.58,0.87]

 Cohabitation

1.055 [0.72,1.54]

0.742** [0.60,0.92]

0.866 [0.67,1.11]

0.937 [0.70,1.25]

0.882 [0.71,1.10]

 Widowed

0.738 [0.39,1.41]

1.378 [0.97,1.96]

0.976 [0.66,1.43]

1.498 [0.97,2.32]

1.469*[1.03,2.10]

 Divorced

1.0 [0.42,1.12]

1.2 [0.91,1.53]

0.996 [0.74,1.34]

1.016 [0.71,1.45]

1.116 [0.86,1.44]

Educational level

 No education

Ref

Ref

Ref

Ref

Ref

 Primary

1.1 [0.83,1.47]

1.007 [0.86,1.19]

0.914 [0.77,1.09]

0.835 [0.68,1.03]

0.903 [0.76,1.07]

 Secondary

1.00 [0.67,1.19]

0.797**[0.68,0.93]

0.908 [0.76,1.08]

0.835 [0.68,1.03]

0.75***[0.64,0.89]

 Higher

0.588 [0.31,1.11]

0.477***[0.34,0.67]

0.594**[0.40,0.88]

0.662 [0.43,1.01]

0.51***[0.37,0.69]

Ethnicity

 Akan

Ref

Ref

Ref

Ref

Ref

 Ga Adangme/ewe

1.00 [0.61,1.22]

1.00 [0.86,1.27]

1.238 [0.99,1.55]

1.265 [0.99,1.61]

1.202 [0.99,1.46]

 Mole-dagbani

1.072 [0.73,1.58]

1.206 [0.96,1.52]

1.135 [0.87,1.47]

1.043 [0.78,1.40]

1.082 [0.86,1.36]

 Other

1.128 [0.79,1.61]

1.101 [0.89,1.37]

0.903 [0.70,1.16]

0.976 [0.74,1.29]

1.057 [0.85,1.31]

Employment

 Not working

Ref

Ref

Ref

Ref

Ref

 Managerial

0.90 [0.51,1.56]

0.855 [0.63,1.16]

1.073 [0.76,1.51]

0.953 [0.66,1.39]

0.921 [0.70,1.21]

 Clerical /sales

1.00 [0.60,1.01]

0.859* [0.74,1.00]

0.911 [0.77,1.08]

0.755** [0.62,0.91]

0.855*[0.74,0.99]

 Agricultural

0.81 [0.61,1.08]

1.00 [0.99,1.41]

1.217* [1.01,1.47]

0.959 [0.77,1.19]

1.242*[1.04,1.49]

 Services

0.325* [0.11,0.92]

0.769 [0.51,1.17]

0.854 [0.52,1.41]

0.421* [0.21,0.86]

0.690 [0.46,1.03]

 Manual

0.686* [0.49,0.96]

0.90 [0.78,1.13]

0.954 [0.78,1.17]

0.773* [0.61,0.98]

0.967 [0.81,1.16]

Religion

 Christianity

Ref

Ref

Ref

Ref

Ref

 Islam

0.813 [0.60,1.11]

0.825* [0.69,0.99]

0.709** [0.58,0.87]

0.772* [0.61,0.98]

0.835 [0.70,1.00]

 Traditionalist

2.054** [1.26,3.35]

1.00 [0.91,1.92]

1.033 [0.72,1.47]

1.363 [0.93,1.99]

1.382 [0.92,2.07]

 No religion

0.8 [0.48,1.48]

1.092 [0.81,1.47]

0.612** [0.44,0.84]

0.861 [0.59,1.25]

0.903 [0.67,1.23]

Parity

 0

Ref

Ref

Ref

Ref

Ref

 1 to 3

0.905 [0.65,1.26]

1.431***[1.18,1.73]

0.996 [0.81,1.23]

0.755* [0.59,0.96]

1.108 [0.92,1.33]

 4 or more

1.1 [0.69,1.61]

1.846***[1.46,2.34]

1.131 [0.87,1.47]

0.787 [0.58,1.06]

1.334*[1.06,1.68]

Health insurance subscription

 No

Ref

Ref

Ref

Ref

 Yes

0.542***[0.49,0.61]

0.880* [0.78,0.99]

0.59***[0.53,0.66]

Frequency of listening to radio

 Not at all

Ref

Ref

Ref

Ref

Ref

 Less than once a week

1.162 [0.89,1.51]

1.00 [0.77,1.06]

0.927 [0.79,1.10]

0.881 [0.73,1.06]

0.878 [0.75,1.03]

 At least once a week

1.047 [0.81,1.36]

0.749***[0.65,0.87]

0.873 [0.74,1.02]

0.793*[0.66,0.95]

0.77***[0.66,0.90]

Frequency of reading newspaper

 Not at all

Ref

Ref

 

Ref

 Less than once a week

1.00 [0.76,1.11]

0.911 [0.74,1.13]

0.936 [0.78,1.12]

 At least once a week

0.914 [0.74,1.13]

0.98 [0.77,1.25]

0.971 [0.79,1.19]

Frequency of watching television

 Not at all

Ref

Ref

Ref

Ref

Ref

 Less than once a week

1.383* [1.06,1.80]

0.830* [0.71,0.97]

0.822* [0.69,0.97]

1.125 [0.92,1.37]

0.846*[0.72,0.99]

 At least once a week

1.00 [0.80,1.38]

0.699***[0.60,0.81]

0.796** [0.68,0.94]

1.132 [0.93,1.37]

0.75***[0.64,0.87]

Household and community level factors

Sex of head of household

 Male

Ref

Ref

Ref

 Female

0.915 [0.80,1.05]

0.97 [0.83,1.14]

1.061 [0.94,1.20]

Wealth

 Poorest

Ref

Ref

Ref

Ref

Ref

 Poorer

1.1 [0.83,1.58]

1.005 [0.83,1.22]

1.008 [0.82,1.23]

1.113 [0.88,1.41]

1.071 [0.88,1.31]

 Middle

1.00 [0.72,1.60]

0.863 [0.69,1.09]

1.031 [0.80,1.32]

1.171 [0.87,1.57]

0.944 [0.75,1.19]

 Richer

0.758 [0.47,1.21]

0.650** [0.50,0.85]

1.016 [0.76,1.36]

0.958 [0.68,1.35]

0.71**[0.54,0.92]

 Richest

0.7 [0.40,1.14]

0.399***[0.29,0.54]

0.764 [0.54,1.08]

0.781 [0.53,1.15]

0.47***[0.35,0.63]

Neighbourhood socio-economic status

 Low

Ref

Ref

Ref

Ref

Ref

 Medium

0.812 [0.52,1.27]

1.00 [0.59,1.13]

1.101 [0.75,1.61]

0.837 [0.58,1.21]

0.851 [0.61,1.19]

 High

1.041 [0.55,1.97]

0.87 [0.54,1.39]

2.042** [1.20,3.49]

1.416 [0.83,2.40]

1.054 [0.65,1.71]

Residence

 Urban

Ref

Ref

Ref

Ref

[1.00,1.00]

 Rural

1.00 [0.57,1.42]

0.948 [0.68,1.32]

1.415 [0.97,2.07]

1.024 [0.70,1.49]

0.998 [0.71,1.40]

Religion

 Western

Ref

Ref

Ref

Ref

[1.00,1.00]

 Central

0.605 [0.35,1.04]

1.00 [0.68,1.59]

0.922 [0.56,1.50]

1.962** [1.19,3.24]

0.95 [0.62,1.45]

 Greater Accra

1.00 [0.37,1.18]

0.888 [0.57,1.37]

0.833 [0.50,1.39]

2.463***[1.47,4.11]

0.93 [0.60,1.44]

 Volta

0.249***[0.12,0.51]

2.732***[1.73,4.32]

1.214 [0.72,2.04]

1.772* [1.03,3.05]

2.20**[1.38,3.53]

 Eastern

1.146 [0.68,1.92]

1.661* [1.09,2.52]

2.135** [1.33,3.43]

2.707***[1.65,4.43]

1.70*[1.11,2.61]

 Ashanti

0.951 [0.57,1.58]

2.041***[1.35,3.08]

1.585 [0.99,2.54]

3.008***[1.85,4.88]

1.75**[1.15,2.67]

 Brong Ahafo

0.608 [0.35,1.04]

1.0 [0.49,1.15]

0.878 [0.54,1.44]

1.956** [1.18,3.23]

0.776 [0.50,1.19]

 Northern

0.90 [0.46,1.66]

2.127** [1.28,3.52]

2.282** [1.29,4.03]

4.740***[2.67,8.43]

2.19**[1.30,3.67]

 Upper East

0.384**[0.19,0.77]

0.9 [0.53,1.46]

0.510* [0.28,0.92]

1.00 [0.54,1.85]

0.770 [0.46,1.29]

 Upper West

1.666 [0.89,3.13]

2.578***[1.55,4.29]

2.672***[1.50,4.75]

1.56 [0.86,2.85]

2.22**[1.32,3.74]

 N

9370

9370

9370

9370

9370

  1. Exponentiated coefficients; 95% confidence intervals in brackets
  2. Ref Reference
  3. Model I is the null model, a baseline model without any determinant variable
  4. Model II = individual level variables
  5. Model III = contextual level variables
  6. Model IV is the final model adjusted for individual and contextual level variables
  7. * p < 0.05, ** p < 0.01, *** p < 0.001