Table 3 Mixed-effects analysis of the association between FGM and SBA among women in sub-Saharan Africa
From: Female genital mutilation and skilled birth attendance among women in sub-Saharan Africa
Variable | Model o | Model I Adjusted odds ratios [95% CI] | Model II Adjusted odds ratios [95% CI] | Model III Adjusted odds ratios [95% CI] |
|---|---|---|---|---|
Fixed effect results | ||||
FGM | ||||
Not undergone FGM | Reference category | Reference category | ||
Undergone FGM | 1.43*** [1.36, 1.49] | 0.91** [0.86, 0.96] | ||
Maternal age | ||||
15–19 | Reference category | Reference category | ||
20–24 | 0.86, 1.04] | 50. [0.81, 0.99] | ||
25–29 | 0.88** [0.80, 0.97] | 0.84*** [0.76, 0.92] | ||
30–34 | 0.86** [0.78, 0.95] | 0.81*** [0.73, 0.90] | ||
35–39 | 0.90* [0.81, 0.99] | 0.86** [0.78, 0.96] | ||
40–44 | 0.85** [0.76, 0.95] | 0.85** [0.76, 0.96] | ||
45–49 | 0.81** [0.70, 0.94] | 0.82* [0.70, 0.95] | ||
Maternal educational level | ||||
No education | Reference category | Reference category | ||
Primary | 1.20*** [1.13, 1.27] | 1.41*** [1.32, 1.50] | ||
Secondary | 2.28*** [2.11, 2.47] | 2.08*** [1.91, 2.27] | ||
Higher | 5.75*** [4.54, 7.30] | 4.68*** [3.67, 5.97] | ||
Marital status | ||||
Never married | Reference category | Reference category | ||
Married | 0.57*** [0.51, 0.64] | 0.84** [0.74, 0.95] | ||
Cohabiting | 0.79** [0.68, 0.91] | 0.87 [0.74, 1.01] | ||
Widowed | 0.49*** [0.40, 0.60] | 0.72** [0.58, 0.90] | ||
Divorced | 0.49*** [0.39, 0.61] | 0.86 [0.68, 1.09] | ||
Separated | 0.66*** [0.55, 0.80] | 0.84 [0.69, 1.03] | ||
Current working status | ||||
No | Reference category | Reference category | ||
Yes | 1.30*** [1.25, 1.37] | 1.12*** [1.06, 1.17] | ||
Religion | ||||
Others | Reference category | Reference category | ||
Christianity | 3.37*** [1.68, 6.77] | 2.57* [1.24, 5.31] | ||
Islamic | 2.96** [1.47, 5.94] | 1.69 [0.82, 3.49] | ||
African Traditional | 2.13* [1.05, 4.33] | 1.40 [0.67, 2.92] | ||
No religion | 2.62** [1.28, 5.38] | 2.28* [1.08, 4.80] | ||
Antenatal care attendance | ||||
0 | Reference category | Reference category | ||
1–3 | 7.72*** [7.09, 8.41] | 5.52*** [5.03, 6.06] | ||
4 or more | 16.3*** [14.98, 17.77] | 10.67*** [9.72, 11.72] | ||
Difficulty with permission to go the health facility | ||||
Big problem | Reference category | Reference category | ||
Not a big problem | 0.73*** [0.69, 0.77] | 0.81*** [0.76, 0.86] | ||
Difficulty getting money needed for treatment | ||||
Big problem | Reference category | Reference category | ||
Not a big problem | 0.96 [0.92, 1.01] | 1.00 [0.95, 1.06] | ||
Difficulty with distance to health facility | ||||
Big problem | Reference category | Reference category | ||
Not a big problem | 1.88*** [1.79, 1.97] | 1.63*** [1.55, 1.72] | ||
Exposure to television | ||||
No | Reference category | Reference category | ||
Yes | 2.15*** [2.04, 2.26] | 1.35*** [1.27, 1.43] | ||
Exposure to radio | ||||
No | Reference category | Reference category | ||
Yes | 1.17*** [1.12, 1.23] | 0.99 [0.94, 1.04] | ||
Exposure to newspaper/magazine | ||||
No | Reference category | Reference category | ||
Yes | 1.32*** [1.20, 1.46] | 1.32*** [1.19, 1.46] | ||
Wealth index | ||||
Poorest | Reference category | Reference category | ||
Poorer | 1.80*** [1.71, 1.91] | 1.41*** [1.33, 1.50] | ||
Middle | 2.85*** [2.68, 3.02] | 1.90*** [1.78, 2.02] | ||
Richer | 5.56*** [5.17, 5.99] | 2.89*** [2.67, 3.14] | ||
Richest | 15.15*** [13.59, 16.90] | 5.06*** [4.48, 5.71] | ||
Place of residence | ||||
Urban | Reference category | Reference category | ||
Rural | 0.42*** [0.39, 0.45] | 0.51*** [0.47, 0.54] | ||
Countries | ||||
Burkina Faso | Reference category | Reference category | ||
Ethiopia | 0.15*** [0.14, 0.17] | 0.17*** [0.15, 0.19] | ||
Guinea | 0.47*** [0.43, 0.51] | 0.52*** [0.47, 0.57] | ||
Kenya | 0.51*** [0.46, 0.55] | 0.20*** [0.18, 0.22] | ||
Liberia | 2.22*** [1.98, 2.47] | 0.76*** [0.66, 0.87] | ||
Mali | 0.99 [0.88, 1.10] | 1.23** [1.08, 1.39] | ||
Nigeria | 0.25*** [0.23, 0.27] | 0.14*** [0.13, 0.16] | ||
Sierra Leone | 3.08*** [2.81, 3.38] | 1.63*** [1.47, 1.81] | ||
Senegal | 1.05 [0.97, 1.14] | 0.85** [0.78, 0.94] | ||
Togo | 0.69*** [0.62, 0.76] | 0.39*** [0.35, 0.44] | ||
Random effect results | ||||
Primary Sampling unit variance (95% CI) | 0.739 [0.655, 0.834] | 0.559 [0.488, 0.640] | 0.368 [0.319, 0.425] | 0.252 [0.214, 0.296] |
Intra-class correlation coefficient | 0.183 | 0.145 | 0.101 | 0.071 |
Likelihood ratio test | 3067.99 (< 0.001) | 1644.02 (< 0.001) | 1350.75 (< 0.001) | 810.92 (< 0.001) |
Wald chi-square | Reference | 8768.67*** | 9256.01*** | 11,069.75*** |
Model fitness | ||||
Log-likelihood | − 35,171.908 | − 28,535.782 | − 28,289.52 | − 25,531.563 |
Akaike’s Information Criterion | 70,347.82 | 57,131.56 | 56,611.04 | 51,151.13 |
Sample size | 57,994 | 57,994 | 57,994 | 57,994 |
Number of clusters | 1609 | 1609 | 1609 | 1609 |