Trends and Inequalities in Use of Maternal Health Care Services in Nepal: Strategy in the Search for Improvements

Table 5

Sociodemographic predictors of four antenatal care visits, institutional delivery, and C-section in Nepal.

	Four ANC			Institutional delivery			C-section
	()			()			()
	% use	Univariate OR (95% CI)	Multivariate OR (95% CI)	% use	Univariate OR (95% CI)	Multivariate OR (95% CI)	% use	Univariate OR (95% CI)	Multivariate OR (95% CI)
Survey year
1994–1996	9.0	1	1	7.6	1	1	1.0	1	1
1999–2001	14.5	1.72(1.28–2.33)	1.81 (1.41–2.33)	9.8	1.33 (0.98–1.81)	1.33 (1.05–1.69)	1.0	1.00 (0.56–1.78)	0.99 (0.58–1.71)
2004–2006	30.3	4.42 (3.28–5.95)	4.20 (3.17–5.57)	19.1	2.89 (2.13–3.92)	2.51 (1.96–3.20)	3.0	3.07 (1.86–5.04)	2.67 (1.65–4.34)
2009–2011	51.6	10.84 (8.07–14.55)	11.53 (8.88–14.96)	40.6	8.38 (6.32–11.11)	9.80 (7.65–12.55)	5.3	5.55 (3.57–8.61)	4.83 (3.13–7.46)
Ecological zone
Mountain	17.5	1	1	8.84	1	1	0.7	1	1
Hill	24.8	1.56 (1.15–2.11)	1.09 (0.84–1.41)	17.4	2.17 (1.56–3.00)	1.28 (0.96–1.72)	2.3	3.24 (1.88–5.58)	1.54 (0.90–2.66)
Terai	25.2	1.58 (1.17–2.14)	1.32 (0.97–1.78)	19.4	2.49 (1.80–3.43)	1.48 (1.11–1.98)	2.7	3.79 (2.26–6.38)	1.90 (1.07–3.38)
Rural-urban residence
Urban	53.3	4.10 (3.31–5.07)	1.46 (1.19–1.79)	54.5	7.04 (5.70–8.70)	2.72 (2.23–3.31)	9.4	5.89 (4.26–8.15)	1.83 (1.29–2.59)
Rural	21.8	1	1	14.5	1	1	1.7	1	1
Age group
15–19	28.5	6.67 (4.08–10.92)	2.99 (1.74–5.15)	22.9	4.51 (2.73–7.44)	1.83 (1.03–3.23)	2.5	1.26 (0.53–2.98)	0.46 (0.18–1.17)
20–29	28.1	6.56 (4.11–10.49)	2.77 (1.70–4.53)	19.9	3.76 (2.33–6.09)	1.31 (0.77–2.23)	2.5	1.28 (0.57–2.90)	0.35 (0.15–0.84)
30–39	15.5	3.08 (1.93–4.93)	1.88 (1.15–3.07)	11.3	1.93 (1.17–3.18)	1.01 (0.59–1.73)	1.9	0.97 (0.40–2.34)	0.40 (0.16–0.97)
≥40	5.6	1	1	6.2	1	1	2.0	1	1
Education level
No education	11.5	1	1	7.9	1	1	1.0	1	1
Primary	32.1	3.64 (3.15–4.21)	2.06 (1.77–2.40)	20.4	3.02 (2.49–3.65)	1.74 (1.42–2.13)	2.5	2.58 (1.64–4.05)	1.41 (0.83–2.38)
Secondary	56.2	9.91 (8.35–11.77)	3.22 (2.71–3.82)	44.8	9.52 (7.89–11.48)	3.06 (2.50–3.73)	5.2	5.58 (3.87–8.05)	1.42 (0.84–2.40)
Higher	86.8	50.81 (34.49–74.87)	10.38 (6.81–15.81)	78.4	42.62 (29.80–60.95)	7.81 (5.08–11.99)	18.5	23.12 (14.48–36.92)	3.02 (1.63–5.60)
Wealth quintile
Poorest	11.2	1	1	5.1	1	1	0.5	1	1
Poorer	16.8	1.60 (1.31–1.95)	1.50 (1.22–1.86)	10.2	2.09 (1.63–2.67)	1.82 (1.42–2.34)	0.5	1.11 (0.50–2.45)	1.02 (0.45–2.33)
Middle	22.4	2.28 (1.83–2.84)	2.03 (1.59–2.61)	15.4	3.37 (2.56–4.43)	2.66 (2.01–3.52)	1.6	3.38 (1.76–6.50)	2.87 (1.42–5.82)
Richer	29.6	3.33 (2.63–4.21)	2.64 (2.02–3.45)	21.7	5.10 (3.95–6.59)	3.57 (2.71–4.71)	2.8	5.83 (3.17–10.70)	4.22 (2.09–8.51)
Richest	54.5	9.46 (7.46–11.99)	5.08 (3.82–6.76)	50.0	18.45 (14.26–23.87)	9.00 (6.55–12.37)	9.0	20.09 (11.13–36.27)	9.37 (4.22–20.83)
Caste/ethnicity
Dalit	18.5	1	1	12.4	1	1	1.0	1	1
Brahmin/Chhetri	33.6	2.23 (1.82–2.74)	1.48 (1.19–1.83)	23.6	2.19 (1.77–2.70)	1.24 (0.99–1.55)	3.8	3.78 (2.27–6.30)	1.85 (1.07–3.20)
Terai madhesi Other Caste	16.2	0.85 (0.64–1.14)	0.65 (0.49–0.87)	15.3	1.28 (0.92–1.78)	1.01 (0.76–1.33)	2.3	2.27 (1.23–4.17)	1.54 (0.83–2.88)
Newar	47.7	4.03 (2.79–5.82)	2.57 (1.76–3.77)	39.3	4.59 (3.18–6.62)	2.17 (1.51–3.13)	6.2	6.25 (3.44–11.38)	2.28 (1.25–4.15)
Janajati	21.9	1.24 (0.96–1.60)	0.93 (0.69–1.24)	14.2	1.18 (0.92–1.50)	0.85 (0.67–1.08)	1.6	1.56 (0.92–2.67)	1.12 (0.65–1.94)
Muslim	14.9	0.77 (0.50–1.18)	0.66 (0.47–0.93)	15.6	1.31 (0.73–2.32)	1.16 (0.71–1.92)	1.1	1.05 (0.32–3.45)	0.72 (0.24–2.16)
Others	13.9	0.71 (0.36–1.40)	0.92 (0.52–1.62)	13.7	1.13 (0.44–2.86)	1.477 (0.65–3.35)	1.0	0.94 (0.25–3.56)	0.73 (0.18–2.92)