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Table 5 Multilevel logistic regression modelsa for the association of intrapartum caesarean delivery with women’s characteristics and organizational factors (N = 1,990, QUALI-DEC)

From: How does hospital organisation influence the use of caesarean sections in low- and middle-income countries? A cross-sectional survey in Argentina, Burkina Faso, Thailand and Vietnam for the QUALI-DEC project

Variables

Adjusted odds rations (95% Confidence interval)

Model 4b

p-value

Model 5b

p-value

Model 6b

p-value

Country

 

0.54

 

0.59

 

0.17

 Burkina Faso

1

 

1

 

1

 

 Argentina

0.63 (0.32–1.23)

0.18

0.58 (0.22–1.50)

0.26

0.46 (0.18–1.14)

0.09

 Thailand

0.80 (0.42–1.50)

0.48

0.76 (0.32–1.82)

0.54

0.47 (0.21–1.04)

0.06

 Vietnam

0.96 (0.50–1.83)

0.91

1.06 (0.45–2.49)

0.88

0.73 (0.37–1.44)

0.36

Complication at delivery

1.81 (1.36–2.39)

< 0.001

1.81 (1.37–2.40)

< 0.001

1.79 (1.35–2.38)

< 0.001

Induced labour

1.42 (0.98–2.05)

0.06

1.42 (0.98–2.07)

0.06

1.39 (0.96–2.01)

0.08

Birth weight

 

< 0.001

 

< 0.001

 

< 0.001

 Low (< 2500 g)

0.59 (0.31–1.13)

0.11

0.58 (0.30–1.11)

0.10

0.60 (0.31–1.15)

0.12

 Normal (2500-4000 g)

1

 

1

 

1

 

 Macrosomia (≥ 4000 g)

3.54 (2.05–6.12)

< 0.001

3.49 (2.02–6.05)

< 0.001

3.58 (2.07–6.19)

< 0.001

Nulliparity

3.23 (2.52–4.15)

< 0.001

3.22 (2.50–4.13)

< 0.001

3.22 (2.51–4.13)

< 0.001

Attending ANC in another private facility

1.28 (0.94–1.74)

0.11

1.31 (0.96–1.77)

0.08

1.26 (0.93–1.71)

0.14

Urban residency

0.78 (0.57–1.06)

0.12

0.75 (0.55–1.03)

0.08

0.79 (0.58–1.08)

0.15

Maternal occupation

 

0.01

 

0.01

 

0.01

 Unemployed/housewife

1

 

1

 

1

 

 Employed formal sector

1.41 (1.02–1.94)

0.03

1.41 (1.02–1.94)

0.03

1.40 (1.02–1.93)

0.04

 Informal sector

0.88 (0.65–1.19)

0.41

0.89 (0.66–1.20)

0.46

0.87 (0.65–1.78)

0.38

Status of the maternity unit

      

 Tertiary level of care

-

-

1.52 (0.72–3.20)

0.27

-

-

 Private practice in the maternity unit

-

-

1.34 (0.69–2.60)

0.38

-

-

 Teaching facility

-

-

0.74 (0.35–1.57)

0.44

-

-

 Functioning US machine in delivery ward

-

-

0.79 (0.40–1.57)

0.51

-

-

 Permanence of an anaesthetist

-

-

0.87 (0.48–1.54)

0.63

-

-

 Any individual delivery room

-

-

1.14 (0.57–2.28)

0.71

-

-

Workload and care capacity

      

 Number of births per one midwife/nurse per day

-

-

-

-

0.79 (0.48–1.29)

0.35

 Number of births per one obstetrician per day

-

-

-

-

0.97 (0.81–1.14)

0.69

 Number of births per admission bed per day

-

-

-

-

0.77 (0.53–1.10)

0.15

 Number of births per delivery bed per day

-

-

-

-

1.45 (1.09–1.93)

0.01

Intraclass correlation

-

-

0.06 (0.03–0.13)

 

0.05 (0.02–1.11)

 
  1. aMixed-effects logistic regression models with random intercept
  2. bModel 4: women’s characteristics; model 5: women’s characteristics and maternity unit status; model 6: women’s characteristics and indicators of workload and care capacity
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BMC Pregnancy and Childbirth

ISSN: 1471-2393

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