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Table 4 Multilevel analysis of factors associated with ITN use among nonpregnant women without children under 5 years

From: Factors associated with insecticide-treated net usage among women of childbearing age in Malawi: a multilevel analysis

Variable

Null model

Model I

aOR (95% CI)

Model II

aOR (95% CI)

Model III

aOR (95% CI)

Individual-level factors

 Age (years)

  15–24

 

1.00

 

1.00

  25–34

 

1.08 (0.75–1.56)

 

1.05 (0.77–1.59)

  ≥ 35

 

1.03 (0.71–1.50)

 

1.07 (0.74–1.55)

 Education

  No education

 

1.00

 

1.00

  Primary education

 

0.95 (0.74–1.22)

 

0.98 (0.76–1.28)

  Secondary+

 

0.89 (0.65–1.24)

 

0.94 (0.67–1.32)

 Occupation

  Unemployed

 

1.00

 

1.00

  Employed

 

1.01 (0.82–1.24)

 

1.02 (0.82–1.28)

 Religion

  Muslim and others

 

1.00

 

1.00

  Catholic

 

0.63* (0.44–0.90)

 

0.64* (0.44–0.91)

  Protestant

 

0.76 (0.55–1.05)

 

0.75 (0.54–1.03)

 Wealth

  Poor

 

1.00

 

1.00

  Middle

 

0.92 (0.69–1.19)

 

0.93 (0.69–1.99)

  Rich

 

0.78 (0.54–1.35)

 

1.81 (0.56–1.17)

 Region

  Northern

 

1.00

 

1.00

  Central

 

1.53** (1.15–2.03)

 

1.53** (1.12–2.09)

  Southern

 

1.31* (1.00–1.72)

 

1.34* (1.00–1.81)

 Residence

  Rural

 

1.00

 

1.00

  Urban

 

1.53** (1.18–1.98)

 

1.57** (1.14–2.16)

 Altitude (m)

  < 1600

 

1.00

 

1.00

  ≥ 1600

 

0.68 (0.17–2.82)

 

0.51 (0.54–1.04)

 Parity

  Primigravida

 

1.00

 

1.00

  Secundigravida

 

0.91 (0.69–1.19)

 

0.93 (0.63–1.28)

  Multigravida

 

0.78 (0.54–1.35)

 

0.81 (0.56–1.17)

 Number of HH members

  ≥ 5

 

1.00

 

1.00

  < 5

 

1.67*** (1.37–2.03)

 

1.66*** (1.37–2.02)

 Number of ITNs in HH

  < 2

 

1.00

 

1.00

  ≥ 2

 

11.89*** (9.6–14.7)

 

10.72*** (8.59–13.37)

 IRS

  No

 

1.00

 

1.00

  Yes

 

1.45 (0.99–2.15)

 

1.24 (0.82–1.88)

 Media exposure

  No

 

1.00

 

1.00

  Yes

 

1.10 (0.91–1.34)

 

1.11 (0.91–1.35)

 Distance to HF

  Problem

 

1.00

 

1.00

  No problem

 

1.01 (0.84–1.22)

 

1.09 (0.89–1.35)

 Women’s autonomy in HC decisions

  Self

 

1.00

 

1.00

  Husband alone

 

0.99 (0.77–1.29)

 

0.99 (0.97–1.28)

  With others

 

1.14 (0.91–1.43)

 

1.11 (0.87–1.40)

 Health behaviour

  Poor

 

1.00

 

1.00

  Moderate

 

1.21 (0.89–1.65)

 

1.21 (0.89–1.65)

  Good

 

1.22 (0.87–1.70)

 

1.22 (0.88–1.71)

Community-level factors

 Community employment

  Low

  

1.00

1.00

  Middle

  

1.02 (0.82–1.26)

0.97 (0.76–1.24)

  High

  

1.02 (0.82–1.28)

0.95 (0.73–1.34)

 Community education

  Low

  

1.00

1.00

  Middle

  

0.85 (0.68–1.06)

0.94 (0.73–1.20)

  High

  

0.79 (0.61–1.01)

0.93 (0.69–1.26)

 Community wealth

  Low

  

1.00

1.00

  Middle

  

1.13 (0.89–1.42)

1.05 (0.81–1.36)

  High

  

1.23 (0.93–1.61)

0.99 (0.69–1.41)

 Community distance to HF

  Low

  

1.00

1.00

  Middle

  

0.84 (0.67–1.06)

1.14 (0.86–1.49)

  High

  

0.96 (0.75–1.25)

1.36 (0.99–1.86)

 Community ITN coverage

  Low

  

1.00

1.00

  Middle

  

2.00*** (1.59–2.50)

1.36* (1.06–1.75)

  High

  

3.95*** (3.14–4.98)

1.49** (1.15–1.96)

 Community women’s autonomy in HC decisions

  Low

  

1.00

1.00

  Middle

  

1.03 (0.68–1.05)

0.94 (0.73–1.21)

  High

  

1.19 (0.97–1.49)

1.12 (0.87–1.45)

 Community IRS coverage

  Low

  

1.00

1.00

  High

  

1.16 (0.96–1.42)

1.22 (0.97–1.54)

 Measure of variation

  Area variance (95% CI)

0.684 (0.492–0.949)

0.347 (0.191–0.631)

0.293 (0.168–0.511)

0.293 (0.148–0.579)

  ICC (%)

17.2

9.6

8.2

8.2

  MOR

2.20

1.76

1.68

1.68

  PCV (%)

Ref.

49.3

57.2

57.2

 Model fit statistic

  AIC

4279.9

3496.8

4135.6

3504.4

  1. Null model contains no explanatory variables; Model I includes individual-level factors only; Model II includes community-level factors only; Model III include both individual-level and community-level factors
  2. ITN insecticide treated nets, HF health facility, HH household, IRS indoor residual spraying, HC health care, ICC  intraclass correlation coefficient, MOR median odds ratio, PVC proportional change in variance, AIC Akaike’s information criterion
  3. * p < 0.05, ** p < 0.01, *** p < 0.001