A comparison of univariate and multivariate multilevel models for repeated measures of use of antenatal care in Uttar Pradesh

Abstract

We compare two different multilevel modelling approaches to the analysis of repeated measures data to assess the effect of mother level characteristics on women's use of prenatal care services in Uttar Pradesh, India. We apply univariate multilevel models to our data and find that the model assumptions are severely violated and the parameter estimates are not stable, particularly for the mother level random effect. To overcome this we apply a multivariate multilevel model. The correlation structure shows that, once the decision has been made regarding use of antenatal care by the mother for her first observed birth in the data, she does not tend to change this decision for higher order births.