Variables Level of involvement Chi-square (χ 2 ) ( value) COR (95% CI) value AOR (95% CI) value Low involvement High involvement District Central Tongu 282 (54.8) 222 (45.0) Ref. Ref. Nkwanta South 233 (45.2) 271 (55.0) 9.53 (0.002) 1.47 (1.15, 1.89) 0.002 1.51 (1.16, 1.96) 0.002 Sex Male 209 (40.6) 232 (47.1) Ref. Ref. Female 306 (59.4) 261 (52.9) 4.29 (0.038) 0.76 (0.59, 0.98) 0.038 0.75 (0.55, 1.00) 0.054 Age <30 171 (33.2) 125 (25.3) Ref. Ref. 30–39 139 (27.0) 131 (26.6) 1.28 (0.92, 1.79) 0.134 1.02 (0.71, 1.48) 0.900 40–49 96 (18.6) 106 (21.5) 1.51 (1.05, 2.16) 0.025 1.21 (0.79, 1.82) 0.372 50+ 109 (21.2) 131 (26.6) 9.42 (0.) 024 1.64 (1.16, 2.31) 0.005 1.18 (0.78, 1.79) 0.432 Marital status Married/cohabiting 406 (78.8) 411 (83.3) Ref. Ref. Divorced/separated 19 (3.7) 19 (3.9) 0.98 (0.51, 1.89) 0.971 0.98 (0.49, 1.94) 0.965 Widowed 20 (3.9) 23 (4.7) 1.13 (0.61, 2.10) 0.684 1.00 (0.52, 1.94) 0.992 Never married and never lived together 70 (13.6) 40 (8.1) 7.94 (0.047) 0.56 (0.37, 0.85) 0.007 0.67 (0.41, 1.09) 0.104 Educational level None 137 (26.6) 149 (30.2) Ref. Ref. Primary 103 (20.0) 94 (19.1) 0.83 (0.58, 1.20) 0.344 0.86 (0.58, 1.26) 0.441 JHS 169 (32.8) 178 (36.1) 0.96 (0.70, 1.32) 0.841 1.02 (0.72, 1.44) 0.933 SHS 80 (15.5) 52 (10.6) 0.59 (0.39,.90) 0.016 0.58 (0.36, 0.94) 0.026 Tertiary 26 (5.1) 20 (4.0) 7.39 (0.117) 0.70 (0.37, 1.32) 0.279 0.67 (0.23, 1.93) 0.461 Occupation Unemployed 39 (7.6) 36 (7.4) Ref. Ref. Trader 80 (15.5) 59 (11.9) 0.79 (0.45, 1.40) 0.436 0.53 (0.27, 1.03) 0.062 Farmer 296 (57.5) 330 (66.9) 1.20 (0.74, 1.95) 0.440 0.79 (0.43, 1.44) 0.439 Tradesman 33 (6.4) 33 (6.7) 1.08 (0.55, 2.09) 0.813 0.68 (0.31, 1.47) 0.325 Seamstress/hairdresser 37 (7.2) 14 (2.8) 0.40 (0.19, 0.87) 0.022 0.30 (0.13, 0.70) 0.005 Civil servant 30 (5.8) 21 (4.3) 16.62 (0.005) 0.75 (0.36, 1.55) 0.450 0.50 (0.17, 1.46) 0.205 Income (GHC) Very (low<100) 133 (25.9) 105 (21.3) Ref. Ref. Low (100–499) 312 (60.7) 295 (60.0) 1.19 (0.88, 1.61) 0.241 1.23 (0.86, 1.75) 0.254 High (500–999) 46 (8.9) 60 (12.2) 1.65 (1.04, 2.62) 0.033 1.79 (1.06, 3.04) 0.029 Very high (1000+) 23 (4.5) 32 (6.5) 6.61 (0.085) 1.76 (0.97, 3.19) 0.061 2.44 (1.21, 4.89) 0.012 NHIS status Nonsubscriber 301 (58.5) 240 (48.7) Ref. Ref. Subscriber 214 (41.5) 253 (51.3) 9.65 (0.002) 1.48 (1.15, 1.90) 0.002 1.67 (1.27, 2.19) <0.001