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Open Access 01-12-2017 | Review

Delayed initiation of antenatal care and associated factors in Ethiopia: a systematic review and meta-analysis

Authors: Gezahegn Tesfaye, Deborah Loxton, Catherine Chojenta, Agumasie Semahegn, Roger Smith

Published in: Reproductive Health | Issue 1/2017

Abstract

Background

Antenatal care uptake is among the key indicators for monitoring the progress of maternal outcomes. Early initiation of antenatal care facilitates the timely management and treatment of pregnancy complications to reduce maternal deaths. In Ethiopia, antenatal care utilization is generally low, and delayed initiation of care is very common. We aimed to systematically identify and synthesize available evidence on delayed initiation of antenatal care and the associated factors in Ethiopia.

Methods

Studies published in English from 1 January 2002 to 30 April 2017 were systematically searched from PubMed, Medline, EMBASE, CINAHL and other relevant sources. Two authors independently reviewed the identified studies against the eligibility criteria. The included studies were critically appraised using the Joanna Briggs-MAStARI instrument for observational studies. Meta-analysis was conducted in RevMan v5.3 for Windows using a Mantel–Haenszel random effects model. The presence of statistical heterogeneity was checked using the Cochran Q test, and its level was quantified using the I² statistics. Pooled estimate of the proportion of the outcome variable was calculated. Pooled Odd Ratios with 95% CI were calculated to measure the effect sizes.

Result

The pooled magnitude of delayed antenatal care in Ethiopia was 64% (95% CI: 57%, 70%). Maternal age (OR = 0.70; 95% CI: 0.53, 0.93), place of residence (OR = 0.29, 95% CI: 0.16, 0.50), maternal education (OR = 0.49; 95% CI: 0.38, 0.63), husband’s education (OR = 0.44; 95% CI: 0.23, 0.85), maternal occupation (OR = 0.75; 95% CI: 0.61, 0.93), monthly income (OR = 2.06; 95% CI: 1.23, 3.45), pregnancy intention (OR = 0.49; 95% CI: 0.40, 0.60), parity (OR = 0.46; 95% CI: 0.36, 0.58), knowledge of antenatal care (OR = 0.40; 95% CI: 0.32, 0.51), women’s autonomy (OR = 0.38; 95% CI: 0.15, 0.94), partner involvement (OR = 0.24; 95% CI: 0.07, 0.75), pregnancy complications (OR = 0.23; 95% CI: 0.06, 0.95), and means of identifying pregnancy (OR = 0.50; 95% CI: 0.36, 0.69) were significantly associated with delayed antenatal care.

Conclusion

Improving female education and women’s empowerment through economic reforms, strengthening family planning programs to reduce unintended pregnancy and promoting partner involvement in pregnancy care could reduce the very high magnitude of delayed antenatal care in Ethiopia.

Trial registration

CRD42017064585.

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Title: Delayed initiation of antenatal care and associated factors in Ethiopia: a systematic review and meta-analysis
Authors: Gezahegn Tesfaye
Deborah Loxton
Catherine Chojenta
Agumasie Semahegn
Roger Smith
Publication date: 01-12-2017
Publisher: BioMed Central
Published in: Reproductive Health / Issue 1/2017
Electronic ISSN: 1742-4755
DOI: https://doi.org/10.1186/s12978-017-0412-4

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Delayed initiation of antenatal care and associated factors in Ethiopia: a systematic review and meta-analysis

Abstract

Background

Methods

Result

Conclusion

Trial registration

Keynote webinar | Spotlight on sleep in brain health

Springer Medicine

Abstract

Background

Methods

Result

Conclusion

Trial registration

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