Prevalence of home delivery and associated factors in Ethiopia: A systematic review and meta-analysis

2020 ◽  
Author(s):  
Asteray Assmie Ayenew ◽  
Azezu Nigussie ◽  
Biruk Zewdu
Keyword(s):  
Systematic Review ◽  
Health Facility ◽  
Associated Factors ◽  
Meta Analysis ◽  
Random Effect ◽  
Home Delivery ◽  
Cochrane Library ◽  
Danger Sign ◽  
Media Access ◽  
Pooled Prevalence

Abstract BackgroundGlobally, maternal morbidity and mortality remained a major public health challenge. Delivering at home is associated with a higher risk of maternal deaths. Findings on the prevalence and associated factors of home delivery are highly variable and inconsistent across Ethiopia. Therefore, the aim of this systematic review and meta-analysis was to estimate the pooled prevalence of home delivery and its associated factors in Ethiopia.MethodPreferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline was followed. The databases used were; PubMed, Google Scholar, Cochrane Library, African Journals Online, Ethiopian's university research repository online library, and manual searching. The search was further limited to studies conducted in Ethiopia and reported in English. Two authors independently extracted all necessary data using a standardized data extraction format. STATA 11 software was used to analyze the data. The Cochrane Q and I2 test were used to assess the heterogeneity of studies. The pooled estimate prevalence and the odds ratios with 95% confidence intervals were computed by a random effect model.ResultA total of 13 studies were included in this meta-analysis with a sample size of 13,535. The national pooled prevalence of home delivery was 48.53 % (95% CI:35, 62). The pooled adjusted odds ratio (AOR) of home delivery for Place of rural residence was 4.3(AOR = 4.3; 95% CI 2.7, 6.8), husband preference was 5(AOR=5.1 95%CI:1.1, 22), not having ANC follows up was 3.3(AOR= 3.3,95%CI:2,6), Women who cannot read & write was 4(AOR=4.36,95% CI:3.1, 6.12), Primary level was 4(AOR=4.21, 95%CI:1.5, 11.6) ,and secondary & above was 1.9(AOR=1.9,95%CI:1.1, 3.45), distance from the health facility was 7(AOR= 7.33, 95%CI:5.75, 9.35), age of mothers 15-24 was 4(AOR =3.7,95%CI:2, 6.6), knowledge of danger sign of pregnancy was 4(AOR=4.60 95%CI:3, 6.8), and no media access was 3.4(AOR=3.495%CI: 1.5, 7.5).ConclusionThis systematic review and meta-analysis showed that home delivery was high in Ethiopia. Place of residence, husband preference, no having ANC follows up, educational status of mothers, distance from health facility, age of mothers, knowledge of danger sign of pregnancy, and no media access increased the risk of home delivery.

scholarly journals Childbirth at home and associated factors in Ethiopia: a systematic review and meta-analysis

2021 ◽  
Vol 79 (1) ◽  
Author(s):  
Asteray Assmie Ayenew ◽  
Azezu Asres Nigussie ◽  
Biruk Ferede Zewdu
Keyword(s):  
Systematic Review ◽  
Odds Ratio ◽  
Associated Factors ◽  
Meta Analysis ◽  
Birth Preparedness ◽  
Media Access ◽  
Complication Readiness ◽  
Poor Knowledge ◽  
Pooled Prevalence ◽  
At Home

Abstract Background Maternal mortality remains a major challenge to health systems worldwide. Although most pregnancies and births are uneventful, approximately 15% of all pregnant women develop potentially life-threatening complications. Childbirth at home in this context can be acutely threatening, particularly in developing countries where emergency care and transportation are less available. Therefore, this systematic review and meta-analysis aimed to assess the prevalence of home childbirth and its associated factors among women in Ethiopia at their last childbirth. Method For this review, we used the standard PRISMA checklist guideline. This search included all published and unpublished observational studies written only in English language and conducted in Ethiopia. PubMed/Medline, Hinari, EMBASE, Google Scholar, Science Direct, Scopus, Web of Science (WoS), ProQuest, Cochrane Library, African Journals Online, Ethiopian’s university research repository online library were used. Based on the adapted PICO principles, different search terms were applied to achieve and access the essential articles from February 1–30, 2020. The overall selected search results were 40 studies. Microsoft Excel was used for data extraction and Stata version 11.0 (Stata Corporation, College Station, Texas, USA) for data analysis. The quality of individual studies was appraised by using the Joanna Briggs Institute (JBI) quality appraisal checklist. The heterogeneity of the studies was assessed by the Cochrane Q and I2 test. With the evidence of heterogeneity, subgroup analysis and sensitivity analysis were computed. The pooled prevalence of childbirth at home and the odds ratio (OR) with a 95% confidence interval was presented using forest plots. Result Seventy-one thousand seven hundred twenty-four (71, 724) mothers who gave at least one birth were recruited in this study. The estimated prevalence of childbirth at home in Ethiopia was 66.7% (95%CI: 61.56–71.92, I2 = 98.8%, p-value < 0.001). Being from a rural area (adjusted odds ratio (AOR) 6.48, 95% confidence interval (CI): 3.48–12.07), being uneducated (AOR = 5.90, 95% CI: 4.42–7.88), not pursuing antenatal (ANC) visits at all (AOR = 4.57(95% CI: 2.42–8.64), having 1–3 ANC visits only (AOR = 4.28, 95% CI: 3.8–8.26), no birth preparedness and complication readiness plan (AOR = 5.60, 95% CI: 6.68–8.25), no media access (AOR = 3.46, 95% CI: 2.27–5.27), having poor knowledge of obstetric complications (AOR = 4.16: 95% CI: 2.84–6.09), and walking distance more than 2 hours to reach the nearest health facility (AOR = 5.12, 95% CI: 2.94–8.93) were the factors associated with giving childbirth at home. Conclusion The pooled prevalence of childbirth at home was high in Ethiopia. Being from a rural area, being uneducated, not pursuing ANC visits at all, having 1–3 ANC visits only, no media access, having poor knowledge of obstetric complications, not having a birth preparedness and complication readiness plan, and walking time greater than 2 hours to reach the nearest health facility increased the probability of childbirth at home in Ethiopia.

scholarly journals Prevalence and factors associated with malaria among under-five children in Ethiopia: A Systematic review and Meta-analysis Protocol

2020 ◽  
Author(s):  
Abay Woday ◽  
Mulluken Dessalegn ◽  
Setognal Birara ◽  
Kusse Urmale
Keyword(s):  
Systematic Review ◽  
Associated Factors ◽  
Statistical Significance ◽  
Grey Literature ◽  
Random Effect ◽  
Random Effect Model ◽  
Cochrane Library ◽  
Under Five ◽  
Under Five Children ◽  
Pooled Prevalence

Abstract Background: The Sub-Saharan African countries have been carried 80% of the global burden of malaria. Consequently, malaria is still the leading cause of under-five mortality in developing nations. In Ethiopia, studies conducted regarding prevalence and associated factors of malaria among under five children are inconsistently reported and highly variable.Objective: to determine the pooled prevalence and associated factors of malaria among under five children in Ethiopia. Methods: The protocol for this review is registered at PROSPERO with registration number: CRD42020157886. A comprehensive search of the following electronic databases were made using: MEDLINE, EMBASE, CINAHL, Scopus, web science, HINARI, Cochrane library, Google Scholar and maternity & infant care databases as well as grey literature uploaded at Ethiopian Health Development Journal were searched until May 2020. The quality of studies will be assessed using Joanna Briggs Institute (JBI) checklist. All identified observational studies reporting the prevalence of malaria and associated factors among under five children in Ethiopia will be considered. Three reviewers will screen all retrieved articles, conduct data extraction, and then critically appraise all identified studies. The analysis of data will be done using STATA 14.0 statistical software. We will determine the pooled prevalence and determinants of malaria among under five children using random effect model with effect size and 95% confidence interval. Heterogeneity among the included studies will be assessed through the Cochrane Q-test statistics and I2 test. Furthermore, publication bias will be checked using funnel plot and egger’s test. Finally, statistical significance level will be declared at a p-value less than 0.05. Discussion: The result from this systematic review will inform and guide health policy planners and researchers on the burden, and determinants of under five children malaria in Ethiopia. To our knowledge, this is the first systematic review in Ethiopia. We will synthesize the findings to generate up-to-date knowledge on malaria among under five children in Ethiopia.

scholarly journals Partograph utilization as a decision making tool and associated factors among obstetric care providers in Ethiopia: A systematic review and Meta-analysis

2020 ◽  
Author(s):  
Asteray Ayenew ◽  
Biruk Ferede Zewdu
Keyword(s):  
Systematic Review ◽  
Associated Factors ◽  
Meta Analysis ◽  
Newborn Care ◽  
Obstetric Care ◽  
Cochrane Library ◽  
Care Providers ◽  
Refresher Training ◽  
Pooled Prevalence ◽  
Obstetric Care Providers

Abstract Background Globally, a total of 13.6 million women have died due to maternal causes from 1990 to 2015. Majority of these deaths occurred in resource-limited countries. Among the causes of these deaths, obstructed and prolonged labor covers the highest percentage, which could be prevented by cost-effective and affordable health interventions like partograph use. Therefore, this systematic review and meta-analysis aimed to assess the level of partograph utilization among obstetric care providers and its associated factors in Ethiopia. Method for this review, we used the standard PRISMA checklist guideline. Different online databases were used for the review: PubMed/Medline, Google Scholar, EMBASE, Cochrane Library, HINARI, WHO Afro Library Databases, and African Online Journals. Based on the adapted PICO principles, different search terms were applied to achieve and access all the essential articles. Microsoft Excel was used for data entrance and Stata version 11.0 (Stata Corporation, College Station, Texas, USA) for data analysis.Result Nineteen studies were included in this systematic review and meta-analysis with a total of 6237 obstetric care providers. The overall pooled prevalence of partograph utilization was 59.95% (95%CI: 46.8–73.09, I2 =99.4%, P <0.001). Being midwifery profession (adjusted odds ratio (AOR):3.97; 95% confidence interval (CI):95%CI:2.63–5.99, I2 =28.8%, P=0.198), presence of supervision (AOR = 3.21; 95%CI: 2.22–4.66, I2=0.0%, p=0.742), Basic Emergency Obstetric and Newborn Care (BEmONC) training (AOR  = 2.90; 95% CI: 2.19–3.84, I2=36.9%, P=0.13), Knowledge of partograph (AOR=2.5; 95%CI: 1.6–3.8, I2=64.58%, P=0.024), on-the-job refresher training on partograph (AOR =5.7; 95%CI:2.5–12.9, I2=87.8%, P<0.001), favorable attitude (AOR=2.12; 95%CI: 1.48–3.04, I2=0.0%, P=0.58), and working at health center (AOR=3.50; 95%CI: 2.49–4.92, I2=49.1%, P=0.08) were the determinant factors for partograph use among obstetric acre providers in Ethiopia.Conclusion The overall pooled prevalence of partograph utilization among obstetric care providers was low. Therefore, supportive supervision, providing Basic Emergency Obstetric and Newborn Care training, on-the-job refresher training on partograph, and promoting midwifery profession are strongly recommended to increase the use of partograph.

scholarly journals Neonatal sepsis and its associated factors in East Africa: a systematic review and meta-analysis, 2019

2019 ◽  
Author(s):  
Biruk Beletew Abate ◽  
Ayelign Mengesha Kasie ◽  
Mesfin Kassaw ◽  
Mikiyas Amare Getu
Keyword(s):  
East Africa ◽  
Neonatal Sepsis ◽  
Associated Factors ◽  
Meta Analysis ◽  
Home Delivery ◽  
Eastern Africa ◽  
Cochrane Library ◽  
Inverse Variance ◽  
Pooled Prevalence ◽  
History Of

Abstract Background : Neonatal sepsis is one of the leading causes of inflated death and illness of neonates. Different primary studies in Eastern Africa showed the burden of neonatal sepsis. However, inconsistency among those studies was seen and no review has been conducted to report the amalgamated magnitude and associated factors. Therefore, this review intended to estimate the national prevalence and associated factors of neonatal sepsis in Eastern Africa. Methods : Using PRISMA guideline, we systematically reviewed and meta-analyzed studies that assessed the prevalence and associated factors of neonatal sepsis from PubMed, Cochrane library, and Google Scholar. Heterogeneity across the studies was evaluated using the Q and the I 2 test. A weighted inverse variance random-effects model was applied to determine the prevalence and the effect size of associated factors. The subgroup analysis was done by country, study design, and year of publication. A funnel plot and Egger’s regression test were used to see publication bias. Result : A total of 26 studies with 11239 participants were used for analysis. The pooled prevalence of neonatal sepsis in East Africa was 29.65% (95% CI; 23.36–35.94).Home delivery(AOR =2.67; 95% CI: 1.15-4.00; I 2 = 0.0%; P=0.996), maternal history of UTI (AOR=2.083; 95% CI :0.24-3.93; I 2 = 69.1%; P=0.001),gestational age (preterm) (AOR=1.56; 95% CI: 1.04-2.08; I 2 = 27.8%;P=0.000) ,prolonged labor (AOR=3.23 ;95% CI: -0.04-6.51; I 2 = 62.7%; P=0.020) and PROM (AOR= 1.95; 95% CI: 0.53-3.37; I 2 = 43.2%; P=0.062) were identified factors of neonatal sepsis. Conclusions : The prevalence of neonatal sepsis in Eastern Africa remains high. This review may help policy-makers and program officers to design neonatal sepsis preventive interventions.

scholarly journals Prevalence unmet need for family planning and its associated factors in Ethiopia 2019: sytematic review and meta analysis

2019 ◽  
Author(s):  
Temesgen Getaneh ◽  
Ayenew Negesse ◽  
Tebabere Moltot
Keyword(s):  
Family Planning ◽  
Associated Factors ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Unmet Need ◽  
Reproductive Age ◽  
Early Marriage ◽  
Cochrane Library ◽  
Pooled Prevalence

Abstract Background unmet need for family planning is a common cuase of uninteded pregnancy which mostly end up with abortion. Many fragmented studies were conducted on unmet need in Ethiopia but no single evidence was present. So this meta analysis was established to estimate the pooled prevalence of unmet need for family planning in Ethiopia. Methods articles were retrived through search engines: PubMed/MEDLINE, EMBASE, CINAHL, Google Scholar, HINARI portal, and Cochrane Library using the preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA) checklist guidelines. Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) was applied for critical appraisal of included articles. Random effect model meta analysis was done to estimate the pooled prevalence of unmet need for family planning with their respective Odds Ratio (OR) and 95% confidence interval (CI). Cochran’s Q statistic, Egger’s and Begg’s test and meta regression were carried out to assess heterogeneity, publication bias and to identify associated factors respectively. Results 15 articles and 17, 585 reproductive age women were included to estimate the polled prevalence of unmet need for family planning in Ethiopia. The pooled prevalence of unmet need for family planning in Ethiopia was 31.45% (95%CI: 26.52, 36.39). Age at first marriage <18yrs with OR=2.3 (95% CI: 1.08, 4.87), being illiterate women with OR= 0.9 (95%CI: 1.19, 3.04), illiterate partner with OR=1.78 (95%CI: 1.18, 2.68) and absence of discussion with their partner with OR=3.52 (95%CI: 2.56, 4.87) were the associated factors. Conclusion This meta analysis revealed the prevalence of unmet need for family planning in Ethiopia was high. Early marriage, illiteracy and absence of open discussion were factors affecting the prevalence of unmet ned for family planning. Therefore, the responsible body inlcuding family health guiadance should strength women empowerment interms of education (equal accessible eduaction for all), avoid early marriage (before 18yrs) and facilitate open partners discussion within house hold.

scholarly journals The prevalence and associated factors of hepatitis B and C virus in hemodialysis patients in Africa: A systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0251570
Author(s):  
Tiruneh Adane ◽  
Solomon Getawa
Keyword(s):  
Hepatitis B ◽  
Associated Factors ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Invasive Procedure ◽  
Control Measures ◽  
Cochrane Library ◽  
Strict Adherence ◽  
Pooled Prevalence

Background Due to its invasive procedure patients on hemodialysis (HD) are at high risk of infections. Infections acquired in dialysis units can prolong hospitalization date and/or prolong illness in patients, and increase treatment cost. There are no adequate data on the prevalence of Hepatitis B virus (HBV) and Hepatitis C virus (HCV) infections in HD patients. Therefore, this study aimed to estimate the pooled prevalence and associated factors of HBV and HCV infections among HD patients in Africa. Method The databases PubMed, Medline, EMBASE, Cochrane library, web of science, African Journals Online, Science Direct, and Google Scholar were searched to identify relevant studies. The review was performed based on Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Data were extracted independently by two authors and analyzed using STATA 11. A random-effect model was fitted to estimate the pooled prevalence with their 95% confidence interval. To detect publication bias funnel plots analysis and Egger weighted regression tests were done. Results The overall pooled prevalence of HBV and HCV infection among HD patients in Africa was 9.88% (95% CI: 7.20–12.56) I2 = 97.9% and 23.04% (95% CI: 18.51–2757) I2 = 99.6%, respectively. In addition, the pooled prevalence of HBV and HCV co-infection was 7.18% (95% CI: 3.15–11.20) I2 = 99.6%. Duration of dialysis was found to be the contributing factor for the occurrence of HBV and HCV among HD patients (OR = 1.44; 95% CI: 1.04, 2.01). Conclusion This study showed that there is high prevalence of HBV and HCV infections in HD patients in Africa. Therefore, strict adherence to precautions of infection control measures, isolation of seropositive patients, improvement in infrastructures, adequate screening of HBV and HCV for the donated blood, and decentralized HD services is needed to minimize the risk of HBV and HCV infections in HD facilities.

scholarly journals Prevalence of Spina Bifida among Newborns in Africa: A Systematic Review and Meta-Analysis

Scientifica ◽  
2020 ◽  
Vol 2020 ◽  
pp. 1-12
Author(s):  
Mohammed Oumer ◽  
Molla Taye ◽  
Hailu Aragie ◽  
Ashenafi Tazebew
Keyword(s):  
Systematic Review ◽  
Spina Bifida ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Fetal Loss ◽  
Cochrane Library ◽  
Forest Plot ◽  
Birth Prevalence ◽  
Pooled Prevalence

Spina bifida is an abnormal closure of the neural tube during the fourth week of development. It is the major cause of fetal loss and considerable disabilities in newborns. The aim of this review is to determine the pooled prevalence of spina bifida among newborns in Africa. PubMed/Medline, Google Scholar, Science Direct, Joanna Briggs Institute (JBI) Library, Cochrane Library, Web of Science, African Journals Online, and Embase databases were systematically searched. Cochran Q test and I2 test statistics were applied to assess heterogeneity across studies. A random-effect model was applied to calculate the pooled prevalence of spina bifida. Forest plot and Galbraith’s plot were used to visualize heterogeneity. Subgroup, sensitivity, meta-regression, and meta-cumulative analyses were performed. All essential data were extracted using a standardized data extraction format, and the JBI quality appraisal checklist was used to assess the quality of studies. Egger’s test and Begg’s test were used in order to detect the publication bias. In the present systematic review and meta-analysis, 6,587,298 births in twenty-seven studies were included. The pooled birth prevalence of spina bifida in Africa was 0.13% with a range between 0.12% and 0.14%. In Africa, the highest burden of spina bifida was detected in Algeria (0.43%), Ethiopia (0.32%), Tanzania (0.26%), Cameron (0.12%), Egypt (0.10%), and South Africa (0.10%). The lowest burden of spina bifida was detected in Libya (0.006%) and Tunisia (0.009%). The high birth prevalence of spina bifida was detected in Africa. There was a significant variation in the prevalence of spina bifida among study countries in Africa. The authors recommend that special awareness creation with the help of health education intervention should be provided for mothers to focus on prevention in order to reduce the burden of spina bifida.

scholarly journals Prevalence and predictors of self-medication among University students in Ethiopia: A systematic review and Meta-analysis

2019 ◽  
Author(s):  
Getahun Fetensa ◽  
Tadesse Tolossa ◽  
Werku Etafa Ebi
Keyword(s):  
Systematic Review ◽  
University Students ◽  
Meta Analysis ◽  
Random Effect ◽  
Systemic Review ◽  
Cochrane Library ◽  
Self Medication ◽  
Medication Practice ◽  
Manual Search ◽  
Pooled Prevalence

Abstract Background Self-medication is the global issue especially on those having access and education about medication irrespective of its side effect. It has a significant impact on resistance and medication-related complication. There are limited and inconsistent studies regarding self-medication practice in Ethiopia. The aim of this systematic review and meta-analysis was to estimates the pooled prevalence of self-medication and its predictors among Ethiopian university students. Method A systematic review and meta-analysis were conducted to assess the prevalence and predictors of self-medication among university students in Ethiopia. We searched literature from the databases of Medline, Hinari, Scopes, PubMed CINAHL, PopLine, MedNar, Embase, Cochrane library, the JBI Library, the Web of Science, Google Scholar and manual search. A total of nine studies reporting the prevalence of self-medication among university students were included. Data were extracted using a standardized data extraction format prepared in Microsoft Excel and the analysis was done using STATA 14 statistical software. To assess heterogeneity, I2 test was used since the included studies exhibit high heterogeneity, a random effect meta-analysis model was computed to estimate the pooled prevalence of self-medication. In another way, the association between predictor variables, and self-medication practice were examined. Result A total of 3513 study respondents from nine studies in Ethiopia published between 2010-2017 were included in the study. The result of our study reveals that a pooled prevalence of self-medication among university students was 45.61% (95%CI: 30.66, 60.57). Included studies have a sample size ranged from 250 to 548 with lowest prevalence (19.81%) of self-medication from University of Gondar, whereas the highest prevalence (77.01%) recorded in a study conducted at Arsi University. Conclusion Prevalence of Ethiopian university students was 45.61%, which is very high with the current global health problem with Anti-microbial resistance increment and other toxicity. In addition to this in this study, the association between self-medication and year of study was insignificant and statistically significant with the sex of participants and income level. Systemic review registration PROSPERO International prospective register of systematic reviews: CRD42018099975

scholarly journals Prevalence of depression among school going adolescents in India: a systematic review and meta-analysis of cross-sectional studies

2021 ◽  
Vol 8 (2) ◽  
pp. 833
Author(s):  
Prashanthi Kamath ◽  
Sushma Marita Dsouza ◽  
Subhransu Mahapatra ◽  
Sruthi Jayakumar
Keyword(s):  
Mental Health ◽  
High School ◽  
Systematic Review ◽  
Meta Analysis ◽  
Random Effect ◽  
Cochrane Library ◽  
Cross Sectional ◽  
School Based ◽  
Pooled Prevalence ◽  
Prevalence Of Depression

The objective of this systematic review was to estimate the pooled prevalence of depression among schoolgoing adolescents in India by using Beck’s Depression Inventory (BDI 1 or BDI 2). A systematic literature search was conducted in PubMed, Ovid MEDLINE, Ovid EMBASE, CINAHL, Cochrane Library, PsycINFO and Google Scholar to identify cross-sectional school-based studies published during 1990-2020. Studies with pre-identified mental illness were excluded. Heterogeneity between studies were examined and estimates were pooled using a random-effects model. Subgroup and sensitivity analysis were performed. Publication bias was evaluated using funnel plot and Egger’s test. We included 13 studies in the meta-analysis. The random effect meta-analysis revealed that the pooled prevalence of depression among school going adolescents was 53% (95% CI: 41% - 65%). By gender, the prevalence was 50% (95 % CI: 38%–62%) in males and 57% (95% CI: 46% - 69%) in females. The subgroup analysis revealed that the pooled prevalence increased with the education levels (High school: 42%; High school and pre-university: 55%; and Pre-university: 67%). In this review we found that more than half of the school going adolescents in India suffered from depression that ranged from mild to severe. These results draw attention to re-look at the mental health policy and newer public health approaches to address depression. Further, strengthening school-based mental health services, along with the community and center-based care is crucial to prevent and effective management of depression among adolescents.

scholarly journals Colostrum avoidance and associated factors in Ethiopia: A systematic review and meta-analysis

2020 ◽  
Author(s):  
Jemberu Nigussie ◽  
Bekahegn Girma ◽  
Alemayehu Molla ◽  
Moges Mareg
Keyword(s):  
Systematic Review ◽  
Associated Factors ◽  
Meta Analysis ◽  
Random Effect ◽  
Health Benefit ◽  
Plain Water ◽  
Analysis Model ◽  
Prelacteal Feeding ◽  
Timely Initiation ◽  
Pooled Prevalence

Abstract Background: Colostrum is the first milk produced by the mammary glands during the second half of pregnancy for a few days (3-4) after birth. However, colostrum is a normative standard for infants’ complete form of nutrition, most mothers' giving prelacteal food such as honey, butter, sugar water, and plain water instead of colostrum to their newborn. In Ethiopia, colostrum was seen as abnormal milk causing abdominal problems, and to mitigate this problem most mothers were discarding the portion of the colostrum. Although studies have been conducted on colostrum avoidance and associated factors in Ethiopia, their report was inconsistent regarding the prevalence and associated factors. The main aim of this systematic review and meta-analysis was to estimate the pooled prevalence of colostrum avoidance and associated factors in Ethiopia.Methods: In this systematic review and meta-analysis databases such as Google, Google Scholar, PubMed/Medline, Science Direct, and Hinari were searched. We found a total of 327 records, of which 292 records were excluded due to duplication and unrelated to our objective. Finally, 35 studies were included in this systematic review and meta-analysis. The data were extracted in Microsoft Excel format and exported to STATA Version 14.0 statistical software for analysis. Heterogeneity was checked by the I2 test. A random-effect meta-analysis model was used to estimate the pooled prevalence of colostrum avoidance and associated factors. Egger’s weighted regression and Begg’s rank correlation test were used to assess publication bias. Result: This review revealed that the pooled prevalence of colostrum avoidance in Ethiopia was 20.5% (95% CI; 16.46, 24.45). Ante-natal care (ANC) visits [OR= 0.274 (95% CI; 0.175, 0.428)], place of delivery [OR= 3.8 (95% CI; 2.9, 4.9)], breastfed counselling [OR= 0.261(95% CI; 0.147 - 0.462), timely initiation of breast feeding [OR = 3.8 (95% CI; 1.9, 7.4)] and prelacteal feeding [OR= 5.77 (95% CI; 4.03- 8.22)] were significant factors for colostrum avoidance. Conclusion: This meta-analysis showed that one of five mothers discarded colostrum in Ethiopia. Colostrum avoidance was higher in rural mothers than in urban mothers. Strengthening ANC visits, institutional delivery, breastfed counseling, early initiation of breastfeeding, and avoidance of prelacteal feeding are recommended interventions to reduce colostrum avoidance in Ethiopia. Furthermore, promoting the health benefit of colostrum and its nutritional value also emphasizes to improving colostrum feeding in the community.

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