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Meta-Analysis
. 2019 Feb 25;8(1):63.
doi: 10.1186/s13643-019-0979-7.

WOMEN's Knowledge of Obstetric Danger signs in Ethiopia (WOMEN's KODE):a systematic review and meta-analysis

Ayele Geleto  1   2 , Catherine Chojenta  3 , Abdulbasit Musa  4   5 , Deborah Loxton  3
Affiliations
Meta-Analysis

WOMEN's Knowledge of Obstetric Danger signs in Ethiopia (WOMEN's KODE):a systematic review and meta-analysis

Ayele Geleto et al. Syst Rev. .

Abstract

Background: According to the 2015 World Health Organization report, globally, an estimated 10.7 million mothers died from 1990 to 2015 due to obstetric complications. This report showed that almost all global maternal deaths (99%) occurred in developing countries and two thirds of these deaths took place in sub-Saharan Africa where the majority of women lack knowledge about obstetric danger signs. In Ethiopia, in several research reports, it has been indicated that women have poor knowledge about obstetric danger signs. Although several studies have been conducted to assess women's knowledge of obstetric danger signs, to date, no systematic review has been conducted in Ethiopia. Therefore, this review is aimed at synthesising the existing literature about women's knowledge of obstetric danger signs.

Methods: We systematically searched for articles from MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Embase, Web of Science, Scopus, Google Scholar and Maternity and Infant Care databases. A combination of search terms including 'knowledge' or 'awareness' or 'information' and 'pregnancy danger signs' or 'obstetric danger signs' or 'obstetric warning signs' and 'Ethiopia' was used to locate appropriate articles. Two reviewers conducted article screening and data abstraction independently. Observational studies published in English and conducted in Ethiopia to date were assessed for quality using the adapted Newcastle Ottawa Scale for cross-sectional studies. The PRISMA checklist was used to present the findings of this systematic review.

Results: From the 215 articles initially screened by abstracts and titles, 12 studies fulfilled the inclusion criteria. All the studies reported women's knowledge of obstetric danger signs during pregnancy, ten articles reported on the level of knowledge during delivery and eight studies reported on the level of knowledge of danger signs during the postpartum period. The pooled random effect meta-analysis level of women's knowledge about obstetric danger signs during pregnancy, delivery and postpartum was 48%, 43% and 32%, respectively. Maternal age, education, income, health service use, distance from facility and women's autonomy were reported in several studies as determinants of women's knowledge of obstetric danger signs.

Conclusions: Women's knowledge about obstetric danger signs in Ethiopia was very poor, which could hamper access to obstetric care when women encounter obstetric complications. Counselling services during antenatal care and community-based health information dissemination about obstetric danger signs should be strengthened.

Systematic review registration: PROSPERO CRD42017077000.

Keywords: Ethiopia; Obstetric danger signs; Pregnancy; Women’s health.

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Conflict of interest statement

Authors’ information

AG is a PhD student, holds a Master of Public Health, and is currently working in the College of Health and Medical Science, School of Public Health, Haramaya University, Harar, Ethiopia. CC (PhD) is a postdoc fellow and she is currently working in the Research Centre for Generational Health and Aging, School of Medicine and Public Health, University of Newcastle, Australia. AM is a PhD student, holds a Master of Science in Clinical Midwifery and currently working in College of Health and Medical Science, School of Nursing and Midwifery, Haramaya University, Harar, Ethiopia. DL (Prof) is a Professor of Public Health and she is currently working in the Research Centre for Generational Health and Aging, School of Medicine and Public Health, University of Newcastle, Australia as Co-Director, and Deputy Director, of the Australian Longitudinal Study on Women’s Health.

Ethics approval and consent to participate

Not applicable.

Consent for publication

Not applicable.

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
PRISMA flow diagram showing the selection of the included articles
Fig. 2
Fig. 2
Random effect meta-analysis level of women’s knowledge about obstetric danger signs during pregnancy in Ethiopia
Fig. 3
Fig. 3
Random effect meta-analysis level of women’s knowledge about obstetric danger signs during delivery in Ethiopia
Fig. 4
Fig. 4
Random effect meta-analysis level of women’s knowledge about obstetric danger signs during postpartum in Ethiopia
Fig. 5
Fig. 5
Level of women’s knowledge about obstetric signs during pregnancy based on the number of danger signs women mentioned
Fig. 6
Fig. 6
Regional variation of level of women’s knowledge about obstetric danger signs during pregnancy
Fig. 7
Fig. 7
Subgroup analysis for level of knowledge about obstetric danger signs during pregnancy among studies conducted at facility and community
See this image and copyright information in PMC

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