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Meta-Analysis
. 2023 Nov 15;18(11):e0291394.
doi: 10.1371/journal.pone.0291394. eCollection 2023.

Prevalence of homebirth preference and associated factors among pregnant women in Ethiopia: Systematic review and meta-analysis

Jira Wakoya Feyisa  1 , Emiru Merdassa  1 , Matiyos Lema  1 , Wase Benti Hailu  1 , Markos Desalegn  1 , Adisu Tafari Shama  1 , Debela Dereje Jaleta  2 , Gamachis Firdisa Tolasa  2 , Robera Demissie Berhanu  3 , Solomon Seyife Alemu  4 , Sidise Debelo Beyena  1 , Keno Melkamu Kitila  5
Affiliations
Meta-Analysis

Prevalence of homebirth preference and associated factors among pregnant women in Ethiopia: Systematic review and meta-analysis

Jira Wakoya Feyisa et al. PLoS One. .

Abstract

Background: Homebirth preference is the intention/plan to give birth outside health facilities with the help of unskilled birth attendants. The preference to give birth at home without a skilled birth attendant leads to care-seeking delays, intrapartum mortality, multiple stillbirths, and postpartum morbidities and mortality. Therefore, this study aimed to estimate the pooled prevalence of homebirth preference and associated factors among pregnant women in Ethiopia.

Methods: Search of Google Scholar, Medline, PubMed, Cochrane Library and Web of Science were done for this study from 20th August 2022 to 6th November 2022. For data extraction and analysis, the standardized data extraction checklist and Stata version 14 were used respectively. Sentence as "Cochrane Q test statistics and I2 statistics were used to check heterogeneity of the studies. The pooled prevalence of homebirth preference was estimated using a random-effects model. The association between homebirth preference and independent variables was determined using an odd ratio with a 95% confidence interval. A funnel plot and Egger's test were used to assess publication bias.

Results: A total of 976 research articles were identified. Seven studies that fulfilled eligibility criteria were included in this systematic review and meta-analysis. The pooled prevalence of homebirth preference in Ethiopia was 39.62% (95% CI 27.98, 51.26). The current meta-analysis revealed that average monthly income <1800 ETB (OR = 2.66, 95% CI 1.44, 4.90) lack of ANC follow-up (OR = 2.57, 95%CI 1.32, 5.01), being multipara (OR = 1.77, 95%CI 1.39, 2.25), poor knowledge about obstetric danger sign (OR = 5.75, 95%CI 1.o2, 32.42), and not discussing the place of delivery with a partner (OR = 5.89 (95%CI 1.1, 31.63) were significantly associated with homebirth preference.

Conclusion: This systematic review and meta-analysis examined the substantial prevalence of homebirth preference in Ethiopia which may contribute maternal and child health crisis. The homebirth preference was associated with low average monthly income (<1800 ETB), lack of ANC follow-up, multipara, poor knowledge about obstetric danger signs, and not discussing with their partner the place of delivery. Improving knowledge of pregnant women about the benefit of health facility delivery and obstetric danger signs is necessary to decrease the prevalence of homebirth preference; for these can reduce negative outcomes occurred during delivery.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. PRISMA flow diagram of included studies in the systematic review and meta-analysis of the prevalence of homebirth preference and associated factors among pregnant women in Ethiopia, 2022.
Fig 2
Fig 2. Forest plot of the pooled estimate of the prevalence of homebirth preference in Ethiopia, 2022.
Fig 3
Fig 3. Subgroup analysis of the prevalence of homebirth preference among pregnant women in Ethiopia based on the region, 2022.
Fig 4
Fig 4. Subgroup analysis of the prevalence of homebirth preference among pregnant women in Ethiopia based on the timing of the study, 2022.
Fig 5
Fig 5. Funnel plot with 95% confidence limit of the prevalence of homebirth preference in Ethiopia, 2022.
Fig 6
Fig 6. Result of sensitivity analysis of homebirth preference in Ethiopia, 2022.
Fig 7
Fig 7. Forest plot of the pooled estimate of the association between education and homebirth preference in Ethiopia, 2022.
Fig 8
Fig 8. Forest plot of the pooled estimate of the association between monthly income and homebirth preference in Ethiopia, 2022.
Fig 9
Fig 9. Forest plot of the pooled estimate of the association between ANC follow-up and homebirth preference in Ethiopia, 2022.
Fig 10
Fig 10. Forest plot of the pooled estimate of the association between parity and homebirth preference in Ethiopia, 2022.
Fig 11
Fig 11. Forest plot of the pooled estimate of association knowledge about danger signs and homebirth preference in Ethiopia, 2022.
Fig 12
Fig 12. Forest plot of the pooled estimate of the association between transportation access and homebirth preference in Ethiopia, 2022.
Fig 13
Fig 13. Forest plot of the pooled estimate of the association between delivery place discussion and homebirth preference in Ethiopia, 2022.
Fig 14
Fig 14. Forest plot of the pooled estimate of the association between place of last delivery and homebirth preference in Ethiopia, 2022.
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