Predictors of Antenatal Care Service Utilization Among Women of Reproductive Age in Ethiopia: A Systematic Review and Meta-Analysis

Abstract

Objective: This study aimed to provide pooled predictors of ANC (antenatal care) service use among women of reproductive age in Ethiopia. Methods: Studies were systematically searched using PubMed, Medline, CINAHL, EMBASE, and Google Scholar. The Newcastle-Ottawa scale (NOS) tool was utilized for quality assessment (risk of bias). All data analyses were conducted by utilizing Stata version 17. A random-effects model was used to obtain the pooled predictors of ANC use. The publication bias was checked using a funnel plot and Egger's regression test. Results: Twenty-two studies with a sample size of 25,671 were included in this review. The identified predictors of ANC service use were highest wealth rank (AOR 1.92 [95% CI: 1.53-2.31]), formal women education (AOR 2.40 [95% CI: 1.75-3.06]), formal husband education (AOR 1.49 [95% CI: 1.36-1.66]), women age ≥ 20 (AOR 1.75 [95% CI: 1.47-2.17]), mass media exposure (AOR 1.44 [95% CI: 1.21-1.66]), good maternal knowledge about the pregnancy complication (AOR 1.49 [95% CI: 1.11-1.88]), planned pregnancy (AOR 1.59 [95% CI: 1.28-1.91]), women autonomy (AOR 1.42 [95% CI: 1.23-1.62]), and positive husband attitude about the ANC service use (AOR 2.63 [95% CI: 1.47-3.79]). Conclusions: Several predictors have increased the ANC service utilization, like wealth status, women's and their husbands' education, older/increasing women's age, media exposure, maternal knowledge about pregnancy complications, planned pregnancy, women's autonomy to decide on household health care, and positive husband attitude about the ANC service utilization.

Keywords: Ethiopia; antenatal care; education status; mass media exposure; planned pregnancy; predictors; reproductive age groups; socioeconomic status; utilization; women.