The three maternal delays in mothers receiving maternal care in Ethiopia: a systematic review and meta-analysis

Abstract Background : In low-income countries like Ethiopia, delay in accessing maternal health care is one of the factors contributing to maternal mortality in developing countries. Several individual studies have been conducted on the prevalence of three maternal delays in Ethiopia. However, there is no pooled prevalence of the three maternal delays. Therefore, this systematic review and meta-analysis aimed to assess the overall prevalence of three maternal delays and associated factors in Ethiopian women. Methods and materials Only published articles were included in this review. Medline/PubMed, Web of Science, Google Scholar, Scopus, the Ethiopian University Repository Online, and the Cochrane Library were the primary databases. The review includes cross-sectional studies written in English that meet the eligibility requirements. The pooled prevalence of women’s preference for home delivery was calculated using a random effects model. In addition, the Eggers test and the funnel plot were used to investigate publication bias. STATA version 14 was used to perform all statistical analyses. Result This review includes nine studies with 4,501 participants. In Ethiopia, The estimated pooled prevalence of first, second, and third maternal delays in Ethiopia was 41.00% [95% CI (32.5, 49.49); I2 = 95.3%, P<0.001], 38.68% [95% CI (33.23, 44.01); I2 = 91.1%, P<0.001], and 49.05% [95% CI (30.72, 67.39.49); I2 = 99.3%, P<0.001]. Lack of antenatal follow-up [OR = 14.98 (6.6, 34.1), I2 = 85.3%, p = 0.001], traveling a long distance [OR = 41.7 (3.4, 65.9), I2 = 75.7%, p = 0.042], and an unavailable skilled maternity health care provider [OR = 31.95 (1.07, 95.7], I2 = 79.7%, p = 0.007] were statistically significant with the first, second, and third maternal delays, respectively. Conclusion According to this report, delay in receiving proper maternal care (third delay) was the most common type of delay among mothers in Ethiopia, followed by delay in seeking maternal care (first delay) and delay in reaching a health facility (second delay). Therefore, it is strongly recommended to improve health care in the facility, facilitate access to the health facility, and raise awareness of women, family, or community to avoid the three types of delays and related factors.