Plain English summary
Background
Method
Development of the review method
Search strategy
Eligibility criteria
Study selection procedure
Screening
Eligibility of studies
Quality assessment
Data extraction process
Data synthesis and statistical analysis
Results
Description of the studies
No | Author and year | Setting of the study | Design of the study | Sample size | Study subjects | Data collection method | Primary Outcome of Interest | Delayed ANC (definition) | Study specific predicting factors for delayed uptake of ANC |
---|---|---|---|---|---|---|---|---|---|
1 | Amentie et al. 2015 [39] | Community based study | Cross sectional | 536 | Reproductive aged women who had at least one birth in the five years prior to the study | Interviewer administered questionnaire | -Utilization of ANC (uptake) -Timing of first ANC initiation | Entry in to care after 12 weeks of gestation | Place of residence (living in rural area) |
2 | Abosse et al. 2010 [27] | Community based study | Cross sectional | 710 | Reproductive aged women who had at least one birth in the five years prior to the study | Interviewer administered questionnaire | -Utilization of ANC (uptake) -Timing of first ANC visit | Entry in to care after 12 weeks of gestation | Place of residence (living in rural area) |
3 | Abuka et al. 2014 [35] | Facility based study | Cross sectional | 406 | Pregnant women attending health facility | Interviewer administered questionnaire | - Timing of first ANC booking | Entry in to care after 12 weeks of gestation | Age (≥20 year), non-attendance of formal education, high parity, perceived that timely ANC is not important, not having information, previous non-use of ANC |
4 | Bayou et al. 2016 [36] | Community based study | Cross sectional | 814 | Reproductive aged women who had at least one birth in the three years prior to the study | Interviewer administered questionnaire | -Early initiation of ANC -At least four ANC visit -Adequacy of ANC | Entry in to care after 12 weeks of gestation | Unintended pregnancy and non-attendance of formal education |
5 | Belayneh et al. 2014 [34] | Facility based study | Cross sectional | 369 | Pregnant women attending ANC service in health facility | Face-to-face interview technique | -Timing of first ANC booking | Entry in to care after 12 weeks of gestation | |
6 | Gudayu 2015 [37] | Facility based study | Cross sectional | 390 | Pregnant women attending ANC service in health facilities | Face-to-face exit interview technique | -Late ANC booking | Entry in to care after 12 weeks of gestation | Not obtaining information on right time to initiate, perceived right time to book ANC (12+ weeks), non-autonomy, and use of urine test to identify pregnancy |
7 | Gudayu et al. 2014 [30] | Facility based study | Cross sectional | 407 | Pregnant women attending health facility | Face-to-face exit interview technique | -Timing of first ANC booking | Entry in to care after 12 weeks of gestation | Age (>25), younger age at marriage, pregnancy checking by means other than urine test, perceived right time to start ANC (12+ weeks), and non-autonomy |
8 | Yilala and Sinishaw 2015 [33] | Facility based study | Cross sectional | 407 | Pregnant women attending antenatal care clinic in health facility | Face-to-face exit interview technique | -Late initiation of ANC | Entry in to care after 12 weeks of gestation | Non-attendance of formal education, poor knowledge of ANC, not receiving advice from HEW, not getting advice on ANC booking, perceived right time of ANC (12+ weeks) |
9 | Zegeye et al. 2013 [65] | Facility based study | Cross sectional | 446 | Pregnant women attending health facility | Face-to-face exit interview technique | -Early ANC visit | Entry in to care after 12 weeks of gestation | High parity, lack of knowledge of ANC, unintended pregnancy |
10 | Tariku et al. 2010 | Facility based study | Cross sectional | 612 | Pregnant women attending health facility | Face to face exit interview | -Timing of first ANC booking | Entry in to care after 12 weeks of gestation | High parity, unintended pregnancy, obtaining advice on when to book first ANC |
11 | CSA 2014 [20] | Community based study | Cross sectional (DHS data) | 1571 | Reproductive aged women who had at least one birth in the five years prior to the survey | Interviewer administered questionnaire | -Timing of ANC initiation -At least one ANC visit | Entry in to care after 16 weeks of gestation | Place of residence (living in rural area) |
12 | Damme et al. 2015 [28] | Facility based study | Cross sectional | 379 | Pregnant women attending ANC service in health facilities | Face-to-face exit interview technique | -Timing of first ANC booking | Entry in to care after 16 weeks of gestation | Non-attendance of formal education, rural residence, low income, having no awareness on timing of ANC |
13 | Ewenetu et al. 2015 [29] | Facility based study | Cross sectional | 178 | Pregnant women attending ANC service in health facility | Interviewer administered structured questionnaire | Late ANC initiation | Entry in to care after 16 weeks of gestation | Non-attendance of education, rural residence, no history of premature birth, late recognition of pregnancy, and unintended pregnancy |
14 | Fisseha et al. 2015 [66] | Facility based study | Cross sectional | 410 | Pregnant women attending ANC service in health facilities | Interviewer administered structured questionnaire | Timing of First ANC Booking | Entry in to care after 16 weeks of gestation | No history of still birth, no pregnancy complications, lack of knowledge of time to initiate ANC, no partner involvement on ANC |
15 | Gebre meskel et al. 2015 [40] | Facility based study | Cross sectional | 409 | Pregnant women attending ANC service in health facility | Interviewer administered structured questionnaire | Timing of First ANC Attendance | Entry in to care after 16 weeks of gestation | Low income, not receiving advice on when to start ANC, household food insecurity, unintended pregnancy |
16 | Girum 2016 [38] | Facility based study | Cross sectional | 362 | Pregnant women attending ANC service in health facilities | Face to face exit interview | Timing of First ANC Visit | Entry in to care after 16 weeks of gestation | Rural residence, low income, non-attendance of education, not receiving advice on timing of visit and unintended pregnancy |
17 | Gulema and Berhane 2017 [67] | Facility based study | Cross sectional | 960 | Pregnant women visiting health facilities for the first time | Interviewer administered structured questionnaire | Timing of First ANC Visit | Entry in to care after 16 weeks of gestation | Unemployment, low income, perceived ANC initiation time (16 weeks +), unintended pregnancy, having pregnancy complications |
18 | Hailesilasie and Enquselasie 2010 [41] | Facility based study | Cross sectional | 419 | Pregnant women attending ANC at government health facilities | Face-to-face interview of pregnant women | Late Initiation of ANC Service Utilization | Entry in to care after 16 weeks of gestation | Younger age, non-attendance of formal education, low perceived benefit of ANC, unintended pregnancy, perceived ANC initiation time (4-6 months) |
19 | Hussen et al. 2016 [42] | Facility based study | Cross sectional | 255 | Pregnant women attending ANC at government health facilities | Interviewer administered structured questionnaire | Timely Initiation of First ANC Visit | Entry in to care after 16 weeks of gestation | Non-attendance of formal education, lack of knowledge of ANC, late recognition of pregnancy, high parity |
20 | Lerebo et al. 2015 [31] | Facility based study | Cross sectional | 415 | Pregnant women attending ANC at government health facilities | Face to face interview of pregnant women | Late Booking for ANC | Entry in to care after 16 weeks of gestation | High parity, unintended pregnancy, perceived right time to book ANC (16 weeks +), no history of abortion |
21 | Mohammed and Berhane 2014 [68] | Facility based study | Cross sectional | 383 | Pregnant women attending ANC at selected public health centres | Face to face interview of pregnant women | Timing of first ANC initiation | Entry in to care after 16 weeks of gestation | Younger age, non-attendance of formal education, incorrect perception of timing of ANC, being busy |
22 | Tekelab and Berhanu 2014 [32] | Facility based study | Cross sectional | 401 | Pregnant women attending ANC service at governmental health centres | Interviewer administered structured questionnaire | Late initiation of ANC | Entry in to care after 16 weeks of gestation | Age (≥25 year), non-attendance of formal education, low monthly income, high parity, previous non-use of ANC, unintended pregnancy |
Magnitude of delayed initiation of ANC
Factors associated with delayed initiation of ANC
Category of the factors | Significantly associated with delayed ANC (COR at 95% CI) | |
---|---|---|
Yes | No | |
Delay one | Maternal age Maternal education Husband’s education Pregnancy intention Women’s autonomy Partner involvement Knowledge on ANC Presence of pregnancy complication Parity | History of abortion Marital status |
Delay two | Place of residence Maternal occupation Monthly income | |
Delay three | Means of checking pregnancy | Previous ANC utilization |
Maternal age
Maternal education
Place of residence
Pregnancy intention
Predictor variable | Subgroup OR (95%CI) | I2
| Combined OR (95% CI) | Overall I2
| |
---|---|---|---|---|---|
Monthly income [≤1000ETB(50USD)] | I | 1.77(1.16, 2.72) | 65% | 2.06(1.23, 3.45) | 91% |
II | 2.26(0.96, 5.29) | 94% | |||
Marital status [In marriage] | I | 0.92(0.55, 1.54) | 77% | 0.81(0.56, 1.16) | 68% |
II | 0.68(0.38, 1.22) | 57% | |||
Maternal occupation [Employed] | I | 0.76(0.53, 1.09) | 83% | 0.75(0.61, 0.93) | 74% |
II | 0.74(0.57, 0.97) | 66% | |||
Husband education [Attended primary/above] | II | 0.44(0.23, 0.85) | 80% | ||
Women’s autonomy [Autonomous] | I | 0.38(0.15, 0.94) | 89% | ||
Previous use of ANC [Previous use] | I | 0.65(0.42, 1.02) | 45% | 0.62(0.34, 1.11) | 85% |
II | 0.53(0.17, 1.67) | 92% | |||
Parity [Nulliparity] | I | 0.51(0.42, 0.61) | 0% | 0.46(0.36, 0.58) | 67% |
II | 0.42(0.27, 0.66) | 81% | |||
Partner involvement [Involved] | I | 0.44(0.21, 0.91) | 85% | 0.24(0.07, 0.75) | 85% |
II | 0.14(0.08, 0.22) | 85% | |||
Knowledge of ANC [Knowledgeable] | I | 0.32(0.22, 0.46) | 4% | 0.40(0.32, 0.51) | 29% |
II | 0.46(0.35, 0.62) | 54% | |||
History of abortion [Have history of abortion] | I | 1.19(0.85, 1.66) | 0% | 1.16(0.79, 1.69) | 77% |
II | 1.14(0.67, 1.95) | 77% | |||
Pregnancy complication [Presence of complication] | II | 0.23(0.06, 0.95) | 97% | ||
Means of identifying pregnancy [Urine] | I | 0.50(0.36, 0.69) | 67% |