Table_4_Adequate antenatal care service utilizations after the onset of COVID-19 pandemic in Ethiopia: a systematic review and meta-analysis.docx

BackgroundThe world faces great difficulty in continuing to provide essential maternity health care after the onset of COVID-19 pandemic Many women have trouble accessing maternity healthcare due to fear of infection. A decline in the utilization of maternity health services is suggested to worsen adequate antenatal care service utilization. Thus, this study aimed to determine the pooled estimate of adequate antenatal care service utilization after the onset of COVID-19 in Ethiopia.
MethodsThe searching of articles was carried out on Web of Science, Scopus, PubMed, CINHAL, Google Scholar, African journals online, and the institutional repository of Ethiopian universities. Using a Microsoft Excel standardized spreadsheet, the data were extracted. A random effect model was used to determine a pooled estimate of adequate antenatal care utilization. I2 statistics were used to quantify the amount of heterogeneity. The evidence of publication bias was examined using Egger's regression test and a visual inspection of the funnel plot. Subgroup and sensitivity analyses were also carried out.
ResultsFinally, this systematic review and meta-analysis included 11 eligible articles. The overall pooled estimate of adequate antenatal care service utilization after the onset of COVID-19 pandemic in Ethiopia was 46.28% (95% CI: 35.32%−57.26%). There is a substantial amount of heterogeneity between studies (I2 = 99.07%, p < 0.001). Pregnant women who visited antenatal care early were 10.9 times more likely to have adequate antenatal care utilization than those without early visits (AOR = 10.93, 95% CI: 7.2–14.66).
ConclusionIn this review, the percentage of women who utilized adequate antenatal care after the onset of COVID-19 pandemic in Ethiopia was less than half. Early antenatal care visit is an important factor to achieve adequate antenatal care service utilizations.
Systematic review registration: CRD42023495279.

背景：自新型冠状病毒肺炎（COVID-19）疫情暴发以来，全球在持续提供基本产科医疗服务方面面临巨大困境。众多女性因惧怕感染而难以获取产科医疗服务。有研究表明，产科医疗服务利用率的下降会进一步削弱充分产前保健(antenatal care)服务的可及性。因此，本研究旨在评估埃塞俄比亚在COVID-19疫情暴发后，充分产前保健服务利用率的合并效应量。
方法：本研究的文献检索在Web of Science、Scopus、PubMed、CINHAL、Google Scholar、African Journals Online以及埃塞俄比亚各高校的机构知识库中开展。采用标准化的Microsoft Excel电子表格进行数据提取。使用随机效应模型计算充分产前保健服务利用率的合并效应量；采用I²统计量量化研究间异质性；通过Egger回归检验及漏斗图可视化检查评估发表偏倚。此外，还进行了亚组分析与敏感性分析。
结果：本系统综述与元分析共纳入11篇符合纳入标准的文献。埃塞俄比亚在COVID-19疫情暴发后，充分产前保健服务利用率的总体合并效应量为46.28%（95%置信区间：35.32%~57.26%）。研究间存在显著异质性（I²=99.07%，p<0.001）。相较于未接受早期产前保健就诊的孕妇，接受早期产前保健就诊的孕妇获得充分产前保健服务的概率为其10.9倍（校正比值比[AOR]=10.93，95%CI：7.2~14.66）。
结论：本综述结果显示，埃塞俄比亚在COVID-19疫情暴发后，接受充分产前保健的女性占比不足五成。早期产前保健就诊是提升充分产前保健服务利用率的重要影响因素。
系统综述注册编号：CRD42023495279。