Adherence to evidence-based intrapartum care practices and influencing factors among obstetric care providers in Ethiopia: A systematic review and meta-analysis

Background

Globally standardized evidence-based intrapartum care practices are essential for enhancing health outcomes for mothers and newborns. Despite recent advancements, Ethiopia grapples with significant challenges in maternal healthcare, with the implementation of evidence-based intrapartum practices falling below recognized standards. To address this gap, our systematic review and meta-analysis investigate existing literature to unveil the current state of evidence-based intrapartum care practices and identify contributing factors in Ethiopia.

Methods

This study focused on Ethiopian research and adhered to the PRISMA checklist. Thirteen relevant studies were identified through databases such as Google Scholar, Web of Science, PubMed, and Scopus. Using STATA version 14, we systematically extracted data employing a checklist. Heterogeneity was evaluated using I2 tests and the Cochrane Q test statistic. To assess publication bias, a funnel plot, Begg's test, and Egger's weighted regression were employed.

Results

In this systematic review and meta-analysis, 1770 research articles were identified, with thirteen studies meeting eligibility criteria for analysis. The pooled prevalence of evidence-based intrapartum care practices was 49.50 % (95 % CI: 39.02–59.98). Factors significantly associated with these practices included good knowledge (OR = 2.64, 95 % CI: 2.04–3.41), in-service training related to intrapartum practice (OR = 2.38, 95 % CI: 1.55–3.64), positive attitudes towards intrapartum care practice (OR = 2.68, 95 % CI: 1.78–4.03), a higher number of obstetric care providers per shift (OR = 2.54, 95 % CI: 1.27–5.10), and educational attainment at the level of Master's degree and above (OR = 4.92, 95 % CI: 2.45–9.91).

Conclusion

This study reveals that despite recognizing the importance of evidence-based intrapartum practices, only half of the observed obstetric care providers apply them. Factors influencing their application include knowledge, in-service training, attitudes, staffing, and education. Recommendations include continuous knowledge enhancement, reinforced in-service training, and psychological support. Optimizing staffing and creating pathways for advanced degrees are also proposed to improve evidence-based intrapartum care practices.