Non-pneumatic anti-shock garment utilization and associated factors in Ethiopia: a systematic review and meta-analysis.

Abstract

Background: The Non-pneumatic Anti-Shock Garment (NASG) serve as a crucial first-aid device designed to apply pressure to the lower body. This device can save women's lives through reducing blood loss and stabilizing the women until definitive treatment is available. Between 2013 and 2015, health institutions in Ethiopia that implemented the NASG reported reduction of 80% in maternal deaths from haemorrhagic shock.So far, a number of studies have been carried out across various regions of Ethiopia to evaluate the extent of Non-pneumatic Anti-Shock Garment. However, the findings have yielded inconsistent conclusions, particularly in developing countries such as Ethiopia. The aim of this study is, therefore, to assess the pooled prevalence of non-pneumatic anti-shock garment utilization and associated factors in Ethiopia.

Methods: The Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) checklist was employed in this study. Relevant articles, written in English, were searched in electronic databases like Medline, Embase, Hinari, AJOL, the Web of Science, Google Scholar and SienceDirect. All observational studies completed or published up to May 31, 2023 and reporting on magnitude of non-pneumatic anti-shock garment utilization and its associated factors were included. The first author name, year of publication, region, town, study design, population, sample size, response rate, total cases and prevalence were all extracted using data extraction format. Data were analyzed using STATA V.15 statistical software. We estimated the pooled odds ratio (OR) along with 95% confidence interval (95% CI).

Results: In this review, we included eight published papers comprising 2690 study participants. The estimated pooled utilization of non-pneumatic anti-shock garment was 43.2% (95% CI: 35.88, 50.52; I² = 93.5%; P-value < 0.001). In particular, the availability of the NASG at an institution, receiving training on the NASG and having good knowledge regarding NASG utilization were significantly associated with increased odds for NASG utilization.

Conclusion: The reported estimates of the level of NASG utilization in Ethiopia have remained poor. The availability of the NASG at an institution, receiving training on the NASG, and having good knowledge regarding NASG utilization were significantly associated with NASG utilization in Ethiopia. Therefore, the current study reinforces the need to implement and to scale up the use of the NASG to prevent excessive blood loss after childbirth.

Review registration: Registered in PROSPERO database on April 08, 2023 with registration number of CRD42023412128.