Antenatal Care Dropout and Associated Factors in Ethiopia: A Systematic Review and Meta-Analysis

Background: Antenatal care during pregnancy is one of the most important strategies for improving maternal and newborn health and preventing maternal and newborn mortality and morbidity. The prevalence and predictors of antenatal care dropout in Ethiopia were studied, and the results were inconsistent and showed considerable variation, and this makes more difficult to provide clear evidence at the national level. Hence, this meta-analysis aimed at estimating the overall prevalence of antenatal care dropout and its associated factors in Ethiopia. Methods: A thorough search of pertinent studies released before December 30, 2022, was explored by using distinct databases such as (PubMed, DOJA, Embase, Cochrane library, African journals online, Google scholar, and web of science and the institutional repository of Ethiopian universities were used to search for relevant studies. Data were extracted using Microsoft Excel, and analysis was performed using STATA version 16. A random-effects model were used to estimate the overall national prevalence of antenatal care drop-out and the odds ratio. test statistics for to assessing heterogeneity and Egger's test for assessing publication bias were used. Results: A total of seven studies were included for this systematic review and meta-analysis with of 11839 study participants. The overall pooled prevalence of antenatal dropout in Ethiopia was found to be 41.37% (95% CI =35.04, 47.70). Distance from the health care facility (AOR = 2.55, 95% CI = 1.79, 3.31), pregnancy complication signs (AOR = 2.88, 95% CI= 2.41, 3.66), place of residence (AOR= 1.59, 95% CI = 1.31, 1.87), educational level (AOR=1.79, 95%CI = 1.37, 2.21), age group(30-49) (AOR=(AOR = 0.57, 95% CI = 0.26, 0.88) were significantly associated with antenatal care dropout. Conclusion: Based on this systematic review and meta-analysis, 41% of Ethiopian women dropped out of antenatal care visits before the minimum recommended visit (four times Hence, to reduce the number of ANC dropouts it is important to counsel and educate women at their first prenatal care. Issues of urban-rural disparity and locations identified as hotspots for incomplete ANC visits require that further attention.