Delays in the decision to seek care and associated factors among women in Ethiopia: systematic review and meta-analysis

Abstract Background Delays in seeking care during pregnancy and childbirth can result in serious complications for women and a major contributor to maternal illness and death, especially in low-resource countries like Ethiopia. However, there is an inconsistency in findings of a study that has been...

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Main Authors: Tesfahun Simon Hadaro, Misgun Shewangizaw, Teketel Ermias Geltore, Merkin Bekele, Lakew Desta Zewude, Mesfin Abebe, Yilma Chisha, Kusse Urmale Mare, Simeon Meskele Leyto
Format: Article
Language:English
Published: BMC 2025-08-01
Series:BMC Pregnancy and Childbirth
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Online Access:https://doi.org/10.1186/s12884-025-07968-4
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author Tesfahun Simon Hadaro
Misgun Shewangizaw
Teketel Ermias Geltore
Merkin Bekele
Lakew Desta Zewude
Mesfin Abebe
Yilma Chisha
Kusse Urmale Mare
Simeon Meskele Leyto
author_facet Tesfahun Simon Hadaro
Misgun Shewangizaw
Teketel Ermias Geltore
Merkin Bekele
Lakew Desta Zewude
Mesfin Abebe
Yilma Chisha
Kusse Urmale Mare
Simeon Meskele Leyto
author_sort Tesfahun Simon Hadaro
collection DOAJ
description Abstract Background Delays in seeking care during pregnancy and childbirth can result in serious complications for women and a major contributor to maternal illness and death, especially in low-resource countries like Ethiopia. However, there is an inconsistency in findings of a study that has been conducted on the delay in decision to seek care. Thus, this review aimed to determine the combined prevalence of delay in decision to seek care and associated factors in Ethiopia. Methods A systematic review and meta-analysis were conducted on the prevalence of delay in the decision to seek care and its associated factors. Five bibliographic databases and libraries, namely, Medline/PubMed, the Cochrane Library, Science Direct, Google Scholar, and Hinari, were used. Data extraction was performed using Microsoft Excel, and after cleaning and sorting, analysis was performed using STATA 17 software. The quality of each article was assessed using the Joanna Briggs Institute critical appraisal tool for prevalence studies. The pooled rate of delays in the decision to seek care and associated factors among mothers was estimated with a random-effects model. Heterogeneity was examined using Cochrane Q statistics and the I2 test, and publication bias was assessed by funnel plots and Egger’s regression test. Results A total of twelve studies were included in this review. The pooled prevalence of delays in the decision to seek care at health facilities among women in Ethiopia was 44.69% (95% CI: 37.02–52.36). Several factors were significantly associated with these delays, including having no formal education (AOR = 4.48; 95% CI: 3.30–5.60), residing in rural areas (AOR = 5.40; 95% CI: 2.30–8.50), being unemployed (AOR = 2.60; 95% CI: 1.80–3.49), husband-only decision-making (AOR = 2.80; 95% CI: 1.13–4.50), and lack of antenatal care follow-up (AOR = 2.90; 95% CI: 1.30–4.10). Conclusion The high pooled prevalence of delayed decision-making in seeking care highlights the urgent need for targeted interventions. These should focus on enhancing access to healthcare services, increasing maternal education, and promoting consistent antenatal care follow-up. Addressing these areas can significantly reduce delays and lead to improve maternal and public health outcomes.
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spelling doaj-art-7caa070bfd464c47a2bde02339bf573c2025-08-20T04:02:50ZengBMCBMC Pregnancy and Childbirth1471-23932025-08-0125111110.1186/s12884-025-07968-4Delays in the decision to seek care and associated factors among women in Ethiopia: systematic review and meta-analysisTesfahun Simon Hadaro0Misgun Shewangizaw1Teketel Ermias Geltore2Merkin Bekele3Lakew Desta Zewude4Mesfin Abebe5Yilma Chisha6Kusse Urmale Mare7Simeon Meskele Leyto8Department of Midwifery, College of Medicine and Health Sciences, Arba Minch UniversitySchool of Public Health, College of Medicine and Health Sciences, Arba Minch UniversityDepartment of Midwifery, College of Health and Medical Sciences, Wachemo UniversityDepartment of Midwifery, College of Health and Medical Sciences, Wachemo UniversitySchool of Public Health, College of Medicine and Health Sciences, Arba Minch UniversityDepartment of Midwifery, College of Medicine and Health Sciences, Dilla UniversitySchool of Public Health, College of Medicine and Health Sciences, Arba Minch UniversityDepartment of Nursing, College of Medicine and Health Sciences, Samara UniversityDepartment of Biomedical Sciences, College of Medicine and Health Sciences, Wachemo UniversityAbstract Background Delays in seeking care during pregnancy and childbirth can result in serious complications for women and a major contributor to maternal illness and death, especially in low-resource countries like Ethiopia. However, there is an inconsistency in findings of a study that has been conducted on the delay in decision to seek care. Thus, this review aimed to determine the combined prevalence of delay in decision to seek care and associated factors in Ethiopia. Methods A systematic review and meta-analysis were conducted on the prevalence of delay in the decision to seek care and its associated factors. Five bibliographic databases and libraries, namely, Medline/PubMed, the Cochrane Library, Science Direct, Google Scholar, and Hinari, were used. Data extraction was performed using Microsoft Excel, and after cleaning and sorting, analysis was performed using STATA 17 software. The quality of each article was assessed using the Joanna Briggs Institute critical appraisal tool for prevalence studies. The pooled rate of delays in the decision to seek care and associated factors among mothers was estimated with a random-effects model. Heterogeneity was examined using Cochrane Q statistics and the I2 test, and publication bias was assessed by funnel plots and Egger’s regression test. Results A total of twelve studies were included in this review. The pooled prevalence of delays in the decision to seek care at health facilities among women in Ethiopia was 44.69% (95% CI: 37.02–52.36). Several factors were significantly associated with these delays, including having no formal education (AOR = 4.48; 95% CI: 3.30–5.60), residing in rural areas (AOR = 5.40; 95% CI: 2.30–8.50), being unemployed (AOR = 2.60; 95% CI: 1.80–3.49), husband-only decision-making (AOR = 2.80; 95% CI: 1.13–4.50), and lack of antenatal care follow-up (AOR = 2.90; 95% CI: 1.30–4.10). Conclusion The high pooled prevalence of delayed decision-making in seeking care highlights the urgent need for targeted interventions. These should focus on enhancing access to healthcare services, increasing maternal education, and promoting consistent antenatal care follow-up. Addressing these areas can significantly reduce delays and lead to improve maternal and public health outcomes.https://doi.org/10.1186/s12884-025-07968-4Delay in seekingInstitutional delivery serviceEmergency obstetric careWomenEthiopia
spellingShingle Tesfahun Simon Hadaro
Misgun Shewangizaw
Teketel Ermias Geltore
Merkin Bekele
Lakew Desta Zewude
Mesfin Abebe
Yilma Chisha
Kusse Urmale Mare
Simeon Meskele Leyto
Delays in the decision to seek care and associated factors among women in Ethiopia: systematic review and meta-analysis
BMC Pregnancy and Childbirth
Delay in seeking
Institutional delivery service
Emergency obstetric care
Women
Ethiopia
title Delays in the decision to seek care and associated factors among women in Ethiopia: systematic review and meta-analysis
title_full Delays in the decision to seek care and associated factors among women in Ethiopia: systematic review and meta-analysis
title_fullStr Delays in the decision to seek care and associated factors among women in Ethiopia: systematic review and meta-analysis
title_full_unstemmed Delays in the decision to seek care and associated factors among women in Ethiopia: systematic review and meta-analysis
title_short Delays in the decision to seek care and associated factors among women in Ethiopia: systematic review and meta-analysis
title_sort delays in the decision to seek care and associated factors among women in ethiopia systematic review and meta analysis
topic Delay in seeking
Institutional delivery service
Emergency obstetric care
Women
Ethiopia
url https://doi.org/10.1186/s12884-025-07968-4
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