A systematic review and meta-analysis of utilization and associated factors of preconception care among women of reproductive age in Ethiopia

In Ethiopia, there is a substantial burden of risky preconception conditions and adverse pregnancy outcomes. The prevalence and determinants of preconception care utilization have been reported inconsistently across studies conducted in Ethiopia. The objective of this study was to assess the prevalence and determinants of preconception care utilization among women of reproductive age group in Ethiopia. A systematic review and meta-analysis of primary studies was conducted. Studies done in Ethiopia were searched using PubMed, Web of Science, Science Direct, CINAHL, Google Scholar, Cochrane Library, Global Health, HINARI, and Google databases. Articles published at any time were selected after a careful screening and assessing studies’ quality using a modified Newcastle-Ottawa appraisal checklist. Data were extracted using a pretested and validated Microsoft Excel spreadsheet and exported to R software version 4.4.1 for analysis. Publication bias assessment, heterogeneity testing, sensitivity analysis, subgroup analysis, and trim-and-fill analysis were performed using appropriate statistical tests. The odds ratio at a 95% confidence interval was used to measure the effects of determinant factors. A total of 21, 097 articles were searched and only 18 primary studies were included in the final analysis. The pooled prevalence of preconception care in Ethiopia was 27.65% (95% CI 19.59–35.72). Formal education (OR 3.29; 95% CI 2.45–4.14), having social support (OR 7.46; 95% CI 2.90-12.02), being over age of 25 (OR 3.76; 95% CI 2.39–5.13), poor obstetrics history (OR 3.86; 95% CI 3.08–4.64), being family planning users (OR 3.00; 95% CI 1.62–4.37), having chronic medical conditions (OR 5.08: 95% CI 3.80–6.36), intended pregnancy (OR 2.25; 95% CI 1.86–2.64), discussing with health care providers (OR 5.57; 95% CI 2.04–9.10), and resided near to health facility (OR 1.62; 95% CI 1.27–1.96) increased the odds of women’s preconception care utilization. This systematic review and meta-analysis revealed that the pooled prevalence of preconception care in Ethiopia is low. Preconception care utilization will be promoted by improving women’s educational status, and health care system, ensuring easy access to health facilities, addressing family planning needs, and strengthening social interactions and relationships.