Women's knowledge towards neonatal danger signs and its associated factors in Ethiopia: A systematic review and meta-analysis

Introduction: Reducing neonatal mortality is an essential part of the third Sustainable Development Goal, to end preventable child deaths. Neonatal danger signs are the most common cause of neonatal mortality and morbidity. In Ethiopia, most babies are born at home or are discharged from the health institutions in the first 24 h, as a result enhancing women's knowledge towards neonatal danger signs and its complication might reduce neonatal morbidity and mortality. Therefore, this systematic review and meta-analysis aimed to assess the women knowledge towards neonatal danger signs in Ethiopia. Method: MEDLINE/PubMed, Scopus, Hinari, Google scholar, web of science electronic databases and grey literature from repository were searched for all the available studies. Fourteen cross sectional studies were included in this systematic review and meta-analysis. Subgroup analysis was conducted for the evidence of heterogeneity. Cochrane I statistics were used to check the heterogeneity of the studies. Egger test with funnel plot were used to investigate publication bias. Result: Fourteen cross-sectional studies with a total of 6617 study participants were included for this study. The overall pooled prevalence of women's knowledge towards neonatal danger sign was 40.7% (95%CI, 25.72, 55.67). Having higher educational status of the women (AOR = 3.86, 95%CI: 2.3-6.5), having higher educational status of the husband (AOR = 4.57, 95%CI: 3.29-6.35), access to mass media (AOR = 1.69, 95%CI: 1.17-2.23), having antenatal care visits (AOR = 2.63, 95%CI: 1.13-4.67), having postnatal care follow up (AOR = 2.55, 95%CI; 1.72-3.79) and giving birth at health institutions (AOR = 2.51, 95%CI:1.68-3.74) were factors associated with knowledge of the women towards danger sign of the neonate. Conclusion: In this systematic review and meta-analysis the pooled prevalence of maternal knowledge towards neonatal danger sign was low. Educational status of the mother, educational status of the husband, access to mass media, antenatal care follow-up, postnatal care follow-up and place of delivery were factors associated with knowledge of the mother towards danger sign of the newborn. Promoting antenatal care, postnatal care follow-up and community-based health information dissemination about neonatal danger signs should be strengthened. Systematic review registration: PROSPERO CRD42019132179.