Predictors of antenatal care service utilization among women of reproductive age in Ethiopia: a systematic review and meta-analysis

Objective: This study aimed to provide pooled predictors of ANC (antenatal care) service use among women of reproductive age in Ethiopia. Methods: Studies were systematically searched using PubMed, Medline, CINAHL, EMBASE, and Google Scholar. The Newcastle–Ottawa scale (NOS) tool was utilized for quality assessment (risk of bias). All data analyses were conducted by utilizing Stata version 17. A random-effects model was used to obtain the pooled predictors of ANC use. The publication bias was checked using a funnel plot and Egger’s regression test. Results: Twenty-two studies with a sample size of 25,671 were included in this review. The identified predictors of ANC service use were highest wealth rank (AOR 1.92 [95% CI: 1.53–2.31]), formal women education (AOR 2.40 [95% CI: 1.75–3.06]), formal husband education (AOR 1.49 [95% CI: 1.36–1.66]), women age ≥ 20 (AOR 1.75 [95% CI: 1.47–2.17]), mass media exposure (AOR 1.44 [95% CI: 1.21–1.66]), good maternal knowledge about the pregnancy complication (AOR 1.49 [95% CI: 1.11–1.88]), planned pregnancy (AOR 1.59 [95% CI: 1.28–1.91]), women autonomy (AOR 1.42 [95% CI: 1.23–1.62]), and positive husband attitude about the ANC service use (AOR 2.63 [95% CI: 1.47–3.79]). Conclusions: Several predictors have increased the ANC service utilization, like wealth status, women’s and their husbands’ education, older/increasing women’s age, media exposure, maternal knowledge about pregnancy complications, planned pregnancy, women’s autonomy to decide on household health care, and positive husband attitude about the ANC service utilization.