Systematic Literature Review and Meta-Analysis of Timely Initiation of Antenatal Care Among Pregnant Women in Ethiopia: Prevalence and Associated Factors

Background: Timely initiation of antenatal care (ANC) is crucial for clinical practices, including routine hypertension screening, fetal heart sound detection, illness identification, eradicating inequalities, providing psychological support, and postpartum family planning. However, the timely start and coverage of prenatal care differ throughout continents, nations, regions, and even within an area. Therefore, this study aims to determine the pooled prevalence of timely initiation of antenatal care and its associated factors. Methods: The studies were searched in various databases such as PubMed, MEDLINE, ScienceDirect, Embase, Google Scholar, Cochran Library, Africa Journal of Online, and university repository. Found 23 research publications, and data was extracted using Microsoft Excel 365 and analyzed using the STATA 17 version. Heterogeneity (I2) was found, and a random effect model was used to determine the pooled prevalence of timely prenatal care commencing. Related factors were also investigated. Result: The overall pooled prevalence of timely initiation of antenatal care among the pregnant women in Ethiopia was 37% (95% CI: 33–42), with statistical heterogeneity (I2 = 98.32%, p = 0.00). Good knowledge about antenatal care (OR=2.2, 95% CI: 1.78-2.62), a secondary education or above (OR=2.32, 95% CI: 1.49-3.14), received advice and counseling (OR= 95% CI:1.76-3.23), planned pregnancy (OR=3.8, 95% CI:2.30-5.30), primigravida (OR=2.21, 95% CI:1.73-2.269), urban residence (OR=2.59, 95% CI: 1.56-3.62) and pregnancy recognition urine test (OR=3.17; 95% CI:1.88-4.46) are the associated of timely initiation of antenatal care. Conclusion: The study indicates that timely antenatal care initiation is low, linked to factors like anticipatory counseling knowledge, education, being a primigravida, urban living, pregnancy detection, planned pregnancy, wealth index, and medical guidance. Regular monitoring and evaluation are needed to reduce complications and improve birth preparedness.