Effect of Maternal Education on Prenatal Adherence of Iron-folic Acid Supplementation in Ethiopia: A Systematic Review and Meta-analysis

Background: Iron-folic acid supplementation is a central preventive measure for maternal anemia, so considering the factors leading to or deterring from adherence is important. This review aims to establish if there is a correlation between increasing maternal education and adherence to iron-folic acid supplementation in Ethiopia. Methods: An electronic database search was conducted using PubMed, Google Scholar, Cochrane Library and African Journals Online. Joanna Briggs Institute Meta-Analysis of Statistical Assessment and Review Instrument was used for quality appraisal of the included studies. The extracted data were entered into Microsoft™ Excel sheet and exported to R-software version 3.6.1 for analysis. Maternal education on adherence of iron-folic acid supplementation was analyzed and subgroup analyses of difference between regions and time of study period were conducted. Results: The online search yielded a total of 936 articles, and based on inclusion/exclusion criteria nine were included in this study with a total of 3263 participants. Applying the random effect model, the analysis revealed that the odds of prenatal adherence of iron-folic acid supplementation were 2.89 times higher in mothers with secondary school education and above as compared to those who had not received formal education. Conclusion: This review identified that increased maternal education leads to improved adherence of iron-folic acid supplementation amongst women across Ethiopia. This information may inform efforts of government and non-government organizations to encourage maternal education in order to sustained adherence of iron-folic acid supplementation. Further research is required in this critical area at regional, national, and global levels.