Under nutrition and associated factors among lactating mothers in Ethiopia: A systematic review and meta-analysis

Abstract Background: Under nutrition is a global problem and in increasing trend in recent years. The burden is high in low and middle-income countries; especially in Africa. Lactating women are among the most vulnerable groups for undernutrition; especially in sub-Saharan Africa. However, the prevalence of undernutrition among this group is inconsistent and inconclusive in Ethiopia, and also the national nutritional plan of 2015 is not yet achieved. Furthermore, to achieve the 2030 Sustainable developmental plan, conducting this type of summarized reviews are helpful. Therefore, we aimed to assess the pooled prevalence of undernutrition and its associated factors among lactating mothers in Ethiopia. Methods: : To write this review and meta-analysis we followed the preferred reporting items for systematic reviews and meta-analysis guidelines. We used PubMed, Hinari, Cochrane Library, science direct databases, Google, and Google scholar for searching. STATA version 14 software and a standardized format were used for analysis and data extraction respectively. Heterogeneity was checked using I 2 . A random-effect meta-analysis model was used to determine the pooled prevalence of undernutrition. Begg's and Egger's tests were conducted to detect publication bias. Subgroup analysis was also conducted and association was expressed by a pooled odds ratio with 95% CI. Result: A total of 16 studies were included with a total of 7830 Ethiopian lactating women. The pooled prevalence of undernutrition among lactating mothers was found to be 23.86% (95% CI: 19.01, 28.72). The result of heterogeneity test was I 2 = 96.7% and p < 0.001). The Begg's and Eger's test findings after we removed two influential primary articles were P: 0.443 and P: 0.306 respectively. Educational status (no formal education) (Pooled OR: 2.30 (95% CI: 1.34, 3.96)) was significantly associated with undernutrition. Conclusion: The pooled prevalence of undernutrition was high. Maternal educational status was significantly associated with undernutrition. Therefore, the federal ministry of health and the concerned stakeholders should give attention to these most vulnerable groups, refine their strategies to address this issue, and strengthen the implementation of the previously designed strategies.