Practice of pharmacological labor pain management and associated factors among healthcare providers in Ethiopia: a systematic review and meta-analysis
Bibliographic record
Abstract
Achieving positive obstetric health outcomes is a global priority, and the implementation of pharmacological and evidence-based interventions for pain relief during labor is strongly recommended. However, there is a notable scarcity of systematic review evidence concerning the practice of pharmacological labor pain management services. Therefore, this study aimed to evaluate the pooled practices of pharmacological labor pain management and the associated factors among healthcare providers in Ethiopia. Studies systematically searched electronic databases including Scopus, Medline/PubMed, Web of Science, Science Direct, African Journal Online, the Wiley Online Library, and National Digital Library repositories from April 1, 2024, to April 30, 2024. Data extracted from Microsoft Excel were imported into STATA version 11 for further analysis. A modified version of the Newcastle–Ottawa scale employed for cross-sectional studies used for quality assessment. A random-effects model was used to estimates pooled prevalence. Cochran's Q test and I 2 statistics were used to assess the heterogeneity of the studies. Percentages and odds ratios (OR) with 95% CI were used to pool the effect measure. The symmetry of the funnel plot and Egger's test were used to check for publication bias. A subgroup analysis was done on the study years, and sample sizes. The pooled practice of pharmacological labor pain management services among healthcare providers was found to be 43.83% (95% CI: 37.45–50.20). Caregivers with sufficient knowledge (AOR: 2.36; 95% CI: 1.99–2.81), those who held positive attitudes (AOR: 3.66; 95% CI: 3.13–4.31), caregivers who received training related to obstetric protocols (AOR: 3.42; 95% CI: 2.36–4.97), laboring mothers expressed a preference for such interventions (AOR=2.33; 95% CI: 1.50, 3.63) were associated with practicing pharmacological labor pain management. The overall pooled practice of pharmacological labor pain management among healthcare providers was found to be inadequate. Key factors such as obstetric care-related training, knowledge, attitudes, and the availability of options for labor pain management were strongly associated with this outcome. Therefore, it is crucial to provide training on labor pain management techniques to enhance healthcare providers’ knowledge and attitudes toward these interventions across all levels of the healthcare system. Moreover, recommend that all healthcare providers offer pain relief in a manner that aligns with the preferences of laboring women, ensuring that care is both responsive and respectful.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.018 | 0.035 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.013 | 0.029 |
| Bibliometrics | 0.011 | 0.009 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".