Knowledge, attitude and practice towards COVID-19 among pregnant women in Africa: A systematic review and meta-analysis

Background: Pregnant women and recent mothers face a higher risk of severe illness from Coronavirus disease 2019 due to physiological and immunological shifts during pregnancy, rendering them more vulnerable to inflammatory lung conditions. This susceptibility poses serious threats to both maternal and newborn health. Therefore, it is imperative for pregnant women to be fully informed about Coronavirus disease 2019 and to implement preventive measures. This study aimed to evaluate the collective knowledge, attitudes, and practices related to Coronavirus disease 2019 among pregnant women across Africa. Methods: The researchers collected studies from multiple databases, including Pub Med/MEDLINE, EMBASE, CINAHL, Science Direct, Scopus, Web of Science, Cochran library, and Google Scholar. A combination of search terms and Boolean operators were utilized to gather relevant literature. Each study underwent quality assessment by five authors independently, using the modified Newcastle Ottawa Scale tailored for cross-sectional research. Statistical analysis was conducted using STATATM Version 11 software, and meta-analysis was performed using the random-effects (Der Simonian and Laird) method. Heterogeneity was evaluated using I-squared (I2) statistics, and a one-out sensitivity analysis was carried out. Results: This systematic review and meta-analysis included 19 articles, involving a total of 7852 participants. It revealed that the combined estimated prevalence of good knowledge about Coronavirus disease 2019, positive attitudes, and good practices among pregnant women was found to be 61.8 % (95 % CI: 53.0%-70.65 %; I2 = 98.7 %), 51.7 % (95 % CI: 30.34%-73.6 %; I2 = 99.3 %), and 52.31 % (95 % CI: 41.48%-63.15 %; I2 = 98.8 %) respectively. Conclusion: This study emphasizes a significant concern: pregnant women exhibit a notable lack of knowledge, positive attitudes, and preventive practices regarding Coronavirus disease 2019. Considering their heightened vulnerability, urgent action is required to improve their understanding, attitudes, and behaviours related to the virus. Healthcare professionals should take proactive measures to educate pregnant women, addressing this crucial gap through various strategies.