Men’s knowledge of obstetrics danger sign and associated factors in low-income countries: a systematic review and meta-analysis

Abstract

Obstetric danger signs refer to unexpected signs that arise during pregnancy, childbirth, or the postpartum period, indicating potential complications that require immediate medical attention. Globally, approximately 15% of pregnant women experience such complications, contributing to an estimated 287,000 maternal deaths annually-equivalent to nearly 800 deaths each day. This review evaluates the literature on men's knowledge of obstetric danger signs, a critical factor in enhancing maternal health outcomes. We performed a comprehensive search for articles using PubMed, Web of Science, Scopus, Hinari, and Google Scholar databases. To identify relevant studies, we employed search terms such as "knowledge," "awareness," "information," "recognition," "pregnancy danger signs," "obstetric danger signs," "obstetric warning signs," and "labor complications," combined with "low-income countries." six reviewers independently screened the articles and extracted data. The included articles in the review are cross-sectional studies, conducted in low-income countries and published in English, with no restrictions of publication years. Study quality was evaluated using a Newcastle-Ottawa Scale. The study was reported following the PRISMA checklist and the protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO) (protocol ID: CRD42024488979). Of the 366 articles initially screened by title and abstract, 13 studies met the inclusion criteria. All the included studies assessed men's knowledge of obstetric danger signs during pregnancy, and childbirth, while only ten assessed their knowledge during the postpartum period. The pooled random-effects meta-analysis indicated that men's knowledge of obstetric danger signs was 36.96% during pregnancy, 40.86% during childbirth, and 35.84% during the postpartum period, with an overall knowledge level of 37.29% based on the summarized random-effects meta-analysis. Key factors influencing men's knowledge included urban residence, educational attainment, access to antenatal care, participation in the health development army, and previous experience with obstetric complications. In low-income countries, men's knowledge of obstetric danger signs remains notably low, potentially hindering their ability to seek timely obstetric care for their partners during complications. Addressing this gap requires strengthening counseling services during antenatal care, expanding community meetings, and enhancing community-based health education on obstetric danger signs.