Hand washing practices at critical times and their associated factors among mothers in Ethiopia: A systematic review and meta-analysis

Abstract

One of the most crucial preventive measures against the spread of infectious diseases is hand washing, a process of hand cleansing that dramatically lowers bacteria in the hands. There is no comprehensive study on hand-washing practices in Ethiopia. Thus, this systematic review and meta-analysis aimed at estimating the pooled prevalence of hand washing practice at a critical time and identifying associated factors among mothers in Ethiopia. Published articles from various electronic databases, such as Medline, Hinari, PubMed, the Cochrane Library, and the Web of Science, were accessed. The search period was from November 1, 2022, to January 10,
2023. The protocol was registered at PROSPERO with registration number CRD42023427409. All observational studies conducted among mothers in the English language were included in the review. Two reviewers independently assessed the articles before inclusion in the final review using the Joanna Briggs Institute Meta-analysis of Statistics Assessment and Review Instrument for critical appraisal. The I-squared test was used to assess heterogeneity. Since the included studies exhibited high heterogeneity, a random-effects model was used to estimate the pooled prevalence of hand washing practice at critical time movements. We found 3,546 studies in our search. Finally, 158 full-text studies were reviewed, and 18 studies fulfilled the inclusion criteria and were included in the final meta-analysis. A total of 6,956 study respondents from 18 studies were included in the study. The results of our study revealed that the pooled prevalence of handwashing practice among mothers was 47.83%, with a 95% confidence interval of 37.27- 58.38. From the pooled estimation, there was a significant association between hand washing practice and educational level, knowledge, availability of water, and attitude of mothers. The pooled prevalence of hand washing practice at critical times among Ethiopian mothers was relatively low, and improving maternal literacy, the availability of water sources in the backyard, and the positive attitude of mothers are needed to maintain and enhance the practice.