Background: The COVID-19 pandemic has a significant challenge for many countries to maintain the provision of essential maternal, newborn, and child health services. Pregnant women could experience difficulties for accessing maternal healthcare due to transport problems, anxiety, and fear of infection. Thus, this systematic review and meta-analysis was aimed to determine the impact of COVID-19 pandemic on antenatal care services utilization in Ethiopia.

Methods: A comprehensive search of literatures was conducted from PubMed, Medline, HINARI, EMBASE, Web of Science, Scopus, and Google scholar from December 24, 2020 to January 14, 2020 following the PRISMA guidelines. Additional studies were searched using a reference of identified articles. Predetermine eligibility criteria were used to select articles. The heterogeneity of the included studies was evaluated using Cochrane Q and I² test. A random effects meta-analysis was computed to determine the pooled estimate of the impact of COVID-19 pandemic on antenatal care services utilization using STATA 11.

Results: Three studies with a total of 1400 study participants were included in the final review. The meta-analysis revealed that antenatal care services utilization among pregnant women in the amid of COVID-19 pandemic in Ethiopia was reduced by 46.33% (95% CI: 33.62, 59.03). Heterogeneity in included studies was exhibited (I² = 95.9%; p < 0.001). As a result, a random effects meta-analysis was performed.

Conclusion: This study revealed that COVID-19 pandemic significantly affects the utilization of antenatal care services in Ethiopia. The finding suggests community sensitization and awareness creation, and outreach services for pregnant women are vital to sustain the delivery of antenatal care services, and reduce the effect of COVID-19 pandemic. Moreover, maternal health care services such as antenatal care should be prioritized as an essential core health care services.

Keywords: Antenatal care, COVID-19, Impact, Meta-analysis, Ethiopia