Self-Care Practices for Puerperal Sepsis Prevention and Associated Factors Among Postnatal Women in Africa: A Systematic Review and Meta-Analysis.

Abstract / Summary

BackgroundPuerperal sepsis remains a preventable contributor to maternal illness. Pregnancy-related sepsis is responsible for ∼10% to 15% of maternal deaths. Despite this burden, no comprehensive review has examined self-care practices related to its prevention. Therefore, this review sought to evaluate self-care behaviors aimed at preventing puerperal sepsis and to explore associated factors among postnatal women in Africa.Data Sources and MethodsWe conducted a systematic review and metaanalysis of 17 eligible studies on the prevalence of self-care practices for puerperal sepsis prevention and their associations among postnatal mothers. Searched PubMed, Web of Science, Wiley Online Library, ScienceDirect, African Journals Online, and Google Scholar from December 10, 2023 to January 15, 2024. A Joanna Briggs Institute adapted tool was used to assess the quality of the studies. Forest plot, Cochran's Q test, subgroup analysis, sensitivity analysis, and metaregression model were used to test heterogeneity between included studies. Funnel plots and Egger's test were used to examine publication bias.ResultsA total of 17 studies that meet the inclusion criteria were included. The pooled prevalence of self-care for puerperal sepsis prevention practices among postpartum women was 36.09% (95% CI: 26.35, 45.82). Among postpartum women, urban dwellers (AOR: 3.23, 95% CI: 1.86, 5.63), those who were above tertiary education status (AOR: 2.81, 95% CI: 1.11, 4.67), those who had a good level of knowledge (AOR: 2.45, 95% CI: 1.11, 4.67), and those who had ≥4 ANC contacts (AOR: 3.75, 95% CI: 2.23, 6.31) were identified as associated factors.ConclusionsOnly 36.09% of postpartum women practiced self-care practices to prevent puerperal sepsis at home. It would be better to design a new healthcare system during maternal healthcare to scale up mothers' self-care puerperal sepsis prevention practices to reduce maternal morbidity and mortality caused by puerperal sepsis. In addition, all healthcare providers recognize the need to foster new thinking and to apply greater action to address identified factors of poor self-care and puerperal sepsis prevention practices.PROSPERO RegistrationCRD420251042794. Self-care practices for puerperal sepsis prevention and associated factors among postnatal women in Africa: A systematic review and meta-analysisPuerperal sepsis remains a preventable contributor to maternal illness. Pregnancy-related sepsis is responsible for ∼10% to 15% of maternal deaths. Although some primary studies have been conducted on self-care prevention practices and related factors, the findings have been inconsistent, making it difficult to generalize their results across Africa. Therefore, this systematic review aimed to evaluate the overall self-care prevention practices and their associated factors among postpartum mothers. I hope our findings will help to identify relevant gaps and contribute to improving self-care practices to prevent complications of puerperal sepsis and encourage early self-reporting about the condition. In addition, all healthcare providers recognize the need to foster new thinking and to apply greater action to address identified factors of poor self-care and puerperal sepsis prevention practices.

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