Maternal Health Literacy and Its Determinants among Pregnant Women in Ethiopia: A Scoping Review of Published and Grey Literature

Articles in Press

Document Type : Review Article.

Authors

1 Assistant professor at College of Health Sciences Department of Midwifery Woldia University, Woldia Ethiopia, MSc in clinical midwifery.

2 Lecturer at College of Health Sciences Department of Midwifery Woldia University, Woldia Ethiopia, MSc in clinical midwifery.

3 Lecturer at College of Health Sciences Department of Midwifery Jimma University, Jimma Ethiopia, MSc in maternity.

4 Lecturer at College of Health Sciences Department of Midwifery Debre Markos University, Debre Markos Ethiopia, MSc in maternity.

5 Lecturer at College of Health Sciences Department of Nursing, Woldia University, Woldia Ethiopia, MSc Surgical nursing.

Abstract

Background and Objective: Maternal health literacy (MHL) is a woman’s ability to access, understand, interpret and use health information to make informed decisions during pregnancy, childbirth, and the postpartum period that benefit both mother and child. It is a critical determinant of maternal and neonatal health outcomes. However, evidence on maternal health literacy and its determinants in Ethiopia remains scarce and fragmented. Hence, mapping existing evidence can inform policymakers and health practitioners, providing a foundation for designing targeted interventions to improve maternal and neonatal health outcomes. To map existing evidence on maternal health literacy and determinant factors among pregnant women in Ethiopia.

Materials and Methods: This scoping review was developed in accordance with the Arksey and O’Malley (2005) framework and the PRISMA-ScR guidelines. Relevant studies were retrieved from peer-reviewed journals, theses, and institutional reports. Data were extracted for study characteristics, measurement tools, maternal health literacy levels, and determinants. Findings were synthesized descriptively and thematically.

Results: in this scoping review, the proportion of adequate maternal health literacy levels was ranged from 25.5% to 55.5%. Three broad themes of determinants were developed: socio-demographic (Socio-demographic factors such as educational attainment, age at first pregnancy, residence, and travel time), health service related (Having antenatal and postnatal care, as well as exposure to counseling during facility-based deliveries), and community or structural factors (Enrollment in Community Based Health Insurance (CBHI) and the presence and accessibility of Health Extension Workers (HEWs) were equally important). 

Conclusion: Maternal health literacy among Ethiopian women remains low and influenced by a combination of socio-demographic, health service related, and community or structural factors. Enhancing MHL requires comprehensive, context-sensitive strategies that improve education, increase access to maternal health services, and strengthen community-based programs. Addressing these multidimensional determinants will empower women to make informed health decisions, ultimately contributing to better maternal and child health outcomes across Ethiopia.

Keywords

Acknowledgments: We Acknowledge Woldia University for giving us internet service and we would like to thank all authors of the primary studies that we included in this systematic review and meta-analysis.


Availability of data and materials: All related data has been presented within the manuscript. The dataset supporting the conclusions of this article is available from the authors upon request.


Conflicts of interest: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.


Consent for publication: Not applicable.


Ethics approval and consent to participate: This study was a scoping review based on publicly available published and grey literature and did not involve human participants or the collection of primary data. Therefore, ethical approval and informed consent to participate were not required.


Funding: There is no fund received for this review from any organization.


Author’s contribution: All authors contributed to the study protocol and AY wrote the design of the work, drafted the work, and substantively revised it. AA, TE, CM, TB, YA and FB revised subsequent drafts of the protocol and approved the result with some revisions. All authors have read and approved the manuscript of this systematic review and meta-analysis. 

 

Open Access Policy: This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.To view a copy of this licence, visit https://creativecommons.org/licenses/by/4.0/

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Journal of Health Literacy

Articles in Press, Accepted Manuscript
Available Online from 16 December 2025

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