Determinants of evidence-based practice among health care professionals in Ethiopia: A systematic review and meta-analysis

Abstract

Introduction Evidence-based practice (EBP) is the art of using up-to-date information for clinical decision-making. Healthcare professionals at all levels are expected to use the latest research evidence for quality care. In Ethiopia inclusive and nationally representative summarized evidence regarding the level of EBP among health professionals is scarce. Therefore, this systematic review and meta-analysis aimed to assess the pooled prevalence of EBP utilization and its determinants among Ethiopian health professionals. Method A systematic review and meta-analysis were conducted using PRISMA guidelines. Comprehensive literature was searched in PubMed, Google Scholar, and African Online Journal databases. A weighted inverse variance random effect model was used to estimate pooled prevalence. Cochrane Q-test and I2 statistics were computed to assess heterogeneity among studies. Funnel plot and Eggers test were done to assess publication bias. Factors associated with EBP were identified using STATA v. 14. Result Overall, 846 articles were retrieved and finally 23 articles were included in this review. The pooled prevalence of good EBP among health professionals was 52.60% (95%CI; 48.15%-57.05%). Knowledge about EBP (AOR = 2.38, 95% CI: (2.08–2.72)), attitude (AOR = 2.09, 95% CI: (1.67–2.60)), educational status (AOR = 3.12, 95% CI: (2.18–4.47)), work experience (AOR = 2.59, 95% CI: (1.48–4.22)), EBP training (AOR = 2.26, 95% CI: (1.87–2.74)), presence of standard guideline (AOR = 1.94, 95% CI: (1.51–2.50)), internet access (AOR = 1.80, 95% CI: (1.47–2.20)), presence of enough time (AOR = 2.01, 95% CI: (1.56–2.60)) and marital status (AOR = 1.73, 95% CI: (1.32–2.28)) were determinants of EBP. Conclusion Around half of health professionals in Ethiopia have good EBP utilization which was low. Knowledge, attitude, educational status, work experience, EBP training, presence of standard guidelines, internet access, presence of enough time, and single marital status were positively associated with EBP. Therefore future interventions should focus on increasing their knowledge and changing their attitude through providing training and addressing organizational barriers like availing standard guidelines, accessing the internet, and minimizing professionals’ workload that enables them to critically appraise and integrate the latest evidence for clinical decision-making to improve the quality of care.

Uptake of evidence-based practice and its predictors among nurses in Ethiopia: a systematic review and meta-analysis

“…Nurses holding a head nurse position were three times more likely to implement EBP in their setting compared to ordinary nurses in the current study meta-regression result. This is in line with findings from Ethiopia ( Wubante and Tegegne, 2022 ; Zewdie et al, 2023 ), China ( Zhou et al, 2015 ; Zhao et al, 2022 ; Zhang et al, 2024 ), Ghana ( Nkrumah et al, 2018 ), Sweden ( Brämberg et al, 2017 ), Cyprus ( Pitsillidou et al, 2020 ), Pakistan ( Aslam et al, 2023 ), Switzerland ( Verloo et al, 2017 ), the USA ( Godshall, 2016 ; Stavor et al, 2017 ), Egypt ( Baiomy and Khalek, 2015 ), and other studies ( Azmoude et al, 2018 ; Bianchi et al, 2018 ; Fry and Attawet, 2018 ; Ayoubian et al, 2020 ; Chen et al, 2020 ; Clavijo-Chamorro et al, 2020 ; Duff et al, 2020 ; Ost et al, 2020 ; Spoon et al, 2020 ; Alqahtani et al, 2022 ; Clavijo-Chamorro et al, 2022 ; Crawford et al, 2022 ; Teixeira et al, 2022 ). This phenomenon could be attributed to the fact that head nurses, occupying leadership positions, tend to receive specialized training and orientation regarding the implementation of Evidence-Based Practice (EBP) and the adoption of new guidelines and procedures as provided by the Ministry of Health and regional health bureaus.…”

“…Nurses who demonstrated a strong understanding of EBP were twice as likely to implement it within their respective settings, as revealed by the findings of the current study. This finding corroborates similar results observed in studies conducted in Ethiopia ( Wubante and Tegegne, 2022 ; Zewdie et al, 2023 ); global ( Li et al, 2019 ); China ( Zhao et al, 2022 ); Sweden ( Brämberg et al, 2017 ); low- and middle-income country ( Shayan et al, 2019 ); worldwide review ( Furtado et al, 2024 ) contexts; Cyprus ( Pitsillidou et al, 2020 ); Pakistan ( Aslam et al, 2023 ); among developed countries ( Riahi and Khajehei, 2019 ); Switzerland ( Verloo et al, 2017 ); and the USA (44,45). This phenomenon may be attributed to the fact that possessing strong knowledge of EBP not only boosts the confidence of healthcare professionals but also enhances their skills to effectively implement it.…”

“…The meta-regression results of the current study indicated that nurses who held favorable attitudes towards EBP were more inclined to implement it compared to those with unfavorable attitudes. This finding is consistent with similar results observed in Ethiopia ( Wubante and Tegegne, 2022 ; Zewdie et al, 2023 ), as well as in global ( Li et al, 2019 ), China ( Zhao et al, 2022 ), low- and middle-income country ( Shayan et al, 2019 ), and worldwide review ( Furtado et al, 2024 ) contexts; among developed countries ( Riahi and Khajehei, 2019 ), the USA ( Godshall, 2016 ; Stavor et al, 2017 ), Saudi Arabia ( Alqahtani et al, 2020 ), and Norway ( Stokke et al, 2014 ). This could be explained by EBP enhancing nurses’ capacity to evaluate and incorporate information for clinical decisions, resulting in favorable outcomes.…”

“…In the present study, the collective estimate of evidence-based practice (EBP) uptake among nurses in Ethiopia stood at 53% (95% CI: 46%–60%). This discovery resonates with previous research conducted within Ethiopia ( Wubante and Tegegne, 2022 ; Zewdie et al, 2023 ). Furthermore, our findings align with those of a global systematic review and meta-analysis ( Li et al, 2019 ).…”