Birth preparedness and complication readiness (BP/CR) is a wide-ranging and inclusive package aimed at encouraging timely access to skilled maternal and neonatal services, promotes active preparation and decision making for delivery by pregnant women and their families[1]. Maternal mortality is one of the most important markers of health inequalities in low, middle and high-income countries and remains a major contributor to unmet public health concerns worldwide [2]. The 2015 World Health Organization report, indicated that more than half a million women were dying each year from the complications of pregnancy and childbirth, in which 99% of these deaths occurring in the developing world [3]. Besides this, for every 100,000 live births, 240 women died during pregnancy, childbirth, or the postpartum period which are mostly from developed countries [4, 5]. There are notable disparities between and within countries in maternal deaths, with wide variations between rich and poor, urban and rural areas particularly in sub-Saharan Africa [6, 7].
A male companion at antenatal care is rare and in many communities, it is unthinkable to find male companions accompanying a woman to the labor room during delivery. Thus male involvement in reproductive health has been promoted as a promising new strategy for improving maternal and child health [8, 9]. Although, birth preparedness and complication readiness is among the common approaches in employment for implementing safe motherhood programs, it may be hindered by male partners involvement since husbands had been the most influential decision-makers and as the key member of the family [10, 11]. According to the Ethiopian Federal Ministry of Health, health and health related indicators 82.20% coverage for ANC, only 18.4% of the deliveries are attended by health professionals, 42.10% for postnatal care coverage [12].
Internationally, there was an estimated 303,000 maternal deaths happen maternal deaths happen year after year from pregnancy and childbirth related complications. About 99% of these deaths happen in underdeveloped countries and the great portion (62%) belongs to the sub-Saharan Africa region [6] . The death of mothers might happen from unexpected emerging complications that happened while the women are pregnant, during labor, or in post-partum period. Birth preparedness and complication readiness during pregnancy period prominently increase positive maternal as well as child health outcomes [13].
Globally, around 1500 women die every day from complications related to pregnancy and childbirth [[4, 5, 14]. Globally, nearly 80% of the maternal morbidity and mortality are directly linked to pregnancy and childbirth complications. Different kinds of evidence showed that the commonest causes of maternal death among women in low-income and middle-income countries differ noticeably according to region. For example; In Africa, hemorrhage causes a third of maternal deaths. However, hypertensive disorders are the most common cause of maternal mortality in Latin American countries[5, 15]. Other major causes of death sepsis, obstructed labor, and complications from abortion also vary by geography [6, 16]. Obstetric related complications including severe hemorrhage, infection, hypertensive disorders, sepsis and obstructed labor, and unsafe abortion are among the key factors to maternal death [3]. Although, there is significantly declined in Abortion and infection related maternal deaths in the last decade, Obstructed labor , hypertensive disorders and hemorrhage continues to be the major cause of maternal deaths[16]. About 125,000 women and 870,000 neonates die every year in Africa, predominantly in the first week of post-partum period. The country Ethiopia, is one of six countries sharing 50% of the total global burden of maternal mortality[17]. Male involvement in pregnancy and labor care has been shown to improve maternal and newborn outcomes. Nevertheless, it continues to be low, especially in low income countries. Numerous strategies have been suggested aimed at backup male involvement in reproductive health and maternity care, nonetheless no assessment has been made in terms of their effectiveness [8, 13, 18]. One of the reasons is the lack of birth preparedness and complication readiness, which is recognized as the most cost-effective and achievable components of safe motherhood programs around the world[1, 19] . Due to this and that reason mothers who are productive and basis for countries development through delivering and growing new generation might be morbid and die. This in turn could drain individuals, families pocket and countries budget at large unless the level of male involvement at each spot of maternal care improved. Thus, this systematic review and meta-analysis study tried to determine the pooled prevalence of male involvement in birth preparedness and complication readiness (BP/CR) and its associated factors in Ethiopia.