Study Protocol and Reporting
A systematic review and Mata-analysis protocol will be prepared using the Preferred Reporting Items for Systematic review and Meta-analyses (PRISMA) guideline [28]. PRISMA-P 2015 checklist will be used to report the protocol [29] (Additional file 1).
Eligibility criteria
All observational studies including cross-sectional, case-control, and cohort will be included. Case reports, case series, conference reports, and expert opinions will be excluded from the review. Studies that only investigate the qualitative approach of male involvement in family planning use will be excluded. If studies that address both quantitative and qualitative finding, we will only consider the quantitative findings result. Community and institution based studies will be included. Studies published in the English language alone will be included. There will not be a restriction on the date of publication.
PECO search guide
Population: Married men
Exposure: Determinates of male involvement in family planning use. Determinates are exposures that increase or decrease the likelihood of males involvement in family planning use in Ethiopia. The determinates can be marital status, the number of children, discussion with partner, knowledge on contraceptive use, ever used family planning methods, participation in community networks, etc.
Comparison: it is the reported reference group for each determinate in each study: marital status versus single, available children or not, good knowledge versus poor knowledge on contraceptives use, discussion of partners on family planning use or not, etc.
Outcome: The primary outcome of studies will be the overall prevalence of male involvement in family planning use among married men in Ethiopia. The secondary outcome of studies will be determinates of male involvement in family planning use among married men in Ethiopia. Male involvement in family planning refers involvement of male at least in one of the following activities; discussion or spousal communication, support, approval and contraceptive use of the husband.
Searching strategy and study selection
Online databases including PubMed, Google Scholar, CINAHL, and unpublished grey literature will be used to search articles from April 10-August 11/2021. In addition, cross-references searching of the included study will be done to include related studies. Removal of duplication, irrelevant studies, and inclusion of eligible studies will be done. The two authors (EW and SB) will independently screen the studies. Studies that mentioned the objective of male involvement in family planning use with full text will be further evaluated for quality by (EW and SB). The articles will be retrieved and exported to Endnote version 8 reference manager software to collect and organize search outcomes [30]. The procedure of searching strategy will be shown in PRISMA diagram (Additional file 2).
The search Medical Subject Heading (Mesh) terms will be developed using the authors’ keywords articles, and PMID of sample index manuscripts on male involvement in family planning use, titles and abstracts of studies. Then, search strategies will be developed using different Boolean operators and modification will be made based of the types of data bases (Additional file 3).
Quality assessments
Assessment of articles using their title, abstract, and full review of the manuscripts will be done before the inclusion of articles in the final meta-analysis. The qualities of each article will be assessed by using the Joanna Briggs Institute Meta-Analysis of Statistics Assessment and Review Instrument (JBI-MAStARI) [31]. Particular attention will be given to clear statement of the objective, inclusion criteria, study subjects, and setting, standard criteria used for measurement of the condition, exposure measurement in a validity and reliability strategies to deal with confounding, outcomes measurement, and appropriate statistical analysis (Additional reference 4). Studies 50% and above of the quality scale will be considered and included in the final systematic review and meta-analysis. Studies that will not be eligible based on the full-text assessment will be excluded. The quality of the full articles will be assessed by two authors (EW and SB). Any disagreement among reviewers will be resolved by the third author (ZH).
Data extraction and management
Data extraction template will be constructed on Microsoft Excel (2016) for full-text eligible articles. Piloting of the data extraction will be carried out before the beginning of the authentic data extraction by all authors. All necessary data will be extracted using the pre piloted excel data extraction tool. The tool will contain information including author name, the year of publication, study area, study design, sample size, prevalence or proportion, odds ratio, lower confidence interval, upper confidences interval, log transformation and standard error of logarithm of prevalence, odds ratio, lower confidence interval, and upper confidences interval will be calculated. The two authors (EW and SB) will independently extract the data. Any discrepancies will be discussed with a third author (ZH) to reach an agreement. Authors will contact the authors of the studies in case of missing data or incomplete reports.
Data synthesis and analysis
The extracted data will be imported to STATA version 14 for analysis. The data will be presented using narrative synthesis of included studies and results will be presented using tables and figures. Square root transformation of data will be done using the Freeman Tuckey variant of the arcsine to avoid variance variability [32].
The pooled prevalence estimate of male involvement in family planning use in Ethiopia will be done using a random-effect model [33]. Forest plots will be used to present the pooled prevalence and its determinates of male involvement in family planning use at a statistical significance level of a p-value of less than 0.05 [34]. Heterogeneity across studies will be assessed using Cochran’s Q [35] and I2 statistics [36]. I2 values of 25%, 50%, and 75% representative of low, moderate, and considerable heterogeneity respectively. Subgroup analysis and Meta-regression will be done based on region and residence (urban and rural) to identify the sources of heterogeneity. Moreover, the sensitivity analysis will be done to investigate the effect size estimates of studies. Publication bias will be checked using visual inspection on the funnel plot [34]. An asymmetry of the funnel plot indicates publication bias. Moreover, Eggers and Begg’s tests [37] will be conducted to check the potential publication bias and a p-value of < 0.05 will be used to declare the statistical significance of publication bias.