Effectiveness of nutritional education intervention during pregnancy on birth outcomes in sub-Saharan Africa: a protocol for a systematic review and meta-analysis

Introduction: Nutritional education intervention during pregnancy is the process of teaching pregnant women about the importance of a healthy diet and how to make healthy food choices. It is an important part of public health and vital to preventing adverse birth outcomes. Therefore, synthesising available evidence on the effect of nutritional education intervention on birth outcomes is essential for decision-making by policymakers and for identifying needed gaps for future research.

Objective: To systematically collect, review and summarise available evidence on the pooled effect of the nutrition education to pregnant women on birth outcomes in sub-Saharan Africa.

Primary and secondary outcome measures: The primary outcome measures will be birth outcomes, while maternal outcomes will be treated as secondary.

Methods and analysis: This systematic review will systematically search and collect data from a variety of databases, including the MEDLINE, CINAHL, EMBASE, Joanna Briggs Institute Database, Cochrane Database, PEDro, POPLINE, ProQuest, OpenGrey (SIGLE), Google Scholar, Google, APA PsycINFO, Web of Science, Scopus and HINARI. In addition, the systematic review will also search for unpublished studies and grey literature from a variety of sources. The review will only include experimental and quasi-experimental studies published in English from 1 January 2013 to 31 December 2023. Two independent reviewers will critically appraise all eligible studies for methodological quality using the standard Joanna Briggs Institute (JBI) Critical Appraisal Checklist for randomised controlled trials. Any disagreements between the reviewers will resolve through discussion. Either a random effects or fixed effects model will be used to pool the data, depending on the appropriateness of the model. The heterogeneity will be assessed statistically using the standard χ² and I² tests. Publication bias will be examined graphically using funnel plots and statistically using Egger's regression test. In the case when funnel plot is asymmetric and/or Egger's test is statistically significant, the trim and fill (Duval and Tweedie's) analysis will be performed. Statistical association between independent and dependent variables will be declared at p<0.05. The meta-analysis will be conducted using the statistical software STATA V.17.

Ethics and dissemination: By synthesising existing research without ethical concerns, this impactful review will be published and presented across academic and relevant institutions.

Prospero registration number: CRD42023473371.