African Journal of Health Sciences Volume 33, Issue No.2, March - April, 2020 49 Prevalence and Determinants of Low Birth Weight in Ethiopia: A Systematic Review and Meta-Analysis *Tamirat Tesfaye Dasa1, Teshager Worku Kassie2, Aklilu Abrham Roba2, Henna Umer Kelel3 1. Hawassa University, College of Medicine and Health Science, P.O. Box 1560, Hawassa, Ethiopia. 2. Haramaya University, College of Health and Medical Sciences, P.O. Box 235, Harar, Ethiopia. 3. Malawi University, College of medicine, Malawi. *Corresponding Author: Tamirat Tesfaye, Maternal and Reproductive Health, Department of Midwifery, College of Medicine and Health Sciences, Hawassa University. Email: tamirathenna@gmail.com, Phone: +251938611577 or +251913861908 Summary INTRODUCTION Low birth weight was defined as weight at birth less than 2500 grams. This had numerous negative outcomes such as fetal and neonatal mortality and morbidity. It was estimated that between year 2000 to 2018, twenty million (15% to 20%) of all births worldwide had low birth weight yearly. Data analyzed from the Swedish Childhood Diabetes Register (SCDR) indicated that, low birth weight infants. were 24% higher odds of developing type-1 diabetes, hypertension, obesity and dyslipidemia in future compared to normal birth weight infants. In Ethiopia, the proportion of births weighing less than 2.5 kg at birth in the past three DHS surveys was 14% in 2005, 11% in 2011, and 13% in 2016. That differed with WHO 2025 goal of achieving 30% reduction in the number of infants born with weight lower than 2500g. OBJECTIVES This systematic review study was aimed to explicitly assess and determine the contributing factors of low birth weight in Ethiopia for intervention. METHODOLOGY Cross-sectional, case-control and cohort studies were conducted in English language. A search of studies in the main databases; PubMed, EMBASE, CINAHL, Web of Science, Scopus, and other gray literature sources was conducted. In respect to eligibility criteria, the investigators included observational studies that had been conducted at a facility setting in different parts of Ethiopia on the prevalence and factors associated with low birth weight, published and accessible from 2000 - 2018 then written in English. Articles with irretrievable full text records with unrelated outcome measures with missing or insufficient outcomes, reviews, commentaries, editorial, case series/reports, and patient stories were excluded. Meta-analyses with random effects, subgroup analyses, and meta-regression were performed. Publication bias was measured using the Egger regression test and visual funnel plot inspection. Pooled odds ratio was done by using RevMan 5.3 software. 16 studies fulfilled the eligibility criteria. RESULT The underlying causes were multi-factorial. Antenatal Care(ANC) and pregnancy complication increased the risk of low birth weight of infants in Ethiopia. Maternal harmful substance exposure(pesticide, noise, radiation and alcohol consumption), undernutrition, infections, poor socioeconomic status, history of chronic diseases, hepatitis B carriers, intrauterine growth restrictions (IUGR) were reported. The pooled prevalence of low birth weight was 18% (95% CI: 13.9%, 22.2%). Gestational age less than 37weeks was (AOR,7.8; 95% CI: 4.7, 12.95), no antenatal care (AOR,3.39; 95% CI: 1.65, 6.98), rural residence (AOR,2.44; 95% CI: 1.94,