Cultural Competence and Associated Factors Among Nurses in Ethiopia: A systemic review and Meta-analysis

Abstract

Background Despite constituting three-quarters of the healthcare workforce and being frontline providers of extended care to patients and their families, there is no nationally representative data on cultural competence among nurses in Ethiopia. Therefore, this systematic review was conducted to assess cultural competence and its associated factors among nurses in Ethiopia. Methods A systematic review and meta-analysis adhering to the PRISMA guidelines was conducted. The PubMed, Scopus, Google Scholar, and EMBASE databases were searched to identify relevant studies. A Šidák–Jonkman random-effects model was employed to calculate the pooled mean score. Heterogeneity among studies was assessed using Cochrane's Q-test and the I² statistic. Funnel plots and Egger's test were used to assess publication bias. The pooled mean score and meta-regression analysis were performed using STATA 17. Results A comprehensive analysis of 643 articles yielded six studies involving 2,344 nurses for inclusion. The pooled mean cultural competence score among Ethiopian nurses was 2.79 (95% CI: 2.25, 3.3). Key factors associated with cultural competence included health institution level (β = 2.28; 95% CI: 1.92–2.87; I² = 0.00%), experience in caring for diverse patients (β = 1.34; 95% CI: 1.1–1.64; I² = 42.37%), and educational level (β = 1.3; 95% CI: 1.01–2.23; I² = 0.00%). Conclusion The level of cultural competence among nurses was found to be moderate, indicating a substantial need for improvement to achieve the standards of culturally competent nursing care. This study revealed that health institution level, experience in caring for diverse patients, and educational level were associated with nurses' cultural competence. Policymakers prioritize initiatives aimed at enhancing cultural competence among nurses working in lower-level health institutions and within nursing programs at technical and vocational levels.