Abstract
BACKGROUND: Burden of care, encompassing objective (e.g., financial strain) and subjective (e.g., emotional distress) dimensions, significantly impacts caregivers of Patients with Mental Illness (PWMI) in Ethiopia, where mental health resources are limited. This systematic review and meta-analysis aimed to estimate the prevalence of burden of care and identify associated factors among caregivers of PWMI in Ethiopia. METHODS: Following Joanna Briggs Institute (JBI) methodology for mixed-methods reviews, we searched PubMed, Scopus, Embase, Ovid, PsychInfo, Web of Science, Google Scholar, and Ethiopian university repositories for cross-sectional and qualitative studies published in English between January 2000 and July 2024. Two reviewers independently screened studies, extracted data using a JBI-guided tool, and appraised quality with JBI checklists. Random-effects models pooled prevalence, with heterogeneity assessed via I(2). Qualitative data were synthesized through meta-aggregation. RESULTS: Ten studies (7 quantitative, n = 2225 caregivers; 3 qualitative, n = 64 caregivers) were included. The pooled prevalence of severe objective burden was 38% (95% CI: 24.4-52.7%, I(2) = 96.7%), and severe subjective burden was 63% (95% CI: 58-67.8%, I(2) = 62%). Female caregivers, close relatives, and those caring for patients with schizophrenia spectrum disorders or severe symptoms faced higher burdens. Social support mitigated burden; stigma exacerbated it. Qualitative themes highlighted emotional distress and financial hardship. CONCLUSIONS: The high burden of care, particularly subjective, underscores the need for public health interventions like financial assistance and support groups to enhance caregiver well-being and PWMI outcomes in Ethiopia.