This study aimed to assess community based essential newborn care practices and associated factors among women who gave birth at home in the last 12 months preceding the survey in Amaro woreda southern Ethiopia. Of the total study participants included in the analysis, 142(29%) were practiced CBNC. However, 60.2 % neonate received clean cord care, 63.1% mothers initiated breast-feeding within one hour and 59.5% received appropriate bathing, which is comparable with study conducted in Southwest Ethiopia (18). The prevalence of community based essential new-born care (CBNC) practice in this study is considered to be higher as compared to other studies reports from Amhara (23.1%) and Aksum (26.7%) (9, 10). This discrepancy may be due to the fact that some of the former studies include both home and facility delivery.
In the current study, paternal education was found to have statistically significant association with community based essential newborn care practices. Babies born to fathers having formal education were two times more likely receiving CBNC than babies born to illiterate fathers’. This finding is consistent with finding in Bangladesh [AOR=1.3], Gojam, Ethiopia [AOR=7.02], Welkite, southwest Ethiopia [AOR=1.21], (9, 17-19). This might be due to the fact that education in the real world has a positive significant effect to practice any healthy life for mothers and children as well families. However, in the current study mothers able to read and write were 65% less practicing CBNC than illiterate mothers. It need further investigation.
Mothers who had her last delivery at home by assisted with relatives or friends were found to be 3.58 times more likely practicing CBNC than those assisted by HW at home This may be due to poor quality of counseling by HEW or HWs results in strong peer pressure to change their view towards CBNC practice.
Having awareness about CBNC is the most important reported factors in the population (15, 19). Besides of the above reported risk factors the level of practicing the community based essential new-born care (CBNC) was 3.49 times highly common among those mothers who had awareness about CBNC than those who did not informed. This finding was consistent with finding in eastern Tigray [AOR=5.63], Aksum town [AOR = 3.36] and Gojam, Ethiopia [AOR=7.9] (9, 10, 17). The finding was found to be contrary to finding in Welkite town, Ethiopia [AOR=0.17] (19). This discrepancy may be due to socio-demographic and socio-cultural differences among participants in different demography of the country. Another reason for variation may be due to the time effect that study conducted.
Neonatal danger has become a substantial problem in many developing countries like Ethiopia. In this regard, health-seeking behavior of mothers for neonatal care highly relies on their knowledge about neonatal danger sign, and it has been hardly investigated (24). In this community-based study, individuals who had awareness about newborn danger sign were 2.18 times more likely practicing community based essential newborn care (CBNC) as compared to the counterpart. The finding in this study considered to be in line with a community based study conducted in Enugu state, South-East Nigeria and North West of Ethiopia (24, 25). This finding might be due to the fact that those mothers who had a positive awareness about neonatal danger sign experienced of how to practice CBNC.
Birth preparedness and complication readiness (BP and CR) is a safe motherhood comprehensive strategy and matrix that includes shared responsibility among the woman and her family, the community, healthcare providers, facilities that serve them, and the policies that affect care for the woman and the newborn (26). Accordingly, the likelihood of Community based essential new-born care (CBNC) practice among those having birth preparedness and complication readiness plan was 3.52 more prone to practice CBNC than counterpart. This finding was in line with finding in Kofale District, South East Ethiopia (26) and it was found to be due to the fact that having birth preparedness and complication readiness plan positively affect the mothers practice to ward community based essential new born care.
Unlike many other study findings, this study did not reveal any association of community based essential new-born care (CBNC) practice with number of ANC visits during last pregnancy, number of last fetus, early PNC for last birth by HEW and counseling about CBNC in the last 12 months. This might be illustrated by variations related to study population, setting, socio-demographic, socio -economic and cultural difference.
One of the strength of this study was findings can be generalized to similar settings and population in other parts of the country since this study is primary data and a community based study.