Newborn care service utilization and associated factors among women who gave birth in Kore district, West Arsi zone, Ethiopia, 2022: a mixed method study

Neonatal mortality remains a major public health concern in Ethiopia, with 30 deaths per 1,000 live births. Despite the Community-Based Newborn Care (CBNC) program, over 50% of mothers and newborns lack postnatal care, particularly in rural areas, contributing to stagnant neonatal mortality rates. This study assessed CBNC service utilization and associated factors among women who gave birth in Kore District, West Arsi Zone, Ethiopia. A community-based cross-sectional study, supplemented by a qualitative approach was conducted from January 02 to February 10, 2022. A total of 560 mothers with their neonates were selected using simple random sampling from the selected kebeles/lower administration unit below the district. Data were collected through a structured, interviewer-administered questionnaire. Additionally, qualitative data were gathered using a focus group discussion guide to complement the quantitative findings. Quantitative data were entered into Epi Info version 7.2 and exported to SPSS version 25 for statistical analysis. Multiple logistic regression analysis was employed to identify factors associated with community-based newborn care service utilization, with results reported as adjusted odds ratios (AOR) with 95% confidence intervals (CI). A p-value ≤ 0.05 was considered statistically significant. Qualitative responses were transcribed and analyzed thematically. The prevalence of community-based newborn care service utilization was 45.3% (95% CI: 41.2–49.6). The mean participant age was 29.32 years (± 6 SD), ranging from 18 to 61 years. Factors significantly associated with service utilization included knowledge of community-based newborn care (AOR = 2.16, 95% CI: 1.34–3.51), attending PNC follow-ups (AOR = 3.27, 95% CI: 1.67–7.72), closed health post (AOR = 0.50, 95% CI: 0.31–0.82), and distance from a health facility (AOR = 2.63, 95% CI: 1.09–5.44). Qualitative findings reinforced these results, emphasizing knowledge, closed health posts, cultural beliefs, and distance as key determinants of utilization. Community-based newborn care (CBNC) service utilization in Kore District was low (45.3%), hindered by limited maternal knowledge, health post closures, distance barriers, and cultural beliefs. Strengthening maternal education, ensuring consistent health post operations, and engaging community leaders are vital in reducing neonatal mortality.