Quality of essential newborn care practice at public health facilities in Sidama Regional State, Ethiopia, 2024: institution based study

Essential newborn care is a routine practice of low-technology care of the newborn, particularly at the time of birth and over the first hours of life. Despite essential newborn care service being a known intervention in the prevention of neonatal mortality, its utilization and quality are not optimal. However, there is limited evidence on the quality of essential newborn care at health facilities. Therefore, this study aims to assess the quality of essential newborn care in labor and delivery rooms of selected health facilities in Sidama Regional State. A cross-sectional study was conducted from February 1st, 2023, to March 1st, 2024, among 551 newborns. Multi-stage sampling was employed to select study participants. A mix of methods, including a structured questionnaire and an observation checklist, was used to collect pertinent data. Both bivariable and multivariable logistic regressions were conducted. Strength of association was determined using adjusted odds ratios with 95% confidence intervals. Statistical significance was also determined at a cutoff p-value less than 0.05. The magnitude of good essential newborn care quality of availability of material for newborn care (input) was 47.5%, immediate essential newborn care (process) 70.1%, and the outcome of care (outcome) 53.9%. Factors associated with good quality of essential newborn care include being a male newborn (AOR = 2.38, 95% CI: 1.52–3.72), having four or more years of experience (AOR = 2.04, 95% CI: 1.25–3.33), using a partograph (AOR = 2.12, 95% CI: 1.27–3.55), providing a high level of friendly service (AOR = 0.10, 95% CI: 0.06–0.17), and categorizing the facility’s inputs as good (AOR = 1.95, 95% CI: 1.11–3.44). This study identified low input and outcome quality dimensions of essential newborn care, unlike process quality dimensions, which are moderately high. Quality essential newborn care provision was low in the study settings. Poor input, inadequate friendly care, being a male newborn, lack of experience, and incomplete partograph use were associated with a decline in the process quality of essential newborn care. Therefore, improving the availability of necessary service equipment, maintaining experienced health care providers, enhancing partograph usage, and educating the community about gender equality are crucial for the provision of quality essential newborn care.