Background: About 47% of under-five deaths occurred in the first month of life. Even though under-five mortality declines globally, death is more concentrated in the first days of life. This provides a clue to focus more on immediate newborn care than ever before. Therefore, this study aimed to assess level of immediate newborn care practice and associated factors among newborns delivered at public health facilities in Debre Markos Town, North West Ethiopia from March 28 to May 27, 2020. Methods: Facility based cross sectional study with quantitative and qualitative methods were used. For the quantitative study a total of 286 mothers with their newborns were included. For the qualitative study 10 key-informants were interviewed. Pre-tested, semi-structured questionnaires and observational checklists were used for the data collection. Collected data were entered into Epi-data version 3.1, and exported to SPSS version 22 for analysis. Binary and multivariable logistic regression were done. Independent variables with a P-value of ≤ 0.25 in bivariable analysis were considered as candidate for multivariable analysis. P-value < 0.05 was used as cut off point for presence of statistical significance in the multi-variable model. Goodness of fit test was checked using Hosmer and Lemeshow test. Results: The level of immediate newborn care practice was 76.9% [(95% CI = (72.0-82.0)].History of ANC follow up(AOR=3.36;95%CI:1.50,7.53), mother’s knowledge on immediate newborn care(AOR=5.29;95%:2.00,14.00), birth-preparedness of the mother(AOR=7.80;95%:3.36,18.06) and availability of drugs, equipment and materials(AOR=6.79;95%CI:3.05,15.12) were found to be independent predictors of the level of immediate newborn care practices.Conclusion: In this study, the level of immediate newborn care practices among newborn neonates was found to be unsatisfactory compared to the national target. So it is important to promote immediate newborn care through adequate supply of essential drugs and equipment, counseling and education on immediate newborn care, promotion of birth preparedness activity and strengthen ANC service for all pregnant women.
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