Zeleke Girma Abate ^1* Misgana Seifu Beyene ² Sultan Hussen Hebo ³ Mekidim Kassa Chinkilo ³ Yosef Haile ³ Temesgen Mohammed Toma ^1,4 Mintesinot Melka Gujo ⁴ Agune Ashole Alto ⁴ Wondimagegn Taye Dema ⁴ Aleme Mekuria ⁵ Endashaw Shibru Asegahegn ⁶

• ¹ South Ethiopia Region Health Bureau Public Health Institute, Regional data management center, Jinka, Ethiopia
• ² Chencha woreda health office, Gamo zone, Chencha, Ethiopia
• ³ Arba Minch University, College of Medicine and Health Sciences, School of Public Health, Arba Minch, Ethiopia
• ⁴ South Ethiopia Region Health Bureau Public Health Institute, Jinka, Ethiopia
• ⁵ Arbaminch college of health sciences, Arbaminch, Ethiopia, Arbaminch, Ethiopia
• ⁶ South Ethiopia Region Health Bureau, Jinka, Ethiopia

Background: Harmful substance-related infections that cause neonatal deaths on the umbilical stump continue to be a major cause of worry, accounting for a large portion of the yearly mortality toll in developing nations such as Ethiopia. In our study region, there is, however, little data regarding these issues. In Chencha town, Southern Ethiopia, mothers who gave birth in the last six months were the subjects of this study.A community-based cross-sectional mixed study design was conducted among mothers who gave birth within the past six months, from April to May 2023. Quantitative data was collected through structured interview questionnaires from 312 randomly selected mothers. The collected data was coded, cleaned, and entered into Epi-info version 7.2.5.0, and analyzed using SPSS version 26. Binary logistic regression analysis was used to identify associated factors, and the strength of association was measured by odds ratios with a 95% confidence interval at a p-value of <0.05. The audio-recorded qualitative data were transcribed in Amharic language and then translated into English and entered into Open Code software version 3.6.2 for analysis using the thematic content analysis method.Results: Harmful newborn cord care practice was prevalent among 55.8% (95% CI: 50.1, 61.4) of the mothers. Factors such as husband's educational status (AOR=3.09, 95% CI: 1.11, 8.67), communication on cord care within the community (AOR=10.24, 95% CI: 5.44, 19.28), and discussions with health workers regarding cord care (AOR=7.26, 95% CI: 3.59, 14.64) demonstrated significant associations with harmful newborn cord care practice (p<0.05). In the qualitative analysis, four themes emerged such as substance applied (butter, Vaseline, and ointment). The reasons for application were moisturizing the cord, facilitating its separation, and promoting its healing. The sources of advice on cord care were relatives, neighbors, and HCW.This study revealed that harmful newborn cord care practice was prevalent among 55.8% (95% CI (50.1, 61.4)) of mothers who gave birth in the last six months. The present study identified husbands' educational status, exposure to cord care messages through interpersonal communication in the community, and mothers who didn't ever engage in discussion with health workers about cord care as significant factors.