Study Area and Period
Institutional based cross-sectional study design was employed from February 1–30/2022 in governmental health facilities of Dire Dawa City. Dire Dawa city is located about 515 km away from Addis Ababa, the capital city. The city has ten public health institutions, among them two of them were hospitals and eight of them were health centers (17).
Study Design
An institutional-based descriptive cross-sectional study design was used.
Source Population And Study Population
All moms who visited the child immunization clinics at the governmental health facilities in DDAC during the study period served as the study's source population. All moms who attended child immunization clinics in particular governmental health institutions during the study period made up the study population.
Inclusion And Exclusion Criteria
All mothers who had baby less than or equal to twelve months and attended child immunization clinic at selected governmental health facilities, of DDAC were included.
Sample Size Determination
Based on research done in North West Ethiopia, where the prevalence of colostrum feeding practice was estimated to be 91.2% (38), the sample size was computed using a single population proportion formula while taking the following assumptions into account. Z value at alpha = 0.05, or 1.96, is the crucial value for a normal distribution at a 95% confidence level. P = Expected Level of Practice of Colostrum Feeding, d = Margin of Error, 0.05. Therefore,
By considering 10% non-response rate and design effect 2 = 123 *10/100 = 123 + 13 = 136*2 = 272.
Sampling Technique
The study population was chosen using a multi-stage sampling procedure. The administrative city's public health facilities are divided into hospitals and health centers based on the ten public health facilities that DDAC possesses (two hospitals and eight health centers). Then one hospital and three health centers were chosen using a straightforward random sampling procedure. Based on each health facility's quarterly extended program of immunization (EPI) unit flow, the total sample size was proportionally distributed for each of the administrative city's health facilities.
Based on EPI registration books at all chosen health institutions, the average number of mothers who visited an EPI unit quarterly was 1405. In the Dilchora referral hospital (DCRH), Genda kore health center (GKHC), Gende Gerada health center (GGHC), and Goro health center (GHC), respectively, there were 570, 310, 251, and 274 mothers who visited the EPI unit on a quarterly basis.
After proportionate allocation, the overall sample size for DCRH, GKHC, GGHC, and GHC was 119, 64, 52, and 57 mothers, respectively. Each facility's eligible mothers were chosen using a methodical random sampling process. By dividing the number of mothers who visited an EPI unit on a monthly basis by the sample size, the sampling interval or Kth units (1405/292 = 5) was calculated. The first Kth units in each healthcare facility were drawn at random to determine the starting unit .
Operational Definition
Colostrum: is the yellowish breast milk during the early days following delivery (18).
Practice: The conduct, custom, or habit of moms of children on CF toward their present children. Participants who react to 60% of practice-related questions are practicing well; participants who respond to 60% of practice-related questions are practicing poorly (19).
Knowledge: In this study, knowledge refers to mothers' understanding of colostrum breast milk and was assessed by mothers' responses to knowledge-related questions. Good knowledge: Mothers who correctly answer 60 percent of questions about knowledge and Mothers who respond to knowledge-related questions with less than 60% have poor knowledge (19).
Study Variables
Dependent variable: Colostrum feeding
Independent factors: Age, place of residence, marital status, religion, level of education, line of work, partner's level of education, and who she was living with are sociodemographic characteristics. Obstetric and reproductive factors: Parity, ANC visits, TIBF, CF, and BF counseling during ANC visits, delivery site, birth attendant, mode of delivery, and BF counseling following delivery. Factors relating to knowledge and practice: the information's source.
Data Collection Tools
Data was gathered using a structured interviewer-administered questionnaire that was adjusted to the local context and derived from pertinent literatures. An expert in this language initially developed the questionnaires in English, after which they were translated into Amharic and then back into English to ensure uniformity. The questionnaire asked about sociodemographic traits, obstetric and reproductive traits, as well as questions about knowledge and practice. Correct answers received a score of + 1, while incorrect ones received a score of − 1. Each mother's score was added up and put into categories.
Data Collection Method
Data collection involved using a standardized interviewer-administered questionnaire that had been pre-tested. Four BSc midwives, a nurse, and a public health officer collected the data under the direction of a public health officer.
Data Quality Control
The instrument was pretested before the actual data collection, and the data were gathered by skilled data collectors. Prior to the actual data collection period, the questionnaire was pre-tested on 5% (15) of the moms who attended the child immunization clinic at Sabian General Hospital but were not included in the study. The investigator gave two days of training to the supervisors and data collectors. Additional adjustments were made based on the findings of the pre-test after the necessary modifications and corrections were made to standardize, ensure, and guarantee its reliability and validity. During data collection, data collectors verified that the data were comprehensive, and supervisors examined the data on a daily basis to ensure it was.
Data Processing And Analysis
The data were entered into Epi data 4.2, edited and cleaned for inconsistencies, missing values and outliers, then exported to SPSS version 25.0 for analysis. During analysis all explanatory variables which have significant association in bivariate analysis with P value < 0.20 was entered into a multivariate logistic regression model to get adjusted odds ratio (AOR) and those variables with 95% of confidence intervals (CI) and a P value of < 0.05 was considered as statistically significance with CFP. Multi collinearity test was done using variance inflation factor and no collinearity exists between the independent variables. The model goodness of the test was checked by Hosmer- Lemeshow goodness of the fit and the p-value of the model fitness of the test was 0.780. Frequency tables, and descriptive summaries were used to describe the study variables.