Seifu, AbiyDr.Betre, MulugetaMesfin, Melat2020-02-252023-11-052020-02-252023-11-052019-08http://etd.aau.edu.et/handle/123456789/20717Background- Annually 1 million newborns worldwide die of infection caused by bacteria that enter the body via the umbilical cord. Regarding this the Ethiopia national strategy of new born and child survival identified chlorhexidine (CHX) as one of the high impact intervention to minimize neonatal mortality. Whereas, studies have shown Human breast milk (HBM) application to the neonatal umbilical cord has a shorter cord separation time and lower rate of infection than CHX or the standard dry cord care (DCC). To the best of the investigators knowledge on to assess cord separation time and rate of cord infection, studies were not conducted comparing the standard DCC with that of CHX or HBM. Objective: - Compare the effect of topical application of HBM, CHX and DCC on neonatal umbilical cord separation time (CST) and assess the rate of cord infection at the Demographic and Health Surveillance Site, Butajira, Ethiopia, 2017/18. Method- From May to November, 2018, a three arm, non- masked, community based, cluster randomized controlled trial was conducted at Butajira Demographic and Health Surveillance site (BDHSS) located in Gurage Zone of the Southern Nations, Nationalities and Peoples´ Region (SNNPR) of Ethiopia. Nine kebeles of the BHDSS were randomized into two intervention groups i.e. HBM and CHX and a control group which is the standard DCC using a lottery method. From a sample size of 337, data were entered and analyzed for 302 term singleton newborns. Baseline characteristics across the groups were compared by ANOVA for continuous variables and Chi square for categorical variables. Mean CST was compared among the groups using one way ANOVA whereas the secondary outcome i.e. rate of omphalities was expressed in terms of frequency and was compared among the groups using Chi square. Level of significance was set at p <0.05 with 95% CI. Result- The mean cord separation time was 5.6 days in HBM group, 5.9days in CHX group, and 5.7days in DCC group but this difference was not statistically significant among the study groups (p value=0.40). The highest signs of cord infection rate were observed in dry care group and this was significant regarding the redness on the base of the cord stump (P<0.001). Conclusion and recommendations- Topical application of HBM is related with shorter cord separation time compared to CHX or DCC. It also has reduced incidence of infection, as much as topical CHX application. Generally the readily available human breast milk should be given further emphasis.en-USHuman Breast Milk, Chlorhexidine , Dry Cord Care , Neonatal Umbilical CordThesis