BACKGROUND- Emergency Obstetric and Newborn Care (EmONC) is a life-saving approaches or care for mother and newborn experiencing complications during pregnancy, childbirth and or postpartum period. Like other developing countries, Ethiopia has high maternal and neonatal mortality (353/100,000 live births and 28/1000 live births respectively by 2015) where majority of them are due to lack of timely, effective and accessible EmONC services. Even though Addis Ababa, Harar and Dire Dawa have met the WHO minimum requirements of EmONC service in terms of Availability and Accessibility unlike other regions, the report shows that the quality of care provided was highly compromised.

OBJECTIVE: Assessment of factors affecting provisions of Quality Emergency Obstetric and Newborn Care services in Public health facilities in Dire Dawa, Ethiopia

METHODS AND MATERIALS- A mixed method design (MMD) was employed in purposively selected health facilities in Dire Dawa city to assess factors affecting provisions of Quality Emergency Obstetric and Newborn Care. Quantitative study includes self-administered standardized questionnaire and health facility survey checklist, an observational checklist. Information letters, consent forms and questionnaires was handled to potential participants by research assistants. Data was coded, cleaned and entered using Epi Info 7 (7.0.9.34) and Analyzed using SPSS version 20 for descriptive and inferential statistics. Qualitative study which includes Key Informant In-depth Interviews and FGDs was cleaned, coded and analyzed using thematic analytic approach, and some important findings was reported with the associated quotations from the extracted discussions.

RESULTS: Of the nine surveyed EmONC Providing facilities in Dire Dawa, 73.9% of health centers and 97.7% of hospitals shows readiness for provision of EmONC services. Of the seven BEmONC facilities designed to provide all signal functions of BEmONC, only six (85.7%) were providing all the eight signal functions of Basic (BEmONC); and 95.0% of Comprehensive (CEmONC) facilities were found to deliver all the ten basic signal functions of CEmONC. Majority (67.35%) of providers were untrained, where large numbers (38.5%) were reported from Health centers. Forty-five (86.04%) were reported of having sufficient knowledge of EmONC; while only 31 (59.4%) reported of having adequate skills and 46 (88.45) reported of having adequate confidence in performing major EmONC procedures.

CONCLUSION: The shortages of trained and specialized Maternal and Neonatal Health Care Practitioners (MNHCPs), and basic infrastructural installments/amenities, drugs and supplies backed by low educational level of clients contributing to lack of improvements in quality of EmONC services in Dire Dawa. Thus, the findings bear considerable implications for policymakers and given local priorities.