Setegn et al. BMC Public Health 2011, 11:217 http://www.biomedcentral.com/1471-2458/11/217 birth and national prevalence of breastfeeding initiation was documented to be low with wide regional differ- ences [1,8-14]. Realizing the importance of timely initiation of breast- feeding, the Ethiopian government had developed infant and young child feeding guidelines giving appropriate emphasis to key messages on timely initiation of breast- feeding in 2004 [15]. Since then, different interventions like breast feeding promotions have been given at health institutions and at the community level by community health extension workers and other health care provi- ders. However, these efforts are not based on systematic evidence on the level of existing practice which might be due to the paucity of data from studies on timely initiation. Therefore, the study sets out to address the issues related to prevalence of timely initiation of breast- feeding and associated factors among mothers in Goba Woreda, Ethiopia. Methods Study setting and Sample A community-based cross-sectional study using both quantitative and qualitative methods of data collection was conducted in Goba district of Bale Zone in the south Eastern Ethiopia. Bale zone is the second largest Zones in Oromia regional state with an area of 67.329.6 km2 and located 430 km from the capital, Addis Ababa. The temperature ranges from 3.5-32°c. The area is known by its eye catching natural and tourist appealing topography like Bale Mountains and Souf-Umor cave. Goba woreda is one of the 20 woreda in Bale zone hav- ing both rural and urban population. The district has one hospital, one health center and more than 20 health posts. According to Goba District Health Office report, the estimated total number of infants in the woreda is 1923 by the year 2009. The sample size was determined using single popula- tion proportion formula assuming an expected preva- lence for timely initiation of breast feeding of 50% with a finite population correction. The sample was multi- plied by a design effect of 2 and by 10% was added non response it giving the final sample size of 668. A total of 668 mother-infant pairs were selected using stratified cluster sampling technique from the urban and rural residences then census was conducted to get the sam- pling frame for selecting mother- infant pairs by simple random sampling technique. For the in-depth interview, 23 individuals (6 health care providers, 9 breastfeeding mothers-three urban and six rural and eight community health extension workers) were selected conveniently. Measurements Quantitative data were gathered using a questionnaire adapted from Ethiopian Demographic Health Survey, Page 2 of 7 WHO, and LINKAGE project which were designed to assess infant and young child feeding practices in devel- oping countries including Ethiopia [8,14,16]. The ques- tionnaire was translated and contextualized to suit the local situation. Data on socio-demographic and eco- nomic factors (income, level of education etc), obstetric factors (like birth intervals, parity, Ante natal care) and health service related factors/practices including post natal counseling were collected by interviewing the mothers of index children. A semi-structured open- ended interview guide was used as a guide for the key informant interview. The data were collected by 12th grade complete stu- dents who took an intensive training for two days was given on the questionnaire and on general approaches to data collection. Timely initiation of breastfeeding was measured by asking mothers provide information regarding the time at which their index infant was put to the breast after delivery. The prevalence of timely initiation of breastfeeding was calculated as the ratio of infants below one year put to the breast within 1 hour of delivery to the total number of infants (< 12 months). Data analysis Quantitative data were checked for completeness, incon- sistencies, entered, coded, cleaned and analyzed using SPSS for windows version 16.0 (SPSS Inc. version 16.1, Chicago, Illinois). Descriptive statistics was computed to determine the prevalence of timely initiation of breast- feeding. Proportions were compared by timely initiation of breast feeding using Chi-square tests. First a bivariate logistic regression was performed. Variables that showed significant association with timely initiation of breast- feeding in the bivariate models were entered in a multi- variable logistic model. To identify independent predictors of timely initiation of breastfeeding, a multi- variable logistic regression model with timely initiation of breast feeding as dependent variable was constructed. All tests were two-sided and a P < 0.05 was considered statistically significant. We present the results as propor- tions, output of the logistic regression as Odds Ratios (OR) with 95% Confidence Intervals. The qualitative data were transcribed in to English language and ana- lyzed manually. Data captured using the field notes were transcribed verbatim into English language and double checked by the investigator. The transcribed data were read carefully and categorized in to thematic frame- works and color coded. The data were summarized by thematic areas and presented in narratives triangulated with the quantitative data. Well-said verbatim of the study participants were used as illustrations in present- ing the results. Letter of Ethical approval was received from Jimma university ethical clearance committee. Official letter of