Background: Estimates of immunization coverage rates in Ethiopia varied widely, but were consistent in that polio birth dose coverage is much lower than other antigens, particularly in semi-pastoralist and pastoralist areas.

Objective: To examine polio birth dose vaccination status and maternal factors affecting polio birth dose in CORE Group Polio Project implementation districts.

Methods: The study used Modified WHO EPI 30 by 10 cluster sampling technique. A total of 672 mothers/caretakers of children 12-23 months of age were included in the study.

Results: From the respondents 582(86.6%) were rural residents. More than 93% of the respondents were mothers’ of the index child and 51.6% were Muslims. Nearly one-fourth(23.8%) of children received polio birth dose(OPV0) by immunization card. The OPV0 coverage reached 54.2% both by card and history. Mothers with four or more ANC visits showed relatively higher rate(25.7%) of OPV0 vaccination than those with less than 4 ANC visits(14.3%). Children who born in health facilities showed a higher OPV0 vaccination rate(27.7%) than those born at home (10.8%). Mothers who got education on polio from community volunteers had higher rate(24.0%) of OPV0 vaccinated children. OPV0 coverage reached at higher rate(20.4%) among mothers who decided on child vaccination compared if decision was made by others(5.0%).

Conclusions: Promotion of antenatal care services could improve the uptake of polio birth dose. Newborn tracking beginning from pregnancy up to the administration of the polio birth dose is crucial. Community awareness raising using locally sound communication interventions is magic bullet to increase coverage of polio birth dose.