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Mathewos Mekonnen,1 Kumera Bekele,1 Kemal Jemal,1 Dejene Hailu,1 Bikila Tesfa,1 Teshale Mulatu2 1Department of Nursing, College of Health Sciences, Salale University, Fiche, Oromia, Ethiopia; 2Department of Midwifery, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Oromia, EthiopiaCorrespondence: Mathewos MekonnenDepartment of Nursing, College of Health Sciences, Salale University, P.O. Box 245, Fiche, Oromia, EthiopiaTel +251- 917-04-43-69Email matemek2010@gmail.comBackground: Oral rehydration therapy reduces mortality and morbidity due to diarrheal diseases. However, Oral rehydration therapy remains to be underused worldwide and particularly in low-income countries. This study aims to assess the prevalence of oral rehydration therapy use during diarrheal episode and associated factors among mothers of under-five children visiting public health facilities in North Showa zone, Oromia region, Ethiopia.Methodology: Institutional based cross-sectional study design was employed for one month in June 2020. A structured interview administered questionnaire was used to collect data. Data were entered into EPI-info 3.5.2 then transported to SPSS 21 version. Descriptive statistical analysis was done, and an association between dependent variables and independent variables were examined in logistic regression models.Results: The overall prevalence of oral rehydration therapy use during diarrheal episode was 51.5%. Maternal literacy [AOR= 2.175, 95% CI: (1.178, 4.015)], mothers occupation being farmer [AOR= 0.394, 95% CI: (0.203, 0.762)], post natal care visit [AOR= 2.565, 95% CI: (1.468, 4.480)] and good knowledge of oral rehydration therapy [AOR= 1.919, 95% CI: (1.132, 3.253)] were significantly associated with oral rehydration therapy use.Conclusion: In this study oral rehydration therapy use was moderate. Maternal literacy, good knowledge of oral rehydration therapy, maternal occupation being a farmer, and postnatal care visit were the independent predictors of oral rehydration therapy use. Therefore, programmers and stakeholders who are working on child health programs should design interventions that focus on factors deterring child oral rehydration therapy use during diarrheal episode morbidity and mortality.Keywords: diarrhea, oral, practice, rehydration solution, under-five children