Prevalence and factors associated with neonatal mortality at masaka district hospital, Rwanda: a cross-sectional study

INTRODUCTION: Neonatal mortality remains a pressing global concern, with millions of infants losing their lives each year. However, there was a lack of specific information regarding the prevalence of neonatal mortality and associated factors at Masaka District Hospital (DH). This study aimed to determine neonatal mortality prevalence and associated factors at Masaka DH. METHODS: A cross-sectional study among 385 neonates using a structured observational checklist for data collection. A multivariable logistic regression analysis was used to assess the independent factors associated with neonatal mortality. RESULTS: Of 385 (54% male and 46% female) neonates, 41 (10.6%) died. The major causes of admission were prematurity 28.5% followed by infection 19.9% and perinatal asphyxia 17.6%. Major causes of death were prematurity accounting for 43.9% and perinatal asphyxia at 29.3%. After adjustment, Apgar Score at 5- and 10-minutes (AOR: 16.37, 95% CI: 5.90-45.40, p-value<0.001), (AOR: 3.55, 95% CI: 0.98-12.79, p-value = 0.032) respectively, gestational age AOR: 0.08, 95% CI: 0.02-0.26), p-value <0.001), Birth weight (AOR:127.01, 95% CI:27.93-577.46), p-value<0.001) were significantly associated with neonatal mortality. Maternal conditions did not show a significant association after adjusting for other variables AOR:2.04 ,95% CI:0.55-7.49, p-value 0.282. Neonates born to mothers who attended antenatal care had significantly lower odds of mortality compared to those whose mothers did not attend (AOR: 0.35, CI: 95% CI: 0.13-0.90, p-value =0. 030). CONCLUSION: Low birth weight, low Apgar scores, prematurity, lack of antenatal care visit were significantly associated with neonatal mortality at Masaka DH.