Neonatal Mortality and Morbidity after Premature Delivery in a Rural Hospital in Tanzania

Background: One global target in the Agenda for 2030 is to decrease the neonatal mortality. However, the progress is slow, and neonatal mortality has become a bigger part of the total under-5-mortality. Prematurity is the most common cause of neonatal mortality. In sub-Saharan Africa, the neonatal mortality is the highest, but the opportunities to implement effective interventions are limited by the lack of reliable data. Aim: This study aims to chart the mortality and morbidity of premature neonates and search risk factors associated with preterm neonatal death at a Tanzanian rural non-referral hospital, which is unique for this kind of study. Methods: This is a retrospective, cross-sectional study conducted at Mchukwi Mission Hospital (MMH). 913 neonates born with low birth weight or admitted at MMH due to prematurity during 2019-2024 were included. Patient data were mainly collected from admission books and patient records. Results: The prevalence of prematurity at the hospital was 14.8% and 6.5% of the premature neonates died. The premature neonates had nearly 3 times increased risk of dying without a significant downward trend during 2019-2023. The significant risk factors for experiencing neonatal death as premature were very low birth weight, extremely low birth weight, likely prematurity, referral, delivery without professional assistance, breech delivery, presence of an associated diagnosis, especially infection or RD, and to have a mother with any complication before delivery, especially placenta previa. Conclusion: The results indicate that neonatal mortality is still a broad problem in rural Tanzania and the situation concerning shortage of staff, lack of education and insufficient medical equipment needs to be improved to decrease neonatal mortality. Although the results probably were affected by insufficient documentation, some of the results are consistent with previous studies.