Neonatal mortality contributors using the three delays audit: a study from Albuluk paediatrics teaching hospital in Sudan

Background: In certain developing countries neonatal mortality rates still showed a slower decline. Many factors were attributed to neonatal mortality that varies from one country to another. This study investigated factors attributed to neonatal mortality in Sudan.Methods: Data was collected from 72 neonatal deaths records at Albuluk pediatrics' teaching hospital, and then it was analyzed using a modified three delays model to determine contributing delays.Results: 31.9% of neonatal mortality occurred on the first day after birth and 86.1% thereafter. Newborn characteristics showed that more than half of dead newborn were male and more than 80% admitted in the age of more than 2 days although there was 26% of involved newborn were preterm. About two third of deliveries were home deliveries and only 52% of the mothers were in regular antenatal care. The leading causes of death were sepsis and pneumonia in 83% followed by birth asphyxia in 11% of total neonatal mortality. Regarding the three delays audit; delay in decision making were present in 54.2% and that was due to inability of the mothers to recognize danger signs, delay in reaching the health care facility was present in 9.8% of the neonatal mortality, while delay in initiation of treatment in the healthcare facility was present in only 6.9%.Conclusions: Maternal knowledge of neonatal danger signs and decision to seek medical care is a major contributor for neonatal mortality in this study. Further efforts should be exerting to raise knowledge of the mothers about danger signs of neonatal illness.