Introduction: Neonatal mortality remains a concern in sub-Saharan African countries, with mortality rates still high at around 35 deaths per 1,000 live births. The overall objective of our study was to assess neonatal mortality in hospitals and the various risk factors for neonatal deaths at the peace Hospital in Ziguinchor.

Materials and Methods: This is a retrospective descriptive and analytical study of newborns aged 0 to 28 days hospitalised in the peace Hospital in Ziguinchor neonatal unit between 1 January 2019 and 31 August 2023. All newborns who died during the study period and whose records were found were included. Data were entered using Microsoft Excel 2019. Data processing was performed using Excel 97-2003 and LibreOffice Calc spreadsheet software.

Results: During our study period, 2,786 newborns were admitted to the neonatal unit. The neonatal mortality rate was 5.13% (143 newborn deaths). The average age of newborns at admission was 1 day, ranging from 0 to 25 days. One hundred and thirty-four (134, or 94%) newborns were between 0 and 7 days old. The average age of the mothers was 27 years, with a standard deviation of plus or minus 7 and extremes of 15 and 43 years. The average birth weight was 2,121 g, with extremes of 400 and 4,600 g. More than half (56.64%) of newborns had a birth weight of less than 2,500 g. Only 39.86% of women had at least 4 antenatal care visits. The majority of newborns were ‘inborn’ (46.85%). Males predominated, with a sex ratio of 1.2. The average length of hospital stay was 4 days, with extremes ranging from 0 to 19 days. One hundred and seventeen (117) newborns (81.82%) died during the early neonatal period and 49 newborns (34.27%) died during the first 24 hours of life. Resuscitation was performed in 54% of newborns. The main causes of neonatal death were prematurity (42.66%), perinatal asphyxia (38.46%), neonatal infection (21.68%) and malformations (10.49%).

Conclusion: Raising public awareness, continuing training in emergency obstetric and neonatal care, and strengthening health facilities with skilled human resources and medical equipment can help reduce mortality rates in our country.