Survival of newborns and determinants of their mortality in Burundi: A prospective cohort study at Kamenge Teaching Hospital

Abstract Background Despite the free healthcare services policy for pregnant women and children under five since 2006, the neonatal mortality rate remains high in Burundi. In 2019, two newborns out of one hundred live births died. This study sought to determine the neonatal survival time and identify factors associated with neonatal mortality in Burundi. Methods We conducted a prospective cohort study to collect data among newborns delivered in the maternity ward of Kamenge Teaching Hospital. Our cohort recruitment was opened over 3 months between October and December 2020 and then the last recruited followed up till January 27, 2021. Kaplan Meier curve and logistic regression were used to analyze data. Results Out of 885 live births followed up at Kamenge Teaching Hospital, 30 died. This resulted in a neonatal mortality rate of 34 per 1,000 live births. Nearly 40% of deaths occurred during the first 24 hours of life and 90% within the first week of life. The main causes of neonatal deaths were preterm complications (60%), birth asphyxia (13.33%), neonatal infections (13.33%), and congenital malformations (13.33%). Factors associated with neonatal mortality were preterm delivery (AOR: 9.01, 95%CI 2.05–39.52), less than four ANC (AOR: 6.64, 95%CI 1.46–30.21), Apgar score at five minutes below 6 (AOR: 10.83, 95%CI 2.61–44.93), and Caesarean delivery section (AOR: 2.47, 95%CI 1.00–6.07). Conclusion Neonatal mortality is relatively high while it is mostly due to preventable factors. The government of Burundi should prioritize comprehensive ANC services to improve maternal and neonatal health.