Prevalence and Factors Associated with Neonatal Mortality in a National Referral Hospital, Mogadishu, Somalia, 2023

<i>Introduction</i>. Despite the global decrease, the neonatal mortality rate has remained high in sub-Saharan Africa, including Somalia. There is a need to continually identify and localize the drivers of neonatal mortality to help policy interventions aimed at its reduction. This study estimated the prevalence of and factors associated with Neonatal Mortality among newborns attending Banadir Hospital 2023. <i>Methods</i>. A facility-based cross-sectional study was conducted among 1435 neonates admitted to the neonatal intensive care unit (NICU) of Banadir Hospital from January to December 2023, and data were extracted from the medical charts and through a structured questionnaire administered to the parents. Descriptive and logistic regression analyses were performed to identify the factors associated with neonatal mortality. <i>Results</i>. The median age of the neonates was 1 (IQR: 1-6) days, 59.4% (853/1435) were male, 54.5% (782/1435) were born at Banadir Hospital, 25.6% (95% CI: 23.5-28.0, 368/1435) newborns died before discharge. The median age of the mothers was 27 years (IQR: 23-30) years. The majority of the mothers 1127 (78.5%) were multiparous, 50.7% (728/1435) had no ANC follow-up, and 79.4% of the neonates stayed at the hospital <7 days. Mother's education (aOR: 0.01; 95% CI: 0.01-0.05), parity (aOR: 9.7; 95%: 5.33-17.7), age of the baby (aOR: 0.23; 95% CI: 0.13-0.39), gestational age (aOR: 7.12; 95% CI: 2.61-19.33), history of chronic disease (aOR: 0.2; 95% CI: 0.06-0.41) and History of abortion (aOR: 0.2; 95% CI: 0.11-0.31) were significantly associated with neonatal mortality. <i>Conclusion</i>. The prevalence of neonatal mortality is high. Neonatal mortality was associated with mother's education, parity, prematurity, history of abortion, history of chronic disease, and being less than 7 days of life. Improved maternal education, early management of preterm birth, and newborn illnesses should be priorities for reducing neonatal deaths.