Abstract: Introduction: Neonatal mortality remains a critical public health challenge in Rwanda, where neonates account for 44% of all under-five deaths and the Northern Province reports a neonatal mortality rate (NMR) of 22 deaths per 1,000 live births. Despite national progress in maternal and child health, facility-specific predictors of neonatal mortality in Gicumbi District have not been previously published. This study aimed to determine the prevalence and independent predictors of neonatal mortality at Byumba Level II Teaching Hospital.
Methods: A retrospective cross-sectional study was conducted at Byumba Level II Teaching Hospital, Northern Province, Rwanda. A total of 234 neonatal records (from a systematically sampled frame of 239) were reviewed for the period April to September 2023. Data were extracted using a validated structured tool (reliability coefficient 0.92; content validity index [CVI] 0.78). Bivariate chi-square analysis identified variables significantly associated with neonatal mortality (p < 0.05), which were entered into multivariate binary logistic regression to calculate adjusted odds ratios (aOR) with 95% confidence intervals (CI), controlling for potential confounders.
Results: The prevalence of neonatal mortality was 6.7% (16/239). Most mothers (95.3%) were enrolled in Mutuelle de Santé health insurance, yet 57.1% attended only 1–3 antenatal care (ANC) visits. Remarkably, 61.6% of neonates had very low birth weight (≤1,500 g). Multivariate analysis identified five independent predictors of neonatal mortality: inadequate ANC attendance of 1–3 visits versus ≥4 (aOR = 3.806; 95% CI: 1.203–12.046; p = 0.019); placenta abruption (aOR = 7.719; 95% CI: 1.260–47.326; p = 0.047); home birth compared to hospital delivery (aOR = 21.283; 95% CI: 1.718–263.628; p = 0.017); respiratory distress (aOR = 3.886; 95% CI: 1.091–13.834; p = 0.036); and congenital anomalies (aOR = 5.538; 95% CI: 1.121–27.350; p = 0.023). Marital status, maternal age, neonatal gender, and birth weight category were not independently significant.
Conclusion: Neonatal mortality at Byumba Level II Teaching Hospital is predominantly driven by modifiable factors. Targeted interventions to increase ANC attendance beyond four visits, eliminate home births among high-risk pregnancies, and strengthen neonatal respiratory care and congenital anomaly management are urgent priorities. These findings fill a critical evidence gap for Northern Province Rwanda and provide a foundation for district-level programme planning aligned with Rwanda's Sustainable Development Goal 3.2 targets.
Keywords: Neonatal mortality; Rwanda; Antenatal care; Home birth; Respiratory distress; Congenital anomalies; Sub-Saharan Africa.
Title: Prevalence and Predictors of Neonatal Mortality at Byumba Level II Teaching Hospital, Northern Rwanda: A Retrospective Cross-Sectional Study
Author: Claudine Ingabire, Charles NSANZABERA
International Journal of Healthcare Sciences
ISSN 2348-5728 (Online)
Vol. 14, Issue 1, April 2026 - September 2026
Page No: 128-137
Research Publish Journals
Website: www.researchpublish.com
Published Date: 29-May-2026
