Determinants of Neonatal Mortality in Referral Facilities of the Health Districts in North Kivu, Democratic Republic of Congo

Over the last two decades, several countries that implemented strategies for reaching the Millennium Development Goals (MDGs), have reduced their infant mortality by more than half.  In spite of global decrease in infant mortality, in 2015, on the point of completion of the MDGs, Sub-Saharan Africa countries among them Democratic Republic of Congo (DRC), remained with highest infant mortality rate. Although making progress, neonatal mortality rate is declining less rapidly than the under-five mortality rate.In order to accelerate reaching infant mortality rate target, several countries among them DRC, have implemented strategies to substantially reduce neonatal mortality.In order to target actions, a descriptive cross-sectional study of neonatal deaths occurred between January 1st, 2009 and June 30th, 2014 was performed in referral health facilities of 6 North Kivu province health zones in DRC. Acute fetal distress, premature birth and infection were found to be the causes of 83.4% (n = 235) of newborn deaths. Inadequate staff capacities and / or poor management were implicated in the occurrence of 52.9% (n = 225) deaths, linked to a set made of acute fetal distress, premature birth and infection including sepsis and pneumonia.   Results show that implementation of sophisticated structures such as neonatal intensive care units are not necessary to reduce neonatal mortality in the context of health facilities in DRC. A rational organization of care management including staff training, application of effective interventions and targeted low cost strategies to fight effectively against neonatal mortality would contribute significantly to reduce infant mortality