The prevalence and determinants of early neonatal complications among newborns delivered at Primary Health Care Facilities in Njombe Region,Tanzania

Background:Neonatal complications are a critical global health issue, especially in low- and middle-income countries. In 2022, about 2.4 million newborns died, with nearly half of under-five deaths occurring in the early neonatal period. Sub-Saharan Africa carries the highest burden, accounting for 57% of under-five deaths and a neonatal mortality rate of 27deaths per 1,000 live births. In Tanzania, reported neonatal deaths ranging from 26 to 40 deaths per 1,000 live births resulting from different early neonatal complications. This study aimed to assess the 1The prevalence and determinants of early neonatal complications among newborns delivered at Primary Health Care Facilities in Njombe Region Tanzania. Methodology:We conducted a facility-based cross-sectional study using secondary data from mother-neonate pairs delivered in selected health facilities. Associations between maternal and obstetric factors and early neonatal complications were assessed using bivariate and multivariable Modified Poisson regression, reporting crude and adjusted prevalence ratios (cPR and aPR) with 95% confidence intervals. Results:The study included 567 neonates from different facilities within the region. The prevalence of early neonatal complications was 40.7%, 95% CI: (0.37- 0.45). The most common early neonatal complications were birth asphyxia (31.7%), early onset neonatal sepsis (28.7%), and respiratory distress (22.8%). Elective caesarean section was protective compared with emergency caesarean and statistically significance (aPR=0.62; 95% CI: 0.58-0.65; p<0.002). Maternal complications during pregnancy or delivery significantly increased risk of early neonatal complications (aPR=1.4; 95% CI: 1.19-1.64; p<0.001). Conclusion: The findings revealed, higher prevalence of early neonatal complications driven several factors such as maternal complications and emergency caesarean sections. Birth asphyxia, respiratory distress and early onset neonatal sepsis were the common complications. To improve neonatal well-being, strengthening intrapartum monitoring and timely planned obstetric interventions are necessary measures to be considered among healthcare workers.