Abstract
BACKGROUND: Neonatal near-miss refers to conditions in which a newborn is on the verge of dying, but survived within 28 days of life. Although the study of neonatal near miss has emerged in many countries, there is limited data about the condition in Garowe, Somalia. Hence, the study aimed to assess the magnitude of neonatal near miss and its associated factors among neonates in Garowe City, Puntland. METHODS: Institution based cross-sectional study was conducted from June 01-29 2024 among randomly selected 375 neonates. Data were collected by trained nurses through face-to-face interview of the mothers or guardians using a pre-tested standard questionnaire. Neonatal near miss was defined as having any of the pragmatic (birth weight <1750g, <33 weeks gestational age,or <5 fifth minute APGAR score) or management criteria (mechanical ventillation, cardiopulmonary resuscitation, nasal continous positive airway pressure, parentral antiobiotics, parentral nutrition, use of vasoactive drugs, or phototherapy within 24 hours of birth). Data were entered into Epidata version 3.1 and exported to Stata version 14.0 for analysis. Bivariable and multivariable logistic regression were done to identify factors associated with neonatal near miss. Level of statistical significance was declared at p-value < 0.05. RESULTS: The magnitude of neonatal near miss was found to be 48.2% (95% CI: 43%, 53%). Neonates born from daily laborer mothers (AOR = 5.72; 95% CI: 1.73-18.89), from women with history of abortion (AOR = 2.75; 95% CI: 1.37-5.53), and those admitted to the neonatal intensive care unit (AOR = 13.99; 95% CI: 7.36-26.59) were more likely to have neonatal near miss. CONCLUSION: Nearly half of neonates in Garowe experienced a near miss event. Maternal occupation, history of abortion, and admission to neonatal intensive care unit were found to be key associated factors. Health care professionals should enhance early identification and follow-up of high-risk pregnancies and newborns, particularly in mothers with a history of abortion or those engaged in physically demanding jobs.