Introduction: Neonatal mortality is a key indicator of international development. Its reduction remains a challenge and a concern for C？te d’Ivoire, which has a high ratio of neonatal deaths (30 per 100,000 live births). The causes are known in the hospitals. We analyzed the causes of neonatal deaths and the factors contributing to them in a second level health facility. Patients and method: The audit of neonatal deaths took place between January 1 2022 to December 31 2022 in the neonatal unit of the Abobo Regional Hospital, using the three delays model. Results: The neonatal mortality rate was 14%, and the main direct causes were neonatal asphyxia (34%), neonatal infection (24%) and prematurity (14%). The three most common delays were: delay in decision-making (84.2%), delay in access to health services (20.2%) and delay in receiving appropriate care (15.7%). These three delays multiplied the risk of death by 1.94, 0.52 and 3.69 respectively. The three other delays were: delay in decision-making (84.2%), delay in access to healthcare services (20.2%) and delay in receiving appropriate care (15.7%). These three delays multiplied the risk of death by 1.94, 0.52 and 3.69 respectively. Conclusion: Neonatal asphyxia and prematurity are the main direct causes of neonatal mortality in our department. To reduce neonatal mortality, it is necessary to overcome the three contributing delays through the effective implementation and evaluation of emergency obstetric and neonatal care.
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