Haydom Lutheran Hospital is located in
rural Northern Tanzania, 300 km from
the nearest urban center, with a poor
rural population in the area. It has
an immediate catchment of ∼500 000
people and serves as a referral hospital
for ∼2 million people.13 The hospital
provides comprehensive emergency
obstetric and basic emergency newborn
care. Midwives largely conduct
deliveries with doctors on call 24
hours. After birth, infants requiring
more than routine care are triaged
to an adjacent neonatal area (a 10-m2
room with 1 long bench, with the capability
of providing intravenous fluids
and antibiotics) and are intermittently
cared for by family members and the
labor staff. Most infants transition
rapidly and are discharged; however,
a subset dies for different reasons.
Our objective for this study was to
determine the presumed causes of
death within the first 24 hours of birth
in this scarcely resourced rural referral
hospital.