Neonatal morbidity and mortality are the major global public health challenges, specifically for the first 28 days of life. Globally, each year over 4 million neonates died within 28 days of birth among 130 million births. Every minute, twenty under-five children die, leading to 8 million deaths before they reach their fifth birthday due to the conditions which could be either avoided or treated. Neonatal mortality accounts for two- thirds of deaths of infants, and nearly two-fifths of all deaths in under-five children. Many babies die nameless and unrecorded, indicating the perceived inevitability of their deaths. Most neonatal deaths (99%) occur in low and middle-income countries, where about half of the deaths occur at home [2].
Ethiopia, one of the countries with the highest neonatal mortality in the world, is responsible for 29 deaths per 1,000 live births which was over 9 times more than that of highly developed countries, where the rate is 29 per 1,000 live births [1].
The health of future societies depends on the health of the children of today and their mothers. The neonatal period is considered as the highest risk period. Childhood mortality is often used as a broad indicator of social development or a specific indicator of the health conditions of a country.
However, child health programs were given low attention, especially neonatal health [5].
Every year an estimated 4 million babies die in the first 4 weeks of life (the neonatal period). Three-quarters of neonatal death happens in the first week, the highest risk of death is on the first day of life. The highest number of neonatal death was in South Asian countries and the highest rate is generally in sub-Saharan Africa. Preventing death in newborn babies has not been a focus of child survival or safe motherhood programs. While we neglect these challenges, 450 newborn die every hour, mainly from the preventable cause which is unjustifiable in the 21 century [2].
Neonatal mortality accounts for 44% of under-five mortality in 2014. Average death during the neonatal period is 30 times higher compared to the rest of under-five children.
Ten countries account for 67% of neonatal mortality globally by which Ethiopia accounts for 4% of global neonatal mortality [6].
Neonatal mortality has three main causes in low and middle-income countries. The complication of preterm, asphyxia, and neonatal infection together contribute to 85% of newborn death.
In 2013, 35% of the global neonatal deaths were caused by complications of preterm birth, 24% by intrapartum related complications, and 25% by infection. The rest of the death is caused by congenital malformations [7, 8].
In Ethiopia, the rate of under-five mortality (U5MR) decreased by 60% from the year 2000 to 2016 which implies from 123 to 67 per 1000 of live births. However, the neonatal mortality rate (NMR) decreased only by 40% from 49/1000 live births to 29 per 1000 live births from 2000 to 2016. Because of this, the share of neonatal mortality in under-five mortality has been increased from 29.5% to 43% [3].
Neonatal health problems are usually seen as similar to an older child's health problem. But, the causes of neonatal mortality and intervention to improve neonatal health are different from that of other under-five children. Neonatal survival is the most important indicator of improved health care during childbirth. There is a gap in integrating the need for care of neonates in the NICU, the neonatal health problems, and health programs for maternal and child health. As a result, there is still slow progress to decrease neonatal mortality in the majority part of the country by which they contribute to the national burden of neonatal mortality in Ethiopia.
Even though there were some endeavors in identifying major causes of neonatal death, in Ethiopia, studies that identify the prevalence and associated factors of neonatal mortality were not applicable as they were not specific for the nurses-led hospital admitted neonates in a single hospital in intensive care unit.
This review demonstrates the impact of nurse-led nursing care in neonatal intensive care unit Which provides with what neonatal health problem majorly challenge the nursing care, and come up with a base line evidence for future applied research and intervention in the hospital. Having data on the prevalence of the problem, it is crucial to take prioritized actions in the unit leaded by neonatal nurses.