Background: Children face the highest risk of dying in their first month of life. Ethiopia is one of the sub-Saharan countries with highest newborn deaths. Afar and Somalia regions in Ethiopia are among the regions with high death rates of newborn children. This study aimed to analyse and identify determinants of neonatal mortality in Afar and Somalia regions, Ethiopia.  Methods: This study used 2016 Ethiopian Demographic and Health Survey data for the analysis. The multivariable logistic regression model was used to identify the significant determinants of neonatal mortality. Adjusted odds ratio with a 95% confidence interval and p-value < 0.05 in the multivariable logistic regression model was reported to declare the statistical significance and strength of association between neonatal mortality and determinants. Results: A total of 2567 newborn children were included in this study. Mortality rate among newborns in the first month was 41 per 1000 live births in Afar and Somalia regions. Health facility delivery (AOR: 0.634; 95% CI: 0.409–0.982), being female (AOR: 0.206; 95% CI: 0.073–0.528), multiple births (AOR: 3.958; 95% CI: 2.293–11.208), small size at birth (AOR: 1.208; 95% CI: 1.003–1.728), secondary and above educational level of mothers (AOR: 0.484; 95% CI: 0.294–0.797) were statistically significant determinants neonatal mortality. Conclusions: In this study, sex of child, place of delivery, birth type, size at birth, mother’s educational level were found to be statistically significant determinants of neonatal death in Afar and Somalia regions, Ethiopia. Mothers with no education should be given health education and institutional delivery should be encouraged to improve the survival of the neonates in Afar and Somalia regions, Ethiopia.

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Introduction: Early neonatal death, which occurs during the prenatal period, is defined as the death of a newborn between 0 and 7 days after birth. It is one of the major public health problems in several developing countries. This study aimed to determine the early neonatal mortality rate and identify determinants of early neonatal mortality in Somalia region of Ethiopia. Methods: The data used for this study were drawn from the 2019 Ethiopia Mini Demographic and Health Survey (2019 EMDHS) data. A multivariable logistic regression model was used to identify the determinants of early neonatal mortality. Adjusted odds ratio (AOR) with 95% CI was used to examine the association of factors with early neonatal mortality. Results: A total of 637 live births were included in this study. The early neonatal mortality rate in the study was 44 (95% CI: 31, 65) deaths per 1000 live births. Male babies (AOR: 1.628; 95% CI: 1.152–4.895), babies delivered at home (AOR: 2.288; 95% CI: 1.194–6.593), and babies born from uneducated mothers (AOR: 2.130; 95% CI: 1.744–6.100) were at increased risk of death in the first 7 days of life after birth. Contrarily, decreased risk of death of babies in the first 7 days of life after birth was associated with urban residence (AOR: 0.669; 95% CI: 0.033–0.721) and singleton (AOR: 0.345; 95% CI: 0.070–0.609). Conclusion: The early neonatal mortality rate in the region was high. The study revealed that sex of child, place of residence, birth type, mother’s educational level, and place of delivery were the determinants of the death of babies in the first 7 days of life after birth. Hence, providing health education to uneducated mothers and enhancing institutional delivery is recommended to minimize the early neonatal mortality rate in the region.