Various strategies have been put in place in Ghana to achieve the United Nations millennium development
goal 4 (MDG 4) on reducing childhood mortality rates by two-thirds by 2015. Global under-five mortality rate
is declining but the proportion of death due to neonatal deaths is still high. We, therefore, examined the
trend in neonatal mortality in a tertiary hospital from 2008 to 2012 to ascertain whether the strategies have
been effective. Data were analysed using SPSS v 20.32. Neonatal mortality rates decreased steadily from 32
per 1000 live births in 2008 to 14 in 2011, but increased drastically to 39 per 1000 live births in 2012. The
overall neonatal mortality rate was 27 per 1000 live births. Majority, 1434 (83%) of the neonates died within
24 hours of birth and 28 (2%) occurred after 2 weeks. The five topmost causes of neonatal deaths within the
period were: prematurity, birth asphyxia, neonatal sepsis, neonatal jaundice, and respiratory distress. In
furtherance, neonatal mortality decreased gradually in the first four years but turned upward in the fifth
year. Improvement in employee incentives and adequate preparation of care providers for early neonatal
care was recommended.