[National reference unit of neonatology: state of play].

Background: The neonatal mortality rate in Mali is one of the highest in the world. Only one national reference neonatology unit is available in the country.
Aim: To describe the time-course of morbidity, mortality, staff and accommodation facilities from 2008 to 2009 in Mali's unique national reference neonatology unit.
Methods: This descriptive and cross-sectional study was conducted in the neonatology unit of Gabriel Touré Teaching Hospital, Bamako. Data concerning staff number of admissions, sex ratio, diseases, patients outcome, capacity and length-of-stay were compiled for the period from 1st January 2008 to 31 December 2012.
Results: Medical staff increased from one to three in 2009 and the number of nurses and midwives decreased from 16 to 14 with an average number of beds of 44. The mean number of hospitalizations per year was 3,900 (range: 3667-4585) with 14% of in-born deliveries and a mean length-of-stay of 3.7 days. Prematurity birth asphyxia and infection represented 80.5% of reasons for admission and 79.5% of deaths. The mortality rate varied from 28.5% to 36.8% with an annual mean of 33.2%. The diseases associated with the highest mortality were tetanus (60.8%), prematurity (42.7%), birth asphyxia (29.4%) and infection (25.7%).
Conclusion: Neonatal mortality remains very high in Mali. Health authorities should take measures to decentralize the care of sick newborns in order to reduce neonatal mortality in Mali.