<p>The overall score for system performance was 83.15%. The system had reported 463 neonatal death over the period of five years. Neonatal death was caused by asphyxia, sepsis, and tradition medicine or herbal the mother takes for easy delivery. Asphyxia accounted for 65% (301/463) of Neonatal Mortality in Sunyani Municipal. In total, there were 63 neonatal deaths for every 1000 live births. Report from the Audits shows 50% of cases can be prevented. The system has successfully audited all neonatal death between 2018 to 2021. There was no case base form, Rumor book, or log book. Data are not analyzed at health facility level.</p>