Dissertation (MSc Pediatric Nursing)There is slower progress on decreasing preterm deaths despite of essential newborn care intervention in Tanzania. About 24% of neonatal deaths in Tanzania occur due to prematurity related complications. The competence regarding Kangaroo Mother Care (KMC) among postnatal mothers and associated health outcomes of preterm babies in central zone is unknown. Therefore the study was aimed to assess competence of postnatal mothers on Kangaroo Mother Care (KMC) and health outcomes of the preterm babies. The study design was an analytical cross sectional involved 363 mothers of preterm babies from three Referral Regional Hospitals in Central zone. Face to face interview using structured questionnaire was used to collect data. Data was analyzed by using SPSS v23. Descriptive statistics was used to describe the distribution of the entire study variable while the inferential statistics helped to analyze the influence of KMC mothers competence on weight gain and hypothermia among preterm babies and the level of significance was set at two side of less than 0.05. Findings showed 62%, 52.6% and 55.4% of the respondents had inadequate knowledge, negative attitude and poor practiceof KMC respectively. Majority of preterm babies (65.3%) had inadequate weight gain and 22.6%of preterm babies experienced hypothermia. The results on association between KMC Practice and health outcome of preterm babies revealed that mothers who had good practice their babies were (AOR=2.036, at95% CI =1.254-3.306; p=0.004). The association between KMC practice and body temperature of a preterm baby showed that, mothers with poor practice their preterm babies were (AOR=7.871, at 95% CI=4.009-15.454; p=0.001). The overall study findings showed inadequate knowledge, negative attitude and poor practice of KMC among mothers of preterm babies which resulted inadequate weight gain and hypothermia to the preterm babies. Further studies needed to assess other factors contributing poor competence of KMC.