Dissertation (MSc Pediatric Nursing)Newborn health and well-being are important for growth and development of the infant. However, evidence indicates that nurses and midwives do not effectively practice and observe the WHO recommendations for essential newborn care. The aim of this study was to assess competence of Essential Newborn Care among nurses and midwives in Zanzibar. A hospital-based analytical cross-sectional study was conducted from January to February 2021 in Zanzibar by involving 246 nurses-midwives. One tertiary hospital and one regional hospital were involved in this study, whereas simple random sampling was used to select primary health facilities. Structured self-administered questionnaire was used to generate the data. The predictors of essential care competence were determined using Binary Logistic regression under multivariate analysis using SPSS version 23.0. The P<0.05 was considered to be significant. A total of 246 nurses/midwives participated in this study. Among them, 27% had inadequate essential newborn care practice and 36% had knowledge related to essential newborn care. Further analysis revealed that 40% of nurses/midwives had positive attitudes towards essential newborn care. The factors influencing ENC. Knowledge of nurses are professional qualification (AOR=8.83, 95% CI=2.00-38.96, p=0.004), present of guideline (AOR=3.52, 95%CI= 1.59-7.80, p=0.002). Attitude of nurses of essential newborn care are residence of participates (AOR=0.17, 95%CI= 0.07-0.38, p=<.0001), availability of equipment (AOR=0.24, 95%CI=0.10-0.55, p=), shortage of staffs (AOR=0.06, 95%CI= 0.02,0.25, p=<.0.001) and Practice of nurses are residence of participants (AOR=3.3, 95%CI= 1.16-9.09, p=0.0242), shortage of staff (AOR= 0.80, 95%CI = 0.02-0.32, p=0.0003) adequate knowledge (AOR=2.80, 95%CI = 1.15-6.84, p=0.0235) and positive attitudes (AOR=3.59, 95%CI=1.52-8.53, p=0.0037) were significantly associated with essential newborn care competence. The nurses and midwives participated in this study demonstrated had low competence of essential newborn care in Zanzibar. While there predictors of essential newborn care were profession qualification, lack of guidelines, area of residence, shortage of staff, inadequate knowledge and negative attitude.