Dissertation (MMED Pediatric and Child Health)Hypoxic Ischemic Encephalopathy (HIE) is an important cause of newborn deaths, and a leading cause of long-term neurological impairment in children. Timely identification of newborns at high risk of death and escalation of therapeutic interventions may reduce mortality and long-term complications. This study aimed at determining the prevalence and predictors of poor outcome among term newborns with HIE at a regional hospital in central Tanzania. This was a prospective observational study, conducted for 9 months from September 2020 to May 2021. A total of 170 term newborns with HIE (ie birth asphyxia and signs of encephalopathy by Thompson score) were enrolled and followed until discharge/death, then assessed at 3 months. Clinical parameters were recorded using a structured data collection sheet. Neurodevelopment assessment was done at age 3 months using HINE. Logistic regression analysis was used to determine predictors of poor outcome for HIE. Out of the 177 enrolled newborns with birth asphyxia, 96% (170/177) had HIE, out of which 44.7% (76/170) had poor in-hospital outcomedefined as death 27% (46/170) or abnormal neurological features at discharge 17.6% (30/170). Severe HIE defined by Thompson score (p<0.0001*), features of aspiration during delivery (AOR=3.06, 95% CI [1.170, 8.014], p=0.0226), APGAR score of <7 at 5 minutes (AOR=2.88, 95% CI [1.133, 7.310], p=0.0262) and seizures occurrence (AOR=4.199, 95% CI [1.651, 10.604], p=0.0026) were independently associated with poor outcome. At 3months follow up among the survivors 12.6% (11/87) had neurological impairment, which was associated with seizures occurrence, severity of HIE and length of hospital stay after delivery. Almost all newborns with birth asphyxia in our study ended up developing HIE; which is associated with high in hospital mortality and significant neurological sequelae later in infants. Severity of HIE by Thomson score and presence of seizures during admission were important factors in predicting neurological status among these infants with HIE.