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In Ethiopia, perinatal death accounts for 40% of all infant deaths. Evidences between 1974 – 2013 suggest that perinatal mortality ranges from 124 per 1000 births. There is scarcity of community level data on patterns and causes of perinatal mortality. In response to this gap and to contribute to the improvement of neonatal mortality, the analysis of trends and causes of under-five mortality generated by Health and Demographic Surveillance System (HDSS) from six networked Ethiopian Universities Research Centers indicates that most causes associated with neonatal death are preventable.