Introduction: Despite the introduction and widespread use of Rhesus (Rh) D immunoglobulinrnfor prevention of hemolytic disease of the fetus/newborn (HDFN), Rh alloimmunization remainsrna significant problem in perinatology. Care management with anti-D prophylaxis in patientsrnpresenting with severe alloimmunization is difficult to access in Sub-Saharan Africa.rnObjective: This study aims to determine the prevalence and assess the existing mechanism forrnmanagement of Rh negative pregnant women in Gandhi Memorial hospital.rnMethods: A cross sectional study using quantitative and qualitative methods was used in thernstudy. A total of 497 women case files were included in the study from September, 2012 tornAugust, 2014 to determine the prevalence by using systematic random sampling. Then anotherrn384 case files of Rh negative women was included by simple random sampling for assessmentrnof the management of Rh negative pregnancy. SPSS was used for data entry and analysis .Tablesrnwere used to show the results, percents and frequencies to describe the variables. Univariate andrnBivariate analysis using Chi square was conducted and p value was determined. In the qualitativernmethod in-depth interview with 7 key informants by using purposive sampling, to assess thernavailability and affordability issues of medication was done. Data was analyzed as per thernprocedure i.e. recording, transcribing, translation and organizing and content analysis wasrnconducted using open code software.rnResultrnThe prevalence of Rh negative was 7.2% with 95%CI (6.9, 7.5). The utilization rate of Anti Drnwas 14.3%. There was 4.7% offer of RAADP at 28 weeks. Regarding Anti D administration allrnsocio demographic factors included in the study were not statistically significant with anti Drnadministration. Qualitative data suggest that special consideration is necessary on this issuernConclusion and RecommendationrnThe prevalence of Rh negative women is of a high magnitude keeping in view the prevalencernrate of the other African countries estimate. There is lack of proper management of Rh negativernpregnant women. Special attention should be given to Rh negative pregnancy to be included inrnmaternal health programs by Ministry of health, donors and other collaborators.