Background: The social society in Africa and most continents, perceives any girl who gives birth before marriage as a wrong doer. Such a girl is deemed to have negated the traditions. Poor and non-communication between adolescents and their parents or guardians has been implicated in most instances. The scenario is the same in the County of study according to information from the respondents and as alluded to by the County Director of health services. The parents and guardians in the County have been called upon to exercise responsibility over their daughters, encourage them to resume school instead of forcefully marrying them off or rejecting them on the bases of pregnancy. The purpose of this study was to give evidence-based health education in relation to family and social support systems in reducing neonatal morbidity and mortality among neonates born to adolescent mothers in the County Referral hospital. Objective: The objective of this study was to describe the role of family and social support in reducing neonatal morbidity and mortality among neonates born to adolescent mothers. Methods: Setting; the study was carried out at a County referral hospital using a randomized control trial design. The participants were expectant adolescent mothers aged 19 years and below attending the antenatal clinic at the hospital. A sample size of 528 respondents (264 cases and 264 controls) was calculated using Pagano formula and realized using simple randomization. Inclusion criteria: adolescent mother ≤ 19 years, gestation period of 26-34 weeks and resident of the study County for sufficient time follow up. Students, non- Kenyans and mothers with existing co-morbidities were excluded for fear of loss to follow up. Results: Negligence and lack of support, 81% (pv 0.000), lack of community emphasis on neonatal care 77% (pv0.001), lack of value for neonatal health, 78% (pv 0.000), lack of knowledge 60% (pv0.003) and poor socioeconomic status, stigma and rejection 89% (pv0.000) were some of the significant study findings. Conclusion: The poor family and social support played a major role in persistently high neonatal morbidity and mortality in the County.