Determinants of discharge against medical advice amongst neonates admitted at Federal Teaching Hospital Gombe, Nigeria

Abstract

Objective: Discharge Against Medical Advice (DAMA) is a major problem in health care delivery in Nigeria. Children, especially neonates, who can neither understand nor contribute to decision concerning their own health, are the most commonly affected. The objective of this study was to identify the reasons proffered for DAMA in neonates and persons involved in making such decisions.

Materials and methods: A descriptive study of consecutive neonates who were discharged against medical advice from the Special Care Baby Unit at Federal Teaching Hospital (FTH), Gombe from January 2016 to December 2017. Patients’ Biodata, Diagnosis, Socio demographic characteristics of both parents, relationship of the person signing DAMA with the patient and the reason (s) for signing DAMA were recorded in a proforma.

Results: Out of the 1,110 neonates admitted during the study period, 103 were discharged against medical advice giving a DAMA rate of 9.3%: Male 50(48.5%) and Female 53(51.5%). Majority 98(95.1%) of DAMA cases were signed by the father and the main reason stated for DAMA was financial constraint 62(60.2%).

Conclusion: Financial constraint was the main stated reason for DAMA and the father was the signatory to DAMA in majority of newborn in FTH, Gombe.