Paediatric discharges against medical advice at a tertiary health centre in Bayelsa State, Nigeria

Introduction: Paediatric discharges against medical advice (DAMA) are common hospital experiences which limit appropriate and comprehensive treatment as a result of abrupt termination of physician care.The fact remains that the children who are the major culprits of this practice are not legally able to participate in this decision making process which may negatively affect their health.Objectives: This present study was carried out with the aim of identifying the DAMA prevalence, the socio-cultural characteristics and reason(s) for DAMA among the paediatric patients admitted into the Niger Delta University Teaching Hospital, Bayelsa.Methods: Case notes of all children who had been discharged against medical advice over a 2 year period(1st of June 2011to 31st of May 2013) were retrospectively reviewed and analysed.Results: One hundred and fortyone children out of a total of 1872 children admitted into the paediatric wards had been discharged against medical advice, giving a DAMA prevalence rate of 7.5%.Out of 120 children whose case notes were retrieved and analysed, there were69(57.5%)males and 51 (42.5%) females with a male: female ratio of 1.4:1.Neonatal septicaemia (32.6%), birth asphyxia (27.9%) and prematurity