Discharge against medical advice (Dama) in children’s ward the Awka, South East Nigeria experience.

Abstract

Background: Until recovery, discharge against medical advice (DAMA) is a rare thing that does happen when one is admitted in a Healthfacility, but these days it appears to be a common occurrence due to some factors.Objective: To evaluate the factors responsible for DAMA in children’s ward of Amaku general hospital Awka (AGHA)Patients and method- The case files of children admitted into the children’s ward of AGHA from January 1, 2007 to December 31, 2009 werereviewed and analysedResults: Of the 498 patients admitted, 10 were DAMA giving a prevalence of 2%. Their ages ranged between 3 months – 9 years. Most of them(75%) belonged to lower social class. HIV/AIDS (62.5%) and protein energy malnutrition PEM (25%) were the predominant disease conditionof affected patients. At the time of DAMA, 75% of them were too ill to go home. The major reason for requesting for DAMA was lack offinance.Conclusion: The findings indicate that lack of finance was the major reason for DAMA. Appeal for government at all levels to adopt policy ofNational Health Insurance scheme to cover all children in Nigeria, will help to discourage the issue of DAMA