Global Advanced Research Journal of Medicine and Medical Sciences (GARJMMS) ISSN: 2315-5159
November 2020, Vol. 9(1), pp. 001-005
Copyright © 2020 Global Advanced Research Journals
DOI: 10.5281/zenodo.4303689

Full Length Research Paper

Neonatal discharges against medical advice at a tertiary center in Bayelsa state: impact of policy changes over a 10-year period

Timipah Peregba West¹*, Oliemen Peterside¹, Onyaye Kunle-Olowu¹ and Theodora Phiemueki Etu-Efeotor²

¹Department of Paediatrics and Child Health, Niger Delta University Teaching Hospital, Okolobiri, Bayelsa State.
²Department of Haematology, Niger Delta University Teaching Hospital, Okolobiri, Bayelsa State.

*Corresponding Author E-mail; timiperegba@yahoo.com; Phone numbers; 07030472193, 08115130177

Accepted 23 November, 2020

Discharge against medical advice among neonates is worrisome as there have been no substantial changes in neonatal mortality in Nigeria in the last decade. This study was carried out to determine the trend of discharge against medical advice among neonates in southern Nigeria and the impact of policy changes over a ten-year period. This retrospective study was carried out among neonates at the Special Care Baby Unit of the Niger Delta University Teaching Hospital, Bayelsa State. Relevant information was obtained and analyzed. The prevalence of neonatal discharge against medical advice was 3.97%, with a mean age of 4.81±5.33 days and a male to female ratio of 1.4:1. It declined from 1.82% in 2009 to 0.85% in 2011 and rose sharply to 9.37% in 2013. A50% fees waiver in 2015 had no impact, while a health insurance scheme in 2017 saw a decline to 3.52%. Neonatal sepsis was the most common diagnosis. Most [43 (56.2%)] discharges against medical advice occurred within six days of admission. Forty-three (58.90%) parents were in the low socioeconomic class and none had health insurance. A lack of finance was the major reason in 74% of neonates and in 76.7% of cases fathers were the main signatories. The prevalence of discharge against medical advice among neonates over the 10-year period remained high, with financial constraint being the main reason and sepsis the most common diagnosis. Universal health insurance will impact positively on its prevalence and improve child health.

Keywords: Neonates, Discharge against medical advice, Ten years, Health Insurance and fees waiver

List of abbreviations 

BHIS: Bayelsa State Health Insurance Scheme; DAMA: Discharge Against Medical Advice; NDUTH: Niger Delta University Teaching Hospital; SCBU: Special Care Baby Unit 

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