What is it about?

Discharge against medical advice has synonyms like leave against medical advice or self-discharge. As the neonates couldn't give consent on their own, it depends on the parents to decide the care for neonates. We have carried out a study on DAMA in one of the largest newborn care units in Bangladesh. We find out the prevalence, causes, and predictors of DAMA in neonates, sheds light on this issue and highlights the need for improved hospital policies and communication with parents. While false perceptions of wellbeing, inadequate facilities for mothers, and financial problems were the most common causes of DAMA, our study also identified several predictors of DAMA, including preterm gestation, vaginal delivery, and timing of outcome after office hours or on weekends. Our study highlights several opportunities to improve the hospital environment and service-related issues, such as ensuring better communication with parents, providing provision for mothers' corner, maintaining a standard ratio of neonates and healthcare providers, and adopting specific DAMA policies by the hospital authority.

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Why is it important?

This study is important because it sheds light on a significant public health problem that can have serious consequences for neonates and their families. The research was conducted in a low-income country, Bangladesh, where the healthcare system faces significant challenges, including a shortage of healthcare providers and inadequate resources. The study highlights the need for tailored interventions that consider the specific cultural and economic factors that may contribute to this problem in Bangladesh.


Discharge against medical advice is a public health problem. It's difficult to find out specific reasons behind this problem. Our study points the light on reasons and predictors so that health care provider could address the neonates and their attendants early to reduce such outcomes. It's also a great pleasure to include a map of the study place for a better understanding of readers.

Dr. Syeda Humaida Hasan
Chittagong Medical College

Read the Original

This page is a summary of: Discharge against medical advice in Special Care Newborn Unit in Chattogram, Bangladesh: Prevalence, causes and predictors, PLoS ONE, April 2023, PLOS, DOI: 10.1371/journal.pone.0284705.
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