en Pediatric Pediatric Original Research Original Research <p> <strong>Abstract</strong></p><p> <strong>Background and Objective:</strong> Often, discharge of children against medical advice has a negative effect on the well-being of the patient. To determine the prevalence of discharge against medical advice (DAMA) among hospitalized children and examine the reasons given by parents/guardians for such discharges.</p><p> <strong>Methods:</strong> A retrospective 2-year medical records audit of children aged one day to 15 years discharged against medical advice was carried out in a pediatric unit of a secondary health-care facility.</p><p> <strong>Results:</strong> The overall prevalence of DAMA was 6.3% while the prevalence among neonates was 7.5%, p>0.05. Sixty-two (56.4%) of all cases were less than 12 months old with neonates accounting for 40 (64.5%) of the 62. The prevalence of DAMA was 2.8 times higher in male neonates compared to female neonates. Thirty two (9.9%) of 322 male neonates compared to 8 (3.7%) of female neonates were DAMA Odd ratio, OR=2.8 95% Confidence Interval, CI= 1.26, 6.20). Majority (65.4%) of the signatories to the discharge documents were the child’s fathers. In only 5.5% of cases were the child’s mothers the signatories. Rate of re-admission was 13.6%. The commonest reason for DAMA in both neonates and older children was financial constraints. Parental disagreement with planned treatment and/or investigations ranked second in the case of neonates.</p><p> <strong>Conclusions:</strong> DAMA is a common social pediatric health problem, especially among infants and has multifactorial etiology. Socioeconomic factors, parental misjudgment of improvement and disagreement with treatment plan were found to have a significant bearing to its occurrence.</p> Children, Discharge against medical advice (DAMA), Hospital fees. 194 199 http://mjiri.iums.ac.ir/browse.php?a_code=A-10-1-282&slc_lang=en&sid=1 Alphonsus N. Onyiriuka didiruka@gmail.com 20031947532846002840 20031947532846002840 Yes Department Of Child Health, University of Benin Teaching Hospital, Pmb 1111, Benin City,Nigeria.