Voluntary Discharge in Pediatrics Units of Different Hospital Settings with a Focus on Nigeria

Voluntary discharge from health facilities affects all patient age groups and climates. It is also called “discharge against medical advice” (DAMA) as the decision is opposed to the desire of the physician. There is a peculiarity in pediatric patients when it comes to DAMA since the decision, in most cases, is taken without their consent. The medical consequences suffered by the patient may be grave, ranging from full recovery to death. This work aims to critically analyze, through literature, the gravity of this situation in terms of prevalence, risk factors and condition, associated ethical-legal challenges and possible solutions in low and middle-income settings like Nigeria. A concentrated literature search was done to find papers that were published between 2000 and 2021 in the Cochrane, Pubmed, Google Scholar and Web of Science Databases. The focus of this review is to gain an understanding of regional variations and the factors that underlie DAMA since these will be relevant in designing interventional strategies to ameliorate the trend, especially in low and middle-income nations.