AUTHOR=Alao Michael Abel , Ibrahim Olayinka Rasheed , Ogunbosi Babatunde Oluwatosin , Nna Emmanuel Okechukwu , Olapegba Peter Olamakinde 

TITLE=Effectiveness of Faith-Based Interventions on the Rate of Discharged Against Medical Advice in Tertiary Newborn Units in Nigeria: A Protocol for an Open Label Randomized Control Trial

JOURNAL=Frontiers in Public Health

VOLUME=Volume 9 - 2021

YEAR=2022

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2021.788383

DOI=10.3389/fpubh.2021.788383

ISSN=2296-2565

ABSTRACT=Background: 
Discharged against medical advice (DAMA) is a risk factor that often leads to adverse outcomes and hospital re-admissions in neonatal units. Few studies have shown that spiritual/faith-based institutions (FBI) tend to have a lower incidence of DAMA compared with public hospitals. Perhaps the holistic approach to patient care that addresses the spiritual needs, the soul and the body component of a being in this setting may account for the observed lower incidence of DAMA. Limited randomized control trials (RCT) exist on faith-based interventions with regards to DAMA in published literature. This study seeks to compare the effectiveness of FBI, social support, religiosity and types of FBI on neonatal DAMA against standard of care in tertiary hospitals in Nigeria. 
Methods: This RCT will be carried out in 2 public tertiary teaching hospitals in 2 of 6 geopolitical zones in Nigeria. The socio-demographic and clinical details of all patients admitted to the neonatal wards during the study period will be documented. Study participants will be selected through a multistage sampling technique. Subjects will be randomized and allocated to treatment and control arms having established baseline measures of social support and religiosity. Ethical approval was obtained from the State Research Ethics Review Committee. Written informed consent will be obtained from the parents/caregivers prior to patient enrolment. The study will be conducted in line with the Declaration of Helsinki 2000. Appropriate statistical tools will be used for data collection and analysis.
Discussion:
The outcome of this analysis will give insight into the effectiveness of the faith-based intervention on DAMA. It will also predict the effect of the mediators of parents/caregivers religiosity, spirituality, forms of FBI, parents/caregivers religious sect and social support on the rate of DAMA on neonatal admission in tertiary hospitals in Nigeria. This may help inform Public Health Institutions and Governments decisions on the determinant of neonatal DAMA and how to mitigate such outcomes. It is hoped that the evidence from this study may guide policy formulation and guidelines on enhancing hospital retention of sick neonates until they are fit for discharge.