Guidelines for responsible short-term global health activities: developing common principles

Abstract

BackgroundGrowing concerns about the value and effectiveness of short-term volunteer trips intending to improve health in underserved Global South communities has driven the development of guidelines by multiple organizations and individuals. These are intended to mitigate potential harms and maximize benefits associated with such efforts.MethodThis paper analyzes 27 guidelines derived from a scoping review of the literature available in early 2017, describing their authorship, intended audiences, the aspects of short term medical missions (STMMs) they address, and their attention to guideline implementation. It further considers how these guidelines relate to the desires of host communities, as seen in studies of host country staff who work with volunteers.ResultsExisting guidelines are almost entirely written by and addressed to educators and practitioners in the Global North. There is broad consensus on key principles for responsible, effective, and ethical programs--need for host partners, proper preparation and supervision of visitors, needs assessment and evaluation, sustainability, and adherence to pertinent legal and ethical standards. Host country staff studies suggest agreement with the main elements of this guideline consensus, but they add the importance of mutual learning and respect for hosts.ConclusionsGuidelines must be informed by research and policy directives from host countries that is now mostly absent. Also, a comprehensive strategy to support adherence to best practice guidelines is needed, given limited regulation and enforcement capacity in host country contexts and strong incentives for involved stakeholders to undertake or host STMMs that do not respect key principles.Electronic supplementary materialThe online version of this article (10.1186/s12992-018-0330-4) contains supplementary material, which is available to authorized users.

A prospective observational study of postoperative follow‐ups and outcomes at a nonprofit, internationally supported pediatric surgery center in Guatemala

“…The Moore Center offers a model that blends the capabilities of a permanent facility offering both surgical services and follow‐up to a local population, with the financial and human capital resources offered by experienced visiting surgical teams. The Moore Center meets the guidelines recommended for short‐term global health activities and short‐term pediatric missions . This type of center has not been previously investigated as a potential improvement over the short‐term surgical mission model.…”

Urban Versus Rural: A Cross-Sectional Study of a Successful Peruvian Global Health Medical Mission

“…In hopes of maximizing care and safety of patients while minimizing cross-cultural misunderstandings, several groups have published recommendations for STMMs. [2,[26][27][28][29][30][31][32] Lasker et al enumerates themes across several guidelines, including preparation of volunteers, partnership with host organization as well as needs assessment, sustainability, legal and ethical conduct, and continued evaluation. [32] Without including these considerations, STMMs run the risk of wasting resources, or even negatively impacting the healthcare of the local population.…”

“…[2,[26][27][28][29][30][31][32] Lasker et al enumerates themes across several guidelines, including preparation of volunteers, partnership with host organization as well as needs assessment, sustainability, legal and ethical conduct, and continued evaluation. [32] Without including these considerations, STMMs run the risk of wasting resources, or even negatively impacting the healthcare of the local population. This study encourages other STMM groups to consider the local needs of their specific population and demonstrates that collection of this type of data is both feasible and beneficial to long-term healthcare efforts.…”

Developing and validating learning domains, competencies, and evaluation items for global health clinical immersion practicums for graduate‐level nursing programs

“…For example, Lasker et al. () pooled existing guidelines on short‐term global health activities to develop core principles across disciplines that emphasize the host perspective, thus ensuring maximal value while minimizing harm. Wilson et al.…”