Identification of Current Best Practices for Short-term Medical Mission Trips and Adherence to Current Common Principles and Guidelines
Keywords:short-term medical missions, global health, medical missions
Background: Recent reviews of published guidelines for conducting short-term medical missions (STMM) identify significant concerns about the lack of adherence and of formal regulations concurrent with the increasing number of individuals and organizations participating in STMM.
Method: A descriptive survey methodology was used. A 44-item survey that identifies current practices utilized by healthcare providers (HCP) who have participated in STMM was used based on the literature and prior research, and distributed electronically to HCP participating in STTM to identify current best practices and compare findings with the most recent recommendations for short-term global health activities. A focus on current operational practices was surveyed and analyzed to develop operational recommendations for the ethical and safe care provided during STMM.
Results: Eighty-seven surveys were included in the final analysis, with 33% (N=29) serving as coordinators for the trip. The majority of the respondents were female (67%) and the primary roles represented were: MD (N=17; 20%), nurse practitioner (N=20; 23%), and registered nurse (N=18; 21%). A majority (N=48; 67%) traveled to South America or Latin America, with 38% (N=33) having participated in four or more STMM. Language proficiency was reported as deficient (N=35; 40%) along with little or no knowledge of the basic culture (N=39; 45%). Additional data were collected on trip preparation, clinic operations, and outcomes follow up.
Conclusions: Using a convenience sample, the results of the survey provide information on the current best practices utilized by HCP who have participated in STMM and compare the findings to assess for adherence with the most recent recommendations for short-term global health activities. There was variation in the degree to which HCP were knowledgeable about specific aspects related to knowledge of local culture, language proficiency, and adherence to recommended practices for STMM. Additional research on STMM is needed, along with further exploration of how evidence based practices for STMM can be implemented to improve access and safety to the care provided while in the host country.
Swanson R, Thacker B. Systems thinking in short-term health missions: a conceptual introduction and consideration of implications for practice. Christ J Global Health. 2015;2(1):7-22. https://doi.org/10.15566/cjgh.v2i1.50
Caldron PH, Impens A, Pavlova M, Groot W. A systematic review of social, economic and diplomatic aspects of short-term medical missions. BMC Health Serv Res. 2015;15:380. https://doi.org/10.1186/s12913-015-0980-3
Martiniuk AL, Manouchehrian M, Negin JA, Zwi AB. Brain gains: a literature review of medical missions to low- and middle-income countries. BMC Health Serv Res. 2012;12(1):134. https://doi.org/10.1186/1472-6963-12-134
Roche SD, Ketheeswaran P, Wirtz VJ. International short-term medical missions: a systematic review. Int J Public Health. 2017;62:31-42. https://doi.org/10.1007/s00038-016-0889-6
Compton, B. Short-term medical mission trips: research and recommendations. Health Prog. 2016;33-36. Available from: https://www.chausa.org/publications/health-progress/article/september-october-2016/short-term-medical-mission-trips-research-and-recommendations
Dainton C, Chu C, Lin H, Loh L. Clinical guidelines for western clinicians engaged in primary care medical service trips in Latin America and the Caribbean: an integrative literature review. Trop Med Int Health. 2016;21(4):470-8. https://doi.org/10.1111/tmi.12675
Melby MK, Loh LC, Evert T, Prater C, Li H, Khan OA (2016). Beyond medical "missions" to impact-driven short-term experiences in global health (STEGHs): ethical principles to optimize community benefit and learner experiences. Acad Med. 2016; 91(5):633-8. https://doi.org/10.1097/ACM.0000000000001009
Gorske A. BPGHM Working Group (2017). International Standards and practice guidelines and health missions. Available from: https://www.bpghm.org/wp-content/uploads/2017/05/ISGsandHealthMissions.pdf
Catholic Health Association of the United States. Short term medical mission trips phase I research findings: practices & perspectives of US partners. St. Louis: (MO): CHA. 2014. Available from: https://www.chausa.org/docs/default-source/international-outreach/short-term-medical-mission.pdf?sfvrsn=0
Rozier MD, Lasker JN, Compton B. Short-term volunteer health trips: aligning host community preferences and organizer practices. Global Health Action. 2017;10(1):1-8. https://doi.org/10.1080/16549716.2017.1267957
Lasker JN, Aldrink M, Balasubramaniam R, Caldron P, Compton B, Evert J, et al. Guidelines for responsible short term global health activities: developing common principles. Globalization Health. 2018;14:18. https://doi.org/10.1186/s12992-018-0330-4
Lasker J. Hoping to help: the promises and pitfalls of global health volunteering. Ithaca, NY: Cornell University Press; 2016.
Houweling R, Astle, B. Principles to guide a volunteer humanitarian faith-based short-term medical mission in Nepal: a case study. Christ J Global Health. 2018;5(3):35-42. https://doi.org/10.15566/cjgh.v5i3.235
Lough BJ, Tiessen R, Lasker JN. Effective practices of international volunteering for health: perspectives from partner organizations. Globalization Health. 2018;14(11):1-11. https://doi.org/10.1186/s12992-018-0329-x
Boston M, Horlbeck D. Humanitarian surgical missions: planning and success. Otolaryng Head Neck. 2015;153(3):320-5. https://doi.org/10.1177/0194599815587889
Alliance for healthcare and systems research. Systems thinking for health systems strengthening. Alliance for healthcare and systems research. Geneva: WHO; 2009. Available from www.who.int/alliance-hpsr/systemsthinking/en/
Seven Standards of Excellence: a code for best practice for short-term mission practitioners. Vancouver, WA: SOE; 2003. Available from: www.soe.org/7-standards/
American Health Lawyers Association. Legal and operational guide for free medical clinics. Washington (DC): 2015. Available from: https://www.healthlawyers.org/hlresources/PI/Documents/Legal_and_Operational_Guide_for_Free_Medical_Clinics.pdf
World Health Organization. Classification and minimum standards for foreign medical teams in sudden disasters [Internet]. Geneva: WHO; 2013. Available from: www.who.int/hac/global_helath_cluster/
Suchdev P, Ahrens K, Click E, Macklin L, Evangelista D, Graham E. A model for sustainable short-term international medical trips. Ambul Pediatr. 2007;7(4):317-20. https://doi.org/10.1016/j.ambp.2007.04.003
Institute for Healthcare Improvement. Improve core processes for administering medications [Internet]. Boston, MA: 2019. Available from: http://www.ihi.org/resources/Pages/Changes/ImproveCoreProcessesforAdministeringMedications.aspx
Dainton C, Chu CH. A review of electronic medical record keeping on medical mobile trips in austere settings. Int J Med Inform. 2017;98:33-40. https://doi.org/10.1016/j.ijmedinf.2016.11.008
Werremeyer AB, Skoy ET. A medical mission to Guatemala as an advanced pharmacy practice experience. Amer J of Pharm Ed. 2012;76(8)(Article 156):1-6. Available from: https://www.ajpe.org/doi/abs/10.5688/ajpe768156
World Health Organization. Guidelines for medical donations [Internet]. Geneva: WHO; 2011. Available from: http://www.who.int/medicines/publications/med_donationsguide2011/en/index.html
Gorske A. Harm from drugs in short term missions: a review of the medical literature. Best Practices in Global Health Missions. November 2016. Available from: https://www.bpghm.org/wp-content/uploads/2017/07/HarmFromDrugsinSTM.pdf
Hawkins J. Potential pitfalls of short term medical missions [Internet]. J Christ Nurs. 2013;30(4):E1-6. Available from: https://nursing.ceconnection.com/ovidfiles/00005217-201312000-00023.pdf
Bajkiewicz C. Evaluating short-term missions: how can we improve? J Christ Nurs. 2009;26(2):110-4. http://dx.doi.org/10.1097/01.CNJ.0000348272.27924.24
How to Cite
Christian Journal for Global Health applies the Creative Commons Attribution License to all articles that we publish. Under this license, authors retain ownership of copyright for their articles or they can transfer copyright to their institution, but authors allow anyone without permission to copy, distribute, transmit, and/or adapt articles, even for commercial purposes so long as the original authors and Christian Journal for Global Health are appropriately cited.
This work is licensed under a Creative Commons Attribution 4.0 International License.