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

Judith N Lasker1, Myron Aldrink2, Ramaswami Balasubramaniam3

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Summary

Concerns about short-term medical missions (STMMs) have led to guidelines. These guidelines, primarily from the Global North, emphasize host partnerships and ethical practices, but need host country input and enforcement strategies.

Keywords:
Best practicesGlobal health educationGuidelinesShort-term medical missionsStandardsVolunteers

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Area of Science:

  • Global Health
  • Medical Ethics
  • Public Health Policy

Background:

  • Growing concerns exist regarding the effectiveness and value of short-term volunteer trips aimed at health improvement in Global South communities.
  • Multiple organizations and individuals have developed guidelines to mitigate potential harms and maximize benefits of these volunteer efforts.

Purpose of the Study:

  • To analyze existing guidelines for short-term medical missions (STMMs) based on literature up to early 2017.
  • To examine the authorship, intended audiences, scope, and implementation focus of these guidelines.
  • To compare guideline content with the perspectives of host communities and staff.

Main Methods:

  • A scoping review of the literature was conducted to identify and analyze 27 guidelines related to STMMs.
  • Guidelines were assessed for authorship, target audience, addressed aspects of STMMs, and attention to implementation.
  • Findings were contextualized with studies on host country staff perspectives.

Main Results:

  • Existing guidelines are predominantly authored by and directed towards Global North educators and practitioners.
  • There is consensus on core principles: host partnerships, preparation, needs assessment, sustainability, and ethical standards.
  • Host country staff agree with key principles but emphasize mutual learning and respect.

Conclusions:

  • Guidelines require integration of host country research and policy directives, which are currently lacking.
  • A comprehensive strategy is needed to ensure adherence to best practices, addressing limited regulation and strong incentives for non-compliance.
  • Future guidelines should incorporate host country perspectives more robustly and address implementation challenges.