Perceptions of a short-term medical programme in the Dominican Republic: Voices of care recipients

Abstract

Participation in short-term global health programmes for low-income countries is increasing amongst practising clinicians and trainees from high-income countries. However, few studies explicitly examine the perceptions of programme recipients. In July 2012, we conducted semi-structured interviews with a purposive sample of 47 adults receiving care from Medical Ministry International, an international non-governmental organisation providing short-term medical programmes in the Dominican Republic. Thirty interviews met criteria for inclusion. Transcripts were independently coded using a descriptive approach. After thematic saturation, 20 interviews were included in the final analysis. Nine major themes were identified: misidentification, access, identified needs, social determinants, faith, language, student involvement, areas for improvement and respect. Recipients were reluctant to discuss programme improvement directly and frequently misidentified the researcher as a caregiver, suggesting a need to separate clearly programme evaluation from care provision. They viewed student involvement positively in a setting where supervision is emphasised, suggesting a potential to develop measures of supervision's adequacy. Finally, recipients' perceptions of respect as an important but intangible programme element encourage broadening the ethical discourse around short-term programmes beyond only tangible goods and services. Our findings support the usefulness of qualitative methods for short-term programme evaluation and generate important hypotheses for future research.

Keywords:

• global health
• short-term medical outreach
• medical missions
• qualitative study
• ethics

Acknowledgements

The authors acknowledge the support provided by Dr Teo Beato and Dr Frida Luna throughout the design and administration of this study in the DR.

Funding

Dr DeCamp's work was funded by a Greenwall Fellowship in Bioethics & Health Policy and an NIH grant [5T32HL007180-38]. This project was supported by a grant from the Osler Center for Clinical Excellence at Johns Hopkins University and a Johns Hopkins University School of Medicine Research Award.

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Funding

Funding: Dr DeCamp's work was funded by a Greenwall Fellowship in Bioethics & Health Policy and an NIH grant [5T32HL007180-38]. This project was supported by a grant from the Osler Center for Clinical Excellence at Johns Hopkins University and a Johns Hopkins University School of Medicine Research Award.