David Geffen School of Medicine at UCLA, Los Angeles, CA, 90095, USA.
Department of Health, Society, and Behavior, University of California, Irvine, Irvine, CA, 92697, USA.
Ann Glob Health. 2023 Mar 3;89(1):17. doi: 10.5334/aogh.3995. eCollection 2023.
There is growing concern about the sustainability and long-term impact of short-term medical missions (STMMs)-an increasingly common form of foreign medical aid-given that brief engagements do little to address the underlying poverty and fragmented healthcare system that plagues many low- and middle-income countries (LMICs). In the absence of formal evaluations, unintended but serious consequences for patients and local communities may arise, including a lack of continuity of patient care, poor alignment with community needs, and cultural and language barriers.
We conducted semi-structured interviews with Honduran healthcare providers (n = 88) in 2015 to explore local providers' perceptions of the impact and sustainability of foreign medical aid on patient needs, community health, and the country's healthcare system.
Respondents represented a random sample of Honduran healthcare providers (physicians, dentists, nurses) who worked for either a government-run rural clinic or non-governmental organization (NGO) in Honduras.
Honduran healthcare providers largely framed foreign medical teams as being assets that help to advance community health through the provision of medical personnel and supplies. Nonetheless, most respondents identified strategies to improve implementation of STMMs and reduce negative impacts. Many respondents emphasized a need for culturally- and linguistically-tailored medical care and health education interventions. Participants also recommended strengthening local partnerships to mitigate the risk of dependence, including on-going training and support of community health workers to promote sustainable change.
Guidelines informed by local Honduran expertise are needed to increase accountability for more robust training of foreign physicians in the provision of context-appropriate care. These findings provide valuable local perspectives from Honduran healthcare providers to improve the development and implementation of STMMs, informing strategies that can complement and strengthen healthcare systems in LMICs.
短期医疗队（STMM）——一种越来越常见的外国医疗援助形式——引起了人们越来越多的关注，因为这种短暂的接触几乎无法解决困扰许多低收入和中等收入国家（LMIC）的贫困和分散的医疗体系问题。由于缺乏正式的评估，可能会给患者和当地社区带来意想不到的严重后果，包括患者护理的连续性不足、与社区需求的不一致以及文化和语言障碍。
我们于 2015 年对洪都拉斯的医疗服务提供者（n=88）进行了半结构式访谈，以探讨当地医疗服务提供者对外国医疗援助对患者需求、社区健康和国家医疗体系的影响和可持续性的看法。
受访者代表了在洪都拉斯工作的政府经营的农村诊所或非政府组织（NGO）的洪都拉斯医疗服务提供者（医生、牙医、护士）的随机样本。
洪都拉斯医疗服务提供者主要将外国医疗队视为有助于通过提供医务人员和物资来促进社区健康的资产。尽管如此，大多数受访者还是确定了改进短期医疗队的实施并减少负面影响的策略。许多受访者强调需要提供文化和语言适应的医疗和健康教育干预措施。参与者还建议加强地方伙伴关系，以降低对外国援助的依赖风险，包括对社区卫生工作者进行持续培训和支持，以促进可持续变革。
需要根据当地的洪都拉斯专业知识制定指导方针，以提高对外国医生提供适合国情的护理的更严格培训的问责制。这些发现为短期医疗队的制定和实施提供了宝贵的当地观点，为改善 LMIC 中的短期医疗队的发展和实施提供了信息，为加强和补充医疗体系提供了策略。
