A Comprehensive Framework to Optimize Short-Term Experiences in Global Health (STEGH)

Henry C Lin,Shivani Shah,Lawrence C Loh

doi:10.1186/s12992-019-0469-7

Abstract

Increasing demand for Short-term Experiences in Global Health (STEGH), particularly among medical trainees, has seen a growth in programming that brings participants from high-income countries to low and middle-income settings in order to engage in service, teaching or research activities. Historically the domain of faith-based organizations conducting “missions”, STEGH are now offered by diverse groups including academic institutions, non-profit organizations, and the private sector, either as dedicated for-profits or through corporate social responsibility arms.The growing popularity of STEGH has resulted in concerns about their negative impacts on host communities. Traditional STEGH are often crafted with little or no input from host community leaders, and this results in activities that do not address locally identified priorities. Other concerns include culturally incongruent programming and the creation of parallel systems that disrupt established local services and redirect scarce local resources, which fosters dependency instead of building capacity. One concern specific to trainees also includes trainee provision of services beyond their scope and training level.To address these concerns, this paper presents a comprehensive framework that aims to categorize promising interventions that might promote greater responsibility in STEGH. Based on the micro-meso-macro framework, this paper proposes various interventions as incentives and disincentives to be deployed at the individual, program, and societal levels to promote greater responsibility in STEGH. Deployed altogether, the interventions contemplated by this framework would foster the optimal context required to encourage responsibility, minimize harms, and optimize host community outcomes for STEGH.

Highlights

Short term experiences in global health (STEGH) have grown in popularity in recent years, among trainees and learners. [1]
A 2005 estimate of the value of United States volunteer time spent abroad was estimated at $2.92 billion, with 10 million volunteers participating in STEGH. [3,4,5] Specific to medical students, participation rates in STEGH increased from 6% of matriculating medical students in 1978 to 32% in 2008, and latest data from the American Association of Medical Colleges suggests that 43.2% of currently enrolled American medical students have participated in some type of STEGH [2]
In parallel with the increasing popularity of STEGH, concerns have risen around potential negative impacts on host communities and the need to be thoughtful and

Summary

Background

Short term experiences in global health (STEGH) have grown in popularity in recent years, among trainees and learners. [1]. [15, 25] for STEGH, interventions must be deployed to, stated make it “uncool” to go abroad with a program that does not meet a specific responsibility standard Implemented, this means setting up contexts that provide incentives for responsibility in STEGH and disincentives for harmful or ineffective practices, for volunteers who choose to participate, sending organizations that plan specific programs, and communities that host STEGH. By and large, these interventions will typically involve the deployment of policy changes internationally and in other settings at institutions/organizations, professional associations, licensing bodies, and government agencies and regulators. Resources Intergovernmental organisations should provide resources towards implementing a broad strategy to inculcate responsibility in STEGH, and support continued meetings and conference that will drive conversations on the best way to turn the tide around many of the concerns expressed to date

Findings

Discussion

Conclusion