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.