title: 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.
authors.affiliation: a Berman Institute of Bioethics and Division of General Internal Medicine , Johns Hopkins University , Baltimore , MD , USA.
authors.forename: Matthew
authors.initials: M
authors.lastname: DeCamp
authors.forename: Samuel
authors.initials: S
authors.lastname: Enumah
authors.forename: Daniel
authors.initials: D
authors.lastname: O'Neill
authors.forename: Jeremy
authors.initials: J
authors.lastname: Sugarman
mesh_terms: D000293:Adolescent; D000328:Adult; D004293:Dominican Republic; D005260:Female; D014943:Global Health; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008493:Medical Missions / Q000941:ethics / Q000458:organization & administration* / Q000592:standards; D008875:Middle Aged; D020380:Needs Assessment; D017060:Patient Satisfaction; D015397:Program Evaluation; D036301:Qualitative Research; D064890:Social Determinants of Health; D013997:Time Factors; D014481:United States; D055815:Young Adult
keywords: ethics; global health; medical missions; qualitative study; short-term medical outreach