Learning from developing countries in strengthening health systems: an evaluation of personal and professional impact among global health volunteers at Addis Ababa University’s Tikur Anbessa Specialized Hospital (Ethiopia)

Abstract

BackgroundThe positive impact of global health activities by volunteers from the United States in low-and middle-income countries has been recognized. Most existing global health partnerships evaluate what knowledge, ideas, and activities the US institution transferred to the low- or middle-income country. However, what this fails to capture are what kinds of change happen to US-based partners due to engagement in global health partnerships, both at the individual and institutional levels. “Reverse innovation” is the term that is used in global health literature to describe this type of impact. The objectives of this study were to identify what kinds of impact global partnerships have on health volunteers from developed countries, advance this emerging body of knowledge, and improve understanding of methods and indicators for assessing reverse innovation.MethodsThe study population consisted of 80 US, Canada, and South Africa-based health care professionals who volunteered at Tikur Anbessa Specialized Hospital in Ethiopia. Surveys were web-based and included multiple choice and open-ended questions to assess global health competencies. The data were analyzed using IBRM SPSS® version 21 for quantitative analysis; the open-ended responses were coded using constant comparative analysis to identify themes.ResultsOf the 80 volunteers, 63 responded (79 percent response rate). Fifty-two percent of the respondents were male, and over 60 percent were 40 years of age and older. Eighty-three percent reported they accomplished their trip objectives, 95 percent would participate in future activities and 96 percent would recommend participation to other colleagues. Eighty-nine percent reported personal impact and 73 percent reported change on their professional development. Previous global health experience, multiple prior trips, and the desire for career advancement were associated with positive impact on professional development.ConclusionProfessionally and personally meaningful learning happens often during global health outreach. Understanding this impact has important policy, economic, and programmatic implications. With the aid of improved monitoring and evaluation frameworks, the simple act of attempting to measure “reverse innovation” may represent a shift in how global health partnerships are perceived, drawing attention to the two-way learning and benefits that occur and improving effectiveness in global health partnership spending.

Helping palliative care healthcare professionals get the most out of mentoring in a low-income country: a qualitative study

“…working rather than teaching) of this experience was protective - helping mentors feel prepared and able to cope with challenge in most cases. This has also been described by Busse et al [14] who cited prior experience along with multiple prior trips and a desire for career enhancement, as being associated with a positive impact on professional development.…”

“…Shared challenges identified in this and other studies include communication and logistical issues, the lack of resources and work place support [14, 15], (Leng unpublished) – most mentors in this study took annual leave to allow them to visit their mentees. Sharing challenges between mentors helped to normalise them and protect from negative emotional responses.…”

“…Additional challenges linked to working as an international volunteer have also been indentified with further insight available from an unpublished survey of 41 international PC volunteers. (Leng, personal communication) Challenges included: cultural and language differences; communication, logistical and resource issues; personal financial and family considerations; lack of work place support; finding an appropriate role and professional relevance [14, 15], (Leng, personal communication)…”

Power, potential, and pitfalls in global health academic partnerships: review and reflections on an approach in Nepal

“…GHAPs can help leverage resources such as funding, professional development opportunities, and clinical and research expertise from places of privilege and power in high-income countries (HICs) to improve healthcare delivery and systems design in low- and middle-income countries (LMICs) [3–9]. Similarly, there is increasing recognition of LMICs as drivers of innovation [10–13], and the personal and professional benefits that accrue to participants from HICs have been well documented [14–16]. …”

Health systems strengthening in global and national contexts

“…Specifically, a multi-sectoral approach for HSS assessment provides more responsive outcome-based indicators, as well as inputs and process indicators that tailor more in addressing the different countries (Kusek & Rist, 2004;Shield et al, 2003). Such process not only engaged more sectors in the process but also provided vital inputs to the current HSS implementation mechanisms to ensure development of a wellintegrated and more comprehensive HSS practice (Busse, Aboneh, & Tefera, 2014;Israel, Schulz, Parker, & Becker, 1998). Such community involvement was also relevant in managing different expectations among the various health systems actors and foster HSS monitoring and evaluation ownership (Barker, 2015;Naimoli, 2009).…”