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Global Health. 2018 Feb 7;14(1):18. doi: 10.1186/s12992-018-0330-4.

Guidelines for responsible short-term global health activities: developing common principles.

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Department of Sociology and Anthropology, Lehigh University, Bethlehem, PA, 18015, USA.
Medical and Surgical Skills Institute, 2440 Westbrook Dr. NW, Grand Rapids, MI, 45904, USA.
Swami Vivekananda Youth Movement, CA-2, KIADB Industrial Housing Area Ring Road, Hebbal, Mysuru, Karnataka State, 570016, India.
University of Arizona College of Medicine, Phoenix, 4550 E. Bell Rd, Suite, Phoenix, AZ, 172, USA.
Catholic Health Association of the United States, 4455 Woodson Road, St. Louis, MO, USA.
University of California, 1001 Potrero Ave., 83, San Francisco, CA, 94110, USA.
Dalla Lana School of Public Health, c/o Public Health and Preventive Medicine Residency Program, University of Toronto, 155 College Street, 5th Floor, MST 3M&, Toronto, ON, Canada.
Center for Global Health and Social Responsibility, University of Minnesota, 420 Delaware Street SE, MMC 329, Minneapolis, MN, 55455, USA.
, Tel Aviv, Israel.



Growing concerns about the value and effectiveness of short-term volunteer trips intending to improve health in underserved Global South communities has driven the development of guidelines by multiple organizations and individuals. These are intended to mitigate potential harms and maximize benefits associated with such efforts.


This paper analyzes 27 guidelines derived from a scoping review of the literature available in early 2017, describing their authorship, intended audiences, the aspects of short term medical missions (STMMs) they address, and their attention to guideline implementation. It further considers how these guidelines relate to the desires of host communities, as seen in studies of host country staff who work with volunteers.


Existing guidelines are almost entirely written by and addressed to educators and practitioners in the Global North. There is broad consensus on key principles for responsible, effective, and ethical programs--need for host partners, proper preparation and supervision of visitors, needs assessment and evaluation, sustainability, and adherence to pertinent legal and ethical standards. Host country staff studies suggest agreement with the main elements of this guideline consensus, but they add the importance of mutual learning and respect for hosts.


Guidelines must be informed by research and policy directives from host countries that is now mostly absent. Also, a comprehensive strategy to support adherence to best practice guidelines is needed, given limited regulation and enforcement capacity in host country contexts and strong incentives for involved stakeholders to undertake or host STMMs that do not respect key principles.


Best practices; Global health education; Guidelines; Short-term medical missions; Standards; Volunteers

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