Impact and Sustainability of Foreign Medical Aid: A Qualitative Study with Honduran Healthcare Providers

Kara L. Faktor; Denise D. Payán; Alejandro J. Ramirez; Folasade P. May

doi:10.5334/aogh.3995

Figures & Tables

Table 1

Honduran healthcare provider respondent professional experience & location, 2015.

	GOVERNMENT-EMPLOYED		NGO-EMPLOYED
	PHYSICIAN* n = 26 n (%)	NURSE n = 38 n (%)	PHYSICIAN n = 13 n (%)	DENTIST n = 11 n (%)	TOTAL n = 88 n (%)
Healthcare setting
CESAMO	26 (100)	22 (58)	–	–	48 (55)
CESAR	–	16 (42)	–	–	16 (18)
NGO STMM	–	–	13 (100)	11 (100)	24 (27)
Organizational experience (years)
< 2 years	10 (38)	6 (16)	6 (46)	2 (18)	24 (27)
2–3 years	4 (15)	3 (8)	3 (23)	2 (18)	12 (14)
4–5 years	3 (12)	3 (8)	1 (8)	–	7 (8)
6–7 years	2 (8)	2 (5)	–	–	4 (5)
8 or more years	2 (8)	18 (47)	–	–	20 (23)
Unknown	5 (19)	6 (16)	3 (23)	7 (64)	21 (24)
Estimated number of patients per day per provider (n = 64)
1–20 patients	6 (23)	8 (21)			14 (22)
21–40 patients	12 (46)	21 (55)			33 (52)
41+ patients	4 (15)	9 (24)			13 (20)
Unknown	4 (15)	–			4 (6)
Clinic location (Department, n = 64)
Francisco Morazán	11 (42)	13 (34)			24 (38)
El Paraíso	13 (50)	23 (60)			36 (56)
Choluteca	1 (4)	1 (3)			2 (3)
La Paz	1 (4)	1 (3)			2 (3)

[i] * Includes physicians in their social service year at CESAMOs and CESARs.

Table 2

Perceived benefits and disadvantages of Short-term Medical Missions (STMMs) and recommendations for improvement based on interviews with Honduran healthcare providers.

	PERCEIVED BENEFITS	PERCEIVED DISADVANTAGES	RECOMMENDATIONS
Medications & Supplies	Increased access to medications during the STMMs, often at no cost to patients Avenues for health center providers to request medication donations from the NGO between STMMs to supplement government supply	Patient reporting of false symptoms or attending multiple STMM days to obtain medications for later use (unnecessary prescriptions) Inconsistent access to the same medication for chronic conditions	Formation of country-specific medication guidelines with reference to the WHO essential medicines list
Foreign Medical Providers	Increased access to physician consultations, including specialist care Perceptions of exceptional empathy for the patient	Expectation of specialist physicians providing primary care Limited knowledge of the local culture and socioeconomic context Devaluing of local physicians	Education of foreign providers regarding local ethics-informed practices Pre-STMM meetings between local and foreign providers
Provision of Care	Extension of primary care services to more remote areas Increased access to specialized services (e.g., dental, gynecology)	Lack of coordination with local providers for follow-up at government health centers in-between STMMs Undue burden on local providers to follow-up on test results from STMM consultations Inadequate prioritization of health needs Language barriers with additional need for qualified interpreters	Strengthening of partnerships with local providers to guide provision of care during STMMs Inclusion of community leaders in planning efforts
Health Education & Prevention	Increased access to screening services (e.g., Pap smear) Provision of antiparasitic medications	Language and cultural barriers limiting the effectiveness of education sessions	Training opportunities and resources for CHWs Visual aids for patient education sessions to address low literacy levels

Impact and Sustainability of Foreign Medical Aid: A Qualitative Study with Honduran Healthcare Providers

Figures & Tables

Table 1

Table 2

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