Promoting ‘No Harm’ and Frugal Innovation Approaches to Global Health Placements for Professional Volunteers and Students in Low- and Middle-Income Countries
Placements in public health systems in low- and middle-income settings have become an increasingly essential component of many early career pathways in health professions, despite the lack of research on the impacts for the individuals and organisations involved. Our research has provided a unique evidence base, raising significant ethical and pedagogical concerns about the quality of learning and the impacts on the National Health Service (NHS) and the health systems of low- and middle-income countries (LMICs).
In response to concerns about aid dependency and the potential damages associated with overseas ‘volunteering’, our action-research approach assessed the role that volunteer deployment played in knowledge mobilisation processes and health systems outcomes.
The findings provided evidence on the contribution that international volunteering makes to the transferable skills that lie at the heart of the NHS 15-year Strategic Plan (2014), with a particular emphasis on multi-disciplinary team-working; communication; attention to cultural diversity and resource management. This provided the evidence base to support a shift in policy in favour of releasing staff to volunteer during a climate of financial crisis.
In 2016, Health Education England funded research focussed on the development of a model of ethical (‘No Harm’) undergraduate placements – the Ethical Educational Placement (EEP) Model – to support skills development in the NHS without burdening LMIC health systems. Benchmarking work found evidence of international students effectively placed without support in facilities, substituting for absent local staff with no supervision, putting themselves and patients at risk and creating limited opportunities for skills enhancement. The action-research intervention (known as the Ethical Undergraduate Placement Project) involved detailed evaluation of over 80 placements.
Funders
Health Education England, Higher Education Funding Council, Tropical Health and Education Trust
Publications
Health Education England (now NHS England) are currently funding Claire Horder’s PhD research on: ‘The contribution of virtual knowledge mobilisation within global health partnerships’.
Publications
Ackers, H.L. and Ackers-Johnson, J. Mobile Professional Voluntarism and International Development: Killing Me Softly?, Palgrave (2017). Book available at: https://doi.org/10.1057/978-1-137-55833-6
Ackers, H.L., Ackers-Johnson, J., Tyler, N. and Chatwin, J., Healthcare, Frugal Innovation, and Professional Voluntarism: A Cost-Benefit Analysis, Palgrave (2017). Book available at:
Chatwin, J. and Ackers, H.L. (2016) Volunteering and overseas placements in the NHS: a survey of current activity, BMJ Open (6)10 http://dx.doi.org/10.1136/bmjopen-2016-012160
Tyler, N., Ackers, H.L., Ahmed, A., Byrne, G. and Byrne-Davis, L. (2020) A questionnaire study of the negative outcomes for UK health professional volunteers in low- and middle-income countries, BMJ Open 10(6). https://doi.org/10.1136/bmjopen-2020-037647
Ahmed, A., Ackers-Johnson, J. and Ackers, H.L. The Ethics of Educational Healthcare Placements in Low and Middle Income Countries: First Do No Harm?, Palgrave (2017). Book available at: https://doi.org/10.1007/978-3-319-48363-4
Ackers, H.L., Ackers-Johnson, J., Ahmed, A. and Tate, N. (2019) Optimising student learning on international placements in low-income settings: the contribution of cultural brokerage, Open Journal of Social Sciences 7(3). https://doi.org/10.4236/jss.2019.73026
Team
Professor Louise Ackers, Dr James Ackers-Johnson, Claire Horder and Juliette Bowman, University of Salford.
Allan Ndawula, Knowledge For Change, Uganda.
For Information Contact Dr James Ackers-Johnson