A partial summary of a key review paper, this one looking at the lack of much quantitative evidence behind medical missions.

Kevin Sykes looked at 67 studies measuring the impact or quality of medical missions. Quantitative studies amounted to little more than 5% of the 1100 publications about medical missions in last 20 years, and 98% of them provided only low level evidence. Half were retrospective or descriptive studies, 13% addressed quality assurance, and 10% were surveys. A full 81% only discussed surgical trips.

Faith based organizations seem underrepresented in the literature⁵³, and Sykes suggests a lack of organizational motivation to publish findings in the medical literature. In particular, there is no work comparing the outcomes or impact of faith based medical missions versus secular efforts.

Many of the lessons from the review can be applied to our quality of care framework:

Preparedness

The review acknowledges that there is “pressure to create practice guidelines”, and touches on the importance of cultural competence in quality of care⁵⁸.

Cost effectiveness

$250 million is spent annually by volunteers⁵, averaging a cost of $12600-84000 per trip⁵, not including the time and financial resources of host communities⁸. The article suggests that the cost per Disability Adjusted Life Year (DALY) should be $150 or less⁴⁵.

Impact and safety

Sykes points out several key areas of need:

“Assumptions that the safety and acceptable rates of risk or rates of complications from high income countries are automatically transferable to medical service trips are unwarranted and could be dangerous”⁶

“Tools for organizations to evaluate their work remain a need”

“Organizations do not prioritize collection and evaluation of data”⁷¹

Finally, while 60-80% of groups track morbidity and mortality data (Maki), those that report outcomes tend to be surgical missions.