The impact of multidisciplinary mobilities on the effectiveness of global health and international development projects

The mobility of healthcare professionals from high-income countries (HICs) to low- and middle-income countries (LMICs) has been growing rapidly over recent decades. The ‘international elective placement’, which was once a preserve of medical student curricula, has now become increasingly common amongst nursing, midwifery and allied health professional students. International volunteering for healthcare professionals has shifted from being mainly missionary or altruistically driven to being a critically important component of clinical experience, professional development and subsequent career progression. Furthermore, there has been a large growth in international aid expenditure since the end of the Second World War and a more recent increase in the desire and ability of populations to travel internationally. These have acted as stimuli for the implementation of a multitude of international development projects designed to build the capacity of healthcare workers in LMICs in order to strengthen local health systems. However, despite the above, there is a distinct lack of research into the real benefits, costs and potential negative effects or externalities associated with such mobilities, or their ability to ethically and sustainably strengthen health systems in LMICs. Most existing literature is written by development actors themselves who often focus on the short-term and have a conflict of interest in proving that their interventions are positive and beneficial in order to justify current and future funding. This portfolio of six published works and eight supporting publications serves to bridge this gap in research and knowledge. Based on the author’s 10+ years of action research experience in the fields of global health, professional volunteering and international development, it suggests that the desired outcomes can be achieved in an ethical and sustainable way but only if certain policies and procedures are adopted and implemented. Combined, the publications generate a unique contribution to knowledge by offering tested, practical ways of enhancing the efficacy of international aid and professional and student voluntarism. For this reason, each publication is directed at key stakeholders and policy makers, providing clear conclusions and recommendations based on in-depth experience and concrete research findings