Low- and Middle-Income Country Perceptions of Global Health Engagements: A Scoping Review

Abstract

More than one million Americans are estimated to participate in global health engagements (GHEs) in low- and middle-income countries (LMICs) each year. A growing number of studies document perceptions of GHEs from the perspective of American and other high-income country (HIC) visitors traveling to LMICs, particularly regarding motivations and satisfaction relative to their participation in these activities. Far fewer studies examine perceptions of GHEs from the perspective of LMIC hosts and other local constituent groups. The purpose of this study was to identify and analyze studies that examined local stakeholder perspectives of global health engagements in LMICs around the world. We conducted a scoping review of PubMed and Google Scholar using the Population-Concept-Context (PCC) framework. Assessment and analysis of articles was conducted by a team of three reviewers (EA, FS, SB). A total of 31 relevant papers published between 2009 and 2021 provided local perspectives of GHEs, with participants falling into three stakeholder categories- providers of care, recipients of care, and community members. Analysis revealed that stakeholder groups often held complex and highly nuanced perspectives of GHEs, perceiving these activities as having both positive and negative implications in the host communities. Synthesis of the eligible studies’ findings resulted in three thematic categories- resources and perceived benefits derived from GHEs; perceived challenges associated with GHEs; and opportunities for improvement of GHEs. To our knowledge, this scoping review is among the first to identify and collectively analyze LMIC stakeholder perceptions of GHEs. Recommendations for future research are provided.