INTRODUCTION
Health care professionals from high-income countries are increasingly interested and engaged in short-term volunteer global health experiences in low-resource settings.1 These experiences may focus on direct service delivery, teaching and training, humanitarian relief work, or global health electives for medical students and residents, among other purposes. A growing body of academic literature addresses guidelines for ethical global health engagement, but there is little consensus on standards and scant evidence of the benefits and potential harms of the engagement efforts on host institutions and communities.2 Additionally, much of the existing literature centers on the perspectives of “sending” institutions and clinicians, rather than the viewpoints and priorities of “host” institutions and practitioners.3
A wide variety of sending institutions engage in short-term global health work. These institutions include charities, churches, or other faith-based organizations, universities, and for-profit entities, and each employs defined operational models to achieve organizational objectives. For example, in the “fly-in medical mission” model, individuals or teams of health professionals volunteer to travel to underserved communities to provide dental care or health services that are otherwise unavailable, such as cleft palate repair or cataract surgery.4 While this model may deliver needed health services, it comes at a high financial cost, estimated at US$3.7 billion annually.4 Other potential problems associated with a direct service delivery approach, such as the fly-in medical mission model, include a high burden on host institution staff in resource-limited settings, power imbalances and perpetuation of global health inequities, a lack of bilateral participatory relationships and longitudinal planning, and concerns about …