Open Access Highly Accessed Research article

Brain Gains: a literature review of medical missions to low and middle-income countries

Alexandra LC Martiniuk12*, Mitra Manouchehrian3, Joel A Negin4 and Anthony B Zwi5

Author Affiliations

1 The George Institute for Global Health Senior Research Fellow, Senior Lecturer, Faculty of Medicine, University of Sydney, Sydney, Australia

2 Scientist, Health Systems Research, Sunnybrook Health Sciences Centre Associate Professor, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada

3 Plan International Canada, 95 St. Clair Avenue West, Suite 1001, Toronto, ON, M4V 3B5, Canada

4 Senior Lecturer in International Public Health Lecturer in International Public Health, Sydney School of Public Health Research Fellow, Menzies Centre for Health Policy, University of Sydney, Sydney, Australia

5 Professor of Global Health and Development, School of Social Sciences, The University of New South Wales, Sydney, NSW, Australia

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BMC Health Services Research 2012, 12:134  doi:10.1186/1472-6963-12-134

Published: 29 May 2012



Healthcare professionals’ participation in short-term medical missions to low and middle income countries (LMIC) to provide healthcare has become common over the past 50 years yet little is known about the quantity and quality of these missions. The aim of this study was to review medical mission publications over 25 years to better understand missions and their potential impact on health systems in LMICs.


A literature review was conducted by searching Medline for articles published from 1985–2009 about medical missions to LMICs, revealing 2512 publications. Exclusion criteria such as receiving country and mission length were applied, leaving 230 relevant articles. A data extraction sheet was used to collect information, including sending/receiving countries and funding source.


The majority of articles were descriptive and lacked contextual or theoretical analysis. Most missions were short-term (1 day – 1 month). The most common sending countries were the U.S. and Canada. The top destination country was Honduras, while regionally Africa received the highest number of missions. Health care professionals typically responded to presenting health needs, ranging from primary care to surgical relief. Cleft lip/palate surgeries were the next most common type of care provided.


Based on the articles reviewed, there is significant scope for improvement in mission planning, monitoring and evaluation as well as global and/or national policies regarding foreign medical missions. To promote optimum performance by mission staff, training in such areas as cross-cultural communication and contextual realities of mission sites should be provided. With the large number of missions conducted worldwide, efforts to ensure efficacy, harmonisation with existing government programming and transparency are needed.

medical missions; low- and middle-income countries; volunteer; human resources