Exploring Nepali Health Personnel Experiences of Collaboration with Short-Term Mobile Medical Teams in Gorkha, Nepal

Abstract

Introduction: Rural and remote areas of Nepal frequently host short-term medical teams responding both to disasters and chronic health needs. Collaboration between visiting medical teams and Host Health Personnel (HHP) has been identified as an important foundation of quality, effective, and sustainable health care for host communities. Published research on collaborative efforts in the planning, implementation, and evaluation of the outcomes of these missions is minimal. Particularly absent is the perspective of HHP on the extent and methods of collaboration. Methods: To explore the experiences of collaboration of HHP with visiting mobile medical teams in a rural region of Nepal this project used qualitative semi structured interviews and analysis through the lens of Critical Social Theory. NVivo© by QSR International was used to organise the interviews into themes to assist analysis. Results: Few teams engaged in good collaboration with HHP throughout their mission. Interpersonal skills of key leaders were highlighted by HHP as foundational for collaboration, resulting in three major themes; Presence: immersion in the context of health needs and openness to learning and change; Dignifying: pertaining to respect, reciprocal arrangements, and sensitivity to social status and organisational position; and Engaging: the initiation of discussions, objective development, and engagement in the offering, denying, and rejecting of services. Conclusion: Despite ongoing calls for improved collaboration between hosts and visiting medical professionals there is still a lack of collaboration. This can lead to relationship breakdown between hosts and visiting teams with consequences for patient care. Medical teams responding to disasters and engaged in specialist medical services need to ensure team leadership has the interpersonal skills required for collaboration and sufficient organisational flexibility to share decision making with HHP.