Accepted for/Published in: Journal of Medical Internet Research
Date Submitted: Jun 9, 2024
Date Accepted: Mar 21, 2025
Income-Based Disparities in Perceived Benefits and Challenges of Virtual Global Health Activities during the COVID-19 Pandemic: A Mixed-Methods Analysis
ABSTRACT
Background:
Global health activities (GHAs) can potentially reduce health disparities by facilitating resource sharing, promoting medical education and professional development worldwide, and enhancing collaboration amongst high-income countries (HICs) and low- and middle-income countries (LMICs). However, the COVID-19 pandemic disrupted in-person GHAs due to strict infection control and travel restrictions. To ensure the continuity of GHAs and further address health inequity, virtual global health activities (VHGAs) are gaining traction.
Objective:
Our research aims to understand how people perceive the benefits and challenges of VGHAs, analyze and compare whether HIC and LMIC respondents have different perceptions of virtual and in-person GHAs, and summarize suggestions for improvement to inform the future development of VGHAs.
Methods:
We conducted a cross-sectional online survey during the COVID-19 pandemic in early 2022. Eligible participants were adult students, trainees or professionals who participated in, created, taught, or facilitated GHAs. We thematically analyzed participants’ free-text responses regarding their perceptions of the benefits and challenges of virtual and in-person GHAs. The patterns differed depending on whether respondents were from HICs versus LMICs, thus we compared the frequencies of mentioning each theme between the two groups.
Results:
A total of 154 respondents from 34 countries were included in the analysis. Key benefits of VGHAs were improved access to global health resources or content, reduced cost, easier scheduling and planning, expanded distance participation, and wider participation and reach. The themes that emerged as challenges of VGHAs included lack of infrastructure to engage virtually, being less motivated and engaged, lack of in-person and hands-on experience, and challenges with virtual communication and collaboration. LMIC respondents were more likely to identify reduced cost as a benefit, lack of infrastructure to engage virtually as a challenge of VGHAs, and to suggest improving the content to be more interesting and relevant compared to HIC counterparts.
Conclusions:
Our findings add to the existing literature by understanding how GHA participants from HICs vs. LMICs perceive the benefits and challenges of VGHAs differently. These data help elucidate what makes VGHAs acceptable to GH partners and suggest improvements to ensure partner needs are served equitably within the partnership.
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