Background: The demand for international volunteer experiences to promote global health and nutrition is increasing and numerous studies have documented the experiences of the international volunteers who travel abroad; however, little is known about effective practices from the perspective of partner organizations. This study aims to understand how variables such as the skill-level of volunteers, the duration of service, cultural and language training, and other key variables affect partner organizations’ perceptions of volunteer effectiveness at promoting healthcare and nutrition. Method: This study used a cross-sectional design to survey a convenience sample of 288 volunteer partner organizations located in 68 countries. Principle components analyses and manual coding of cases resulted in a categorization of five generalized types of international volunteering. Differences among these types were compared by the duration of service, skill-level of volunteers, and the volunteers’ perceived fit with organizational needs. In addition, a multivariate ordinary least square regression tested associations between nine different characteristics/activities and the volunteers’ perceived effectiveness at promoting healthcare and nutrition. Results: Partner organizations viewed highly-skilled volunteers serving for a short-term abroad as the most effective at promoting healthcare and nutrition in their organizations, followed by slightly less-skilled long-term volunteers. The greatest amount of variance in perceived effectiveness was volunteers’ ability to speak the local language, followed by their skill level and the duration of service abroad. In addition, volunteer training in community development principles and practices was significantly related to perceived effectiveness. Conclusion: The perceptions of effective healthcare promotion identified by partner organizations suggest that program and volunteer characteristics need to be carefully considered when deciding on methods of volunteer preparation and engagement. By better integrating evidence-based practices into their program models, international volunteer cooperation organizations can greatly strengthen their efforts to promote more effective and valuable healthcare and nutrition interventions in partner communities.
Two major players in the growing international volunteering industry are international volunteer cooperation organizations (IVCOs) based in countries that send volunteers overseas and volunteer partner organizations (VPOs) in communities in low- and middle-income countries that host the volunteers. The target population for this study included VPOs located in the Global South. There are tens of thousands of such organizations around the world, with no listing that would allow contacting a random sample of VPOs. However, many IVCOs that partner with VPOs are members of networks that coordinate international volunteering. Researchers created a formal collaboration with six key international volunteer service networks (IVSNs) that worked with their members IVCO to distribute surveys to partner VPOs around the world. In addition to providing access to VPOs with an interest in improving volunteer practices, the research collaboration with IVSNs and IVCOs helped to ensure the active engagement and consultation of non-academics in the survey and research design stages of the study and to ensure that research goals were mutually beneficial. Thus, non-academic partners played an active role identifying survey participants in the partner countries, in implementing the research protocol, and in helping to interpret results. Collaborating IVSNs sent a brief information packet to all IVCOs within their networks, describing the research and requesting their participation and consent to collaborate in the research project. As a result of these requests, the researchers established collaborative partnerships with a total of 46 IVCOs. IVCOs were located in the US (37%), Canada (13%), Germany (13%), Australia (5%), Spain (5%), and the UK (4%), Korea (3%), and nine other high-income countries. These IVCOs were asked to select a sample of VPOs in the countries where they worked that might be willing to participate in the survey. Two criteria were placed on the selection of VPOs, which included: (1) the VPOs should each have a minimum of 1 year working history with the IVCOs, and (2) they should have hosted a minimum of three international volunteers. Researchers developed a survey to assess how various practices of international volunteering affect diverse outcomes — including but not limited to the promotion of healthcare and nutrition. VPOs were asked to identify their organization’s most important priority areas among a list of 20 pre-identified categories. “Healthcare promotion / disease prevention / maternal or child health” was one of these main categories. VPOs were also asked to estimate what percentage of international volunteers had served for various lengths of time in their organization. Respondents were presented with six response options to measure duration ranging from “less than 1 week” to “1 year or more”. Respondents were further asked to rate how many international volunteers working with their organization had particular traits (including being highly skilled, having competencies that fit with organizational needs, etc.). These responses options were presented on a 5-point Likert scale ranging from “none” to “all”. Finally, respondents were asked to rate how effective international volunteers were at promoting healthcare and nutrition in their organization. These responses options were presented on a 5-point Likert scale ranging from “very poor” to “excellent”. The survey was administered online to all contacts identified by the 46 collaborating IVCOs. These surveys were translated into three languages (English, French, and Spanish). Collaborating IVCOs were given two choices for the administration of surveys to their partners. As one option, the IVCOs could send the researchers contact details for their VPOs. As a second option, the IVCOs could contact their partners directly with an anonymous link to the survey. In the first case, one follow-up email was sent. In the second case, no follow-up email was sent, as the researchers had no method for tracking the rate of response or participation. In all cases, participation was completely voluntary. All surveys were taken by an administrator of the participating VPOs—typically the executive officer. Among organizations contacted directly by the researchers, 1,130 VPOs received the survey and 239 responded (22%). The response rate among VPOs contacted by the IVCOs is unknown as partner IVCOs were not able to articulate how many VPOs were contacted; however, 81 VPOs among this group responded. A few surveys were dropped from the analysis due to incomplete responses. In total, the analysis includes 288 survey responses from VPOs operating across 68 low- and middle-income countries. Many of these VPOs were located in Southeast Asia, with more than 15% of VPOs located in either India or Indonesia. Around 23% of partner organizations were located in the African continent. Participating VPOs reported hosting most of their volunteers from South Korea (44%), the USA (35%), Germany (26%), France (15%), the UK (14%), Canada (12%), Japan (12%), Switzerland (11%), and Australia (10%). In order to assess differences across the diverse characteristics of volunteer programs, we carried out an initial principle components analysis (PCA). Variables included in the PCA included the duration of volunteer service; volunteers’ education, skills, and competencies; group placement status; minimum age of volunteers accepted by VPOs; and the resources expended and/or received by VPOs to host volunteers (if any). PCA yielded three broad categories (individual long-term volunteers, highly skilled and older short-term volunteers, and medium-term volunteers). However, several variables failed to load well on any of these three components, with other variables loading on multiple components. Overall, a viable solution could not be attained from PCA alone based on overlapping constructs (for e.g. short-term volunteers were alternately perceived as both highly skilled and unskilled). This led the researchers to code each case response manually, based on their knowledge of the sending programs combined with a manual inspection of survey responses on the duration of service, volunteer age, and the skill- and educational-level of volunteers. Manual coding of case responses resulted in five broad categories of volunteers represented in the survey responses: less-skilled long-term, less-skilled short-term, semi-skilled medium-term, skilled short-term, and skilled long-term volunteers. These categories were heuristically determined rather than by formulaic computation of skill-level and duration of service. Nonetheless, some categories do follow general “types” of international volunteering. Skilled short-term volunteers have significant skills, training and experience and usually serve for less than 8 weeks because they often maintain concurrent employment [39–41]. Skilled long-term volunteers typically live and work in low-income communities for one year or more, and are usually required to hold a college degree as a minimum educational requirement [42–44]. They were the most common form of volunteers in our sample and are often referred to as “development volunteers” because the long-term skilled volunteering model has a long-standing historical precedence tied to Western development theory and practice [45]. Less-skilled short-term volunteering has also been referred to as volunteer tourism or “voluntourism” in the literature, and is often performed by young people with few marketable skills [46, 47]. Unskilled long-term and semi-skilled medium-term volunteers are not common categories in written literature or scholarly examination. Although these forms did not fit any of the three main forms of international volunteering often discussed in scholarship, they were evident in the data and represent the variety and flexibility of volunteering options for people interested in serving abroad. Table 1 illustrate differences in these five categories by duration of service, skill-level of volunteers, and their perceived fit with organizational needs. This five-category typology of volunteers was used to illustrate how categorical differences impacted the level of volunteers’ perceived effectiveness at promoting healthcare and nutrition. Descriptive characteristics of VPOs by category (n = 286 VPOs) To assess bivariate differences among VPOs that listed healthcare and disease prevention as a key priority (n = 71), the researchers completed a series of bivariate or chi-square tests, as well as Analysis of Variance (ANOVA) tests, followed by pairwise comparisons using a Tukey post hoc test to determine statistically significant differences. Because of the complicated nature of reporting Tukey tests for 5-category responses, bivariate statistics were not reported in tables but are reported in the text. Researchers also ran a multivariate OLS linear regression to analyze how differences in nine volunteer characteristics and activities are associated with the level of volunteers’ perceived effective at promoting healthcare and nutrition. The multivariate analysis was used to better control for the multiple influences of duration and skills on perceived effectiveness, and to assess additional variables previously associated with volunteer effectiveness. Nine variables included in the multivariate model include the computed number of days volunteers served (originally a 6-category response); partners’ perceptions about the degree of volunteers who are highly skilled, culturally sensitive, from a higher-income country, highly motivated, and speak the local language (5-category responses); and binary responses about whether volunteers received the following types of training before or during service with their organization: community development training, cross-cultural training, and language training. Prior to entering variables in the regression model, univariate analyses were completed to verify that assumptions of regression were met. Likewise, bivariate correlations and distributions between variables included in the model were all well within acceptable ranges.
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