Access, Interest and Equity Considerations for Virtual Global Health Activities During the COVID-19 Pandemic: Quantitative Analysis of a Mixed Methods Study.

Abstract Background: Global health activities reduce health disparities by promoting medical education, professional development, and resource sharing between high- and low- to middle-income countries. Virtual global health activities facilitated continuity and bidirectionality in global health during the COVID-19 pandemic, but while virtual engagement holds potential for promoting equity within partnerships, research on equitable access to and interest in virtual global health activities is limited. Methods: We conducted a cross-sectional, online, mixed-methods survey from January to February 2022 examining access to virtual activities before and during the pandemic across resource settings. Eligible participants were participants or facilitators of global health activities. Closed- and open-ended questions elicited participants’ access to and interest in virtual global health engagement. Results: We analyzed surveys from 265 respondents representing 45 countries (high-income 57.0% vs. low- to middle-income 43.0%). High-income country respondents had significantly more access to global health funding through their own organization and more flexibility for using funds. More respondents from low- to middle-income countries versus high-income countries reported loss of more types of in-person access due to the pandemic at their own institutions, while more respondents from high-income countries versus low- to middle-income countries reported loss of in-person activities at another institution. While all respondents reported an increase in access to virtual global health activities during the pandemic, more respondents from low- to middle-income countries versus high-income countries gained virtual access more often through another organization. There were significant differences and trends between respondent groups in different resource environments in terms of accessibility to and interest in different virtual global health activities, both during and after the pandemic. Qualitative results are presented in another manuscript. Conclusions: Our results highlight the need to examine accessibility to virtual global health activities within partnerships between high- and low- to middle-income countries. While virtual activities may bridge existing gaps in global health education and partnerships, further study on priorities and agenda setting for such initiatives, with special attention to power dynamics and structural barriers, are necessary to ensure meaningful virtual global health engagement moving forward.