1. Abstract
International Medical Development and Investment (IMDI) programmes as foreign aid supported by developed
countries often fail to be implemented efficiently and effectively in developing countries. The research to date
suggests that this is due to cultural differences (Binder, 2007) (Earley & Mosakowski, 2004), government
corruption (Outreville, 2007), the misuse of grants (Bell, 2009), lack of a sustainable strategy (Schümer, 2007)
and lack of transparency (Outreville, 2007). Therefore, the aim of this study is to use a case study methodology
to confirm that these are, in fact, the actual causes, and to investigate these in depth in one specific location.
This will be done in order to refine the current process for delivering programmes efficiently and effectively in
recipient countries. The principles underpinning this research are based on the concept of Universal Health
Coverage (UHC) (World Health Organisation, Geneva, 2013 pp. 4). Even when foreign aid or humanitarian
relief originates from outside of developing countries, programme implementation must be adapted by local
people (at the institutional level) in a sustainable way.
The Quality-Improvement Process in medical systems (Rowe, de Savigny, Lanata, & Victora, 2005) was used to
analyse the case study and was subsequently refined in order to highlight transparency, two way
communication and sustainability. These refinements were then used to develop a questionnaire and proposed
model.
This proposed model consists of two stages: (1) developing international collaboration between local
institutions and the various international organisations, then (2) using a refined implementation process
deduced from Project Process Groups, a basic project delivery process of project management (PMI, 2008), for
sustainable development (Adams, 2006) in recipient countries.
A questionnaire was created for testing the proposed model, and a total of six interviews using this
questionnaire then took place. Three of the interviewees were working on one Pacific Island and the other three
were based in Australia. All of these six interviewees were working on similar programs but for different
organisations. The six respondents had different levels of responsibility within their organisations. The results

2. showed that although all the interviewees mentioned that international collaboration brings benefits to
recipient countries and organisations, there was no formal international collaboration between the institutions
and the relevant international organisations. Hence, the result of this study suggests that collaboration between
institutions and other organisations is needed for information and resource sharing. Through such practices,
IMDI programmes can be implemented more efficiently and effectively in recipient countries.