Many Chinese, in response to a call from God, have traveled out of China to share the gospel. Yet attrition rates for Chinese missionaries remain high. In this article, based on an analysis of missiological literature and field research with 12 Chinese missionaries and 14 Chinese physicians with short-term missionary experience, I will propose nine best practices in Chinese missionary sending that a mission-sending organization might perform in order to facilitate Chinese missionary sustainability. These best practices include:
- Provide Careful Selection of Missionary Candidates,
- Provide Adequate Pre-Field Training,
- Provide Properly Implemented Member Care,
- Provide Adequate Salary and Benefits,
- Provide for Organized Mutually Supportive Teams,
- Facilitate Cooperation of Mission-Sending Organization and the Chinese Church,
- Provide for Family,
- Consider Mission Agency Factors that Affect Attrition, and
Without calling, obviously there will be no missionaries sent.Yet a calling needs support. Mission-sending organizations, through the use of best practices, can be that support.
Best Practice 1: Provide Careful Selection of Missionary Candidates
Careful selection of missionary candidates decreases preventable attrition rate (PAR). Missionary sending organization should select missionaries who have a clear calling. Spiritual life, character, ministry skills, and relational patterns as well as the specific criteria listed in part one of the Three Part, Missionary Tracking Guide are helpful in selecting among eligible candidates.  Field research corroborated literature findings. Sending decisions should not be made quickly. Family support for a missionary call is helpful. The selection process should happen in close cooperation with the local church of origin for the missionary. A marketable skill is important.
Best Practice 2: Provide Adequate Pre-Field Training
Higher pre-field candidate training correlates with lower PAR. Eight core competency skills have been identified. These skills include 1) spiritual formation, 2) interpersonal relationships, 3) culture, 4) language, 5) church planting methodologies, 6) translation, 7) administration skills, and 8) practical life skills. Currently, Chinese contextualized training materials, policy manual prototypes, and financial and personnel structure resources are still inadequate in depth and scope. , 
Field research again corroborated literature findings. Though there are a few available experienced Chinese missionaries who might serve as faculty at mission training schools, many of these are unwilling to do so because of potential security risks. Missionary training centers have been established for Chinese missionaries, but are yet few in number and may lack an adequate selection of courses. Missionary training is often largely theoretical. A systematic plan providing both didactic- and practicum-based training is advisable for prospective missionaries. While theological knowledge is of recognized importance, spiritual maturity is more highly valued in the context of Chinese missionary training. One positive note: training geared toward the needs of medical missionaries is becoming available in China.
Various training models are in use, ranging from locally available missionary schools to online courses of variable quality. Both missionary interviewees and Christian physicians emphasized the need for mentoring of those interested in missions. Currently available training emphasizes four main areas: 1) relationship with God, 2) intercultural training, 3) practical issues, and 4) theological and biblical knowledge. The development of missionary training centers and curriculum as well as the recruitment of experienced faculty is a best practice that will support sustainable deployment of Chinese missionaries.
Best Practice 3: Provide Properly Implemented Member Care
The “Best Practice Model of Member Care” suggested by Kelly O’Donnell can be used as a “grid and a goad” to help evaluate and utilize various sources and types of member care. Though properly implemented member care facilitates missionary sustainability, beyond a certain point, greater levels of member care by a mission sending organization often do not result in less attrition of missionaries.  The only area where care and support for the missionary showed a clear positive effect was in the area of letter writing and phone calls. Member care expectations of interviewed Chinese missionaries correlated well with O’Donnell’s model.
Best Practice 4: Provide Adequate Salary and Benefits
Field research indicated that Chinese missionaries generally have difficulty garnering adequate financial support for missionary service. Individual givers provide the bulk of donated funds for Chinese missionary sending. Financial lack is a major source of Chinese missionary attrition. Prospective missionary physicians surveyed by means of focus groups were generally upbeat about the possibility of obtaining support from the Chinese church, hoping they might be compensated at a rate even higher than that paid to physicians remaining in China. Such hopes do not match the lived reality of currently serving Chinese missionaries. Tentmaking models are a useful source of money.
Best Practice 5: Provide for Organized Mutually Supportive Teams
The mission sending organization has a strategic role in organizing teams that can be mutually supportive while on the mission field. Ethnically homogenous teams offer many advantages though certainly missionaries from newer sending countries (NSC) can receive help from established teams sent from older sending countries (OSC). Long-term missionaries, however, expressed concern that friction and interpersonal conflict might result in team dynamics causing more harm than good, especially in the context of present day China. Those who grew up without siblings because of China’s one-child policy may experience added difficulty in sensing needs and temperament ups and downs of fellow team members, thereby leading to increased interpersonal strain.
Best Practice 6: Facilitate Cooperation of Mission-Sending Organization and the Chinese Church
Close cooperation between missionaries, mission-sending organizers, and the Chinese church will facilitate sustainable deployment of Chinese missionaries. Nevertheless, a measure of freedom for the mission-sending organization, while maintaining accountability of the mission-sending structure to the church, allows mission-sending leadership to make decisions based on the needs and priorities of the mission field. If the church too tightly controls a mission-sending organization, the mission agenda may gravitate towards the desires and perspectives of the sending country rather than a more appropriately focused field-driven mission plan.
Missionaries sent from a church through a mission-sending organization should not become the latter’s sole responsibility. Missionary interviewees emphasized that the sending church needs to understand its ongoing relationship with and responsibility towards the mission-sending organization. The church is responsible to financially support its missionaries, to maintain communication, and to continue in relationship with them. Churches also support the cause of missions through spiritual formation of future missionaries.
The mission-sending organization, for its part, should facilitate the local church’s participation in mission service. It might teach the church giving practices, bridge communication between the missionary and the church, and enlist the church’s help with a variety of needs. The mission-sending organization and sending church function best in meeting the missionary’s need through close cooperation with each other.
Best Practice 7: Provide for Family
The local church could cooperate with the mission-sending organization to see that basic needs of aging parents were met. A fund could be set up to supply missionary parents with a monthly allowance that normally a working son or daughter would provide to their parents had they remained in China. Without plans for taking care of the needs of parents, it is difficult to imagine how sustainable mission-sending practice might take root in China. Strategies should be formulated to meet the needs of a spouse as well as those of children (especially related to education).
Best Practice 8: Consider Mission Agency Factors Affecting Attrition
The Reducing Missionary Attrition (ReMAP) study revealed that agency size strongly correlated with PAR, such that larger mission-sending agencies experienced, in some cases, 5-6 times less attrition than smaller mission sending agencies. Such a large decrease in missionary attrition associated with increasing agency size surprised the authors of the study who postulated that perhaps a “critical mass” (number of missionaries) is necessary to keep workers on the field. Other instructive findings noted by the Missions Commission include:
- Mission agencies that focused on pioneer work or church planting had a lower PAR than those agencies that focused on relief.
- Workers in their own country are more prone to attrition.
- Smaller agencies have lower PAR when working with indigenous churches while larger agencies do best when church planting.
Agency factors, including size, are not easily controlled. Nevertheless, general patterns relating to mission sending organization characteristics may help in selecting strategies for sustainable deployment of Chinese missionaries.
Best Practice 9: Pray
The principal request from missionary interviewees, attested to by pages and pages of transcribed data, was for more prayer. Other recent indigenous mission-sending movements in South Korea and Nagaland, India, were strongly established in prayer and a resolute confidence in the Bible as God’s reliable revelation for mankind. Prayer is a foundational best practice for sustainable deployment of Chinese medical missionaries.
In this article, I have presented nine best practices in Chinese missionary sending that have the potential to facilitate sustainable medical missionary sending. Given the importance of the mission-sending organization in implementation of these best practices, see my article, “Difficulties with Church-Based Models in Chinese Missionary Sending: Understanding the Need for Mission-Sending Organizational Development in China” where I focus on a strategic plan for the development of the Chinese mission-sending infrastructure.