Job pack: Gynecologist /Obstetrician TRHB Country Ethiopia Employer Tigray regional health bureau : The placement covers 4 hospitals in Tigray region Duration 6 months Job purpose The overall placement objective is to contribute to the maternal and child health program by strengthening the labor and delivery wards of 4 targeted hospitals and providing capacity building training for Midwives on newborn care. Contents: 1. Job Description... 2 2. Personal considerations... 4 3. Background and contextual information... 6
1. Job Description Responsibilities Key Performance Indicators Competencies Skills and Knowledge The volunteer is expected to oversee patient care in clinical areas through supervising junior staff. Moreover, he/she is expected to play a vital role in the following areas: Train local staff in provision of comprehensive emergency obstetric and newborn care Assess the situation, and provide technical support that improves the service at GYN/OBY department Develop Emergency protocols for Proper handling of Maternal and newborn Emergencies. Strengthen linkage between labour ward and NICU. Training on B/CEmONC is provided to relevant staff and followed up for improvement in the care and service by the staff trained. Relevant and required clinical guidelines, protocols, procedures, etc. are adapted/developed and used or ensure that they are properly practiced if already exist Referral linkage between labour ward and NICU strengthened Building and Sustaining working relationships The social skills to build and actively maintain working relationships that foster teamwork and collaboration with others for the benefit of a common goal. Open Minded and Respectful A non-judgemental approach that values other people and culture. Seeking and Sharing Knowledge Recognition that learning is a twoway and continuous process. Facilitating Positive Change The ability to analyise problems and develop lasting solutions in line with VSO approaches. Essential Doctor of Medicine (MD) with specialty in GYN/OBY - Certificate of Specialty or equivalent post graduate clinical training in Gynecology and Obstetrics. If it is from the Royal college then the candidate should be above STV5 level of training. Desirable -Work experience as GYN/OBY in Africa. Essential A minimum of two years experience as Gynecologist and Obstetrician at a hospital level. Desirable Additional remarks: This placement is a cluster placement where the volunteer is expected to support four general hospitals in the region, namely, Adigrat, Alamata, Korame and Woukro General Hospitals. To a greater extent the work of the volunteer involves capacity building focusing on training of General Adaptability A flexible approach and the ability to adapt behavior to different situations. Resilience The self-confidence to work with a variety of situations, diverse people and ambiguity. Prior experience in clinical teaching and working in hospital settings
1. Personal considerations In addition to the job description, the following information should be used when considering whether a placement is suitable for you. Personal health considerations If you have a significant current or past medical condition and/or you have general concerns about staying healthy as a volunteer, please use this information to assess whether this placement will be suitable for you. All volunteers require medical clearance from a VSO medical adviser before they are able to take up a placement with VSO. Occasionally, VSO may consider that this placement is too great a risk for you in terms of your personal health and you would be advised to consider a different placement. For further guidance about medical assessment and volunteering with a medical condition please see the frequently asked questions on VSO website. Access to medical care and support The standard and quality of local medical care and support available at this placement will depend on its location within the country. Health facilities are likely to be more poorly resourced in rural areas of Ethiopia in terms of medical expertise, equipment, infrastructure and regular supplies of medication. However, this may not be the case in the capital city or in a larger town, where in some countries there may be a reasonable standard of medical care. The following gives you an indication of where the placement is in relation to the country office and how easy it would be to make the journey if you were ill. There are basic health facilities including health clinics and hospitals in Tigray region. In particular this placement is covering four general hospitals and these health facilities are able to diagnose and treat common health problems. If the required health service is not available in the area of placement more advanced health facilities are available in Addis Ababa. There is five times per day, seven days a week flight from regional capital city of Tigray, Mekele. The flight takes only one hour. Wukro, Adigrat, korame and Alamata are found in a distances of 45 Km, 125 Km, 160 km and 180 Km from Mekele respectively. Transportation is available daily from the cities to Mekele. There are also selected Hospitals to give service to staff and volunteers which are located in the Addis Ababa city. They are 5-15 minutes drive from the program Office. The Korea Hospital and Hayat are the two best equipped local hospitals and can provide comprehensive medical services. In Addis there are additional well equipped private hospitals that give service 24 hours. For general / minor health concerns VSO have a contract with Dr Melaku Ferede, a general internal medicine specialist with a clinic 10 minutes drive from the Programme Office. He has long experience of treating expatriates and can provide basic laboratory services in- Page 3
house. Address: Silasse Higher Clinic PO Box 32919 Addis Ababa Tel.:- Mobile 0911 214 874 cell phone (24hrs), 0116 461 286 (home), 0111 242 020 and 0111 240 888 (office) This placement is: As stated above, this placement is cluster placement covering four hospitals in Tigray region. The volunteer will rotate every six weeks to a different hospital to cover the four hospitals within six months of placement. The plan is paediatrician, paediatric nurse and Gyn/Obs volunteers to arrive in country at the same time and to work as group covering all the hospital to maximize the placement outcome. If you wish to discuss your personal circumstances or health concerns in confidence with VSO s medical team before you apply for this placement please contact medical@vsoint.org. Accompanying partner or family: If you have a partner or children who are planning to accompany you to your placement, please use this section to assess whether this placement will be suitable for you. This placement does not have any restriction for accompanying partners. But for children who are school age all schools available in the placement area are local. One cannot get international schools. In-addition this placement is a six months placement with change of placement hospital every six weeks. Motorcycle requirements Motorcycle ride is not requirement for in town transport - Line taxis and Bajaj are available on prescribed routes around the city. Security information Tigray region is a safe place to live and there is no serious security problem and concern of risk in the area. There is continued peace and stability in the regions. The one constraint is the attention the volunteer will be subjected to as a foreigner. For the most part this attention is not unfriendly however it can be annoying and occasionally upsetting. Page 4
Theft is the main crime against foreigners in Ethiopia. Volunteers should be ok as long as they Keep belongings in a safe place. Being aware is usually the best defence. People are generally helpful and friendly and it is possible to have friendships with local people. To ensure volunteers safety and security VSO hires day and night guards for volunteers who look after their houses. 2. Background and contextual information Improving maternal and neonatal health is a priority identified by the Federal Ministry of Health. Ethiopia has one of the highest rates of maternal and neonatal mortality in Africa. While on progress in reducing maternal and neonatal mortality, challenges still remain to achieve these critical goals. Ethiopia is characterized by High mortality, high fertility and low life expectancy. Although there have been improvements of access to reproductive Health and emergency obstetrics care services, access still remains very low. VSO-E health Program In line with the government priorities VSOE health sector works on MNCH areas. Below are the key interventions areas and results achieved: a. Maternal health i. Improving care and services VSO intervention through international Gy/Ob and midwife volunteers have brought significant improvement and changes in maternal wards and lives health outcome of women by improving diagnosis and treatment of patients by introducing new practices and tools such as clinical audit, death review, adapting treatment and diagnosis protocols, guidelines, manuals, etc. to ensure consistent treatment and diagnosis; bed-side teaching; infection control and hand washing techniques/practices, etc. This means that the program was responsive to the beneficiaries. ii. HRH one of the significant achievements of volunteers in the hospitals placed and wards assigned was building the capacity of medical staff working with them every day. The Ethiopian counterparts: midwives, nurses, physicians benefited through skill transfer of volunteers. Regular coaching, mentoring, on-the-job trainings were some of the methods used to upgrade skills of medical staff in the maternity ward. iii. MWHs maternity waiting home establishment is another component of intervention in maternal health. The aim is to address problems related to delays in reaching appropriate care due to lack of access to transport or lack of resources to pay for transport. The intervention targets pregnant women with danger signs and identified pregnancy complications and to bring them closer to needed obstetric care and thereby improve maternal and neonatal outcome. The intervention extends from hospital to community and was closely linked with health centers and local communities Page 5
iv. Community based interventions from the demand side VSO in collaboration with the local CSOs has been implementing projects in the rural areas geared towards raising awareness among the key actors like community and religious leaders, men, local government leaders, etc. to address barriers related to low service utilization by women. The intervention also includes harmful traditional practices and gender based violences. b. Newborn health Engaged aggressively in undertaking the establishment of neonatal intensive care units (NICUs) and community based newborn corners (CBNCs) using VSO model. Main features of VSO model is it is low cost, affordable, sustainable, local ownership, scalable &r replicable, need & evidence driven. Key activities are: i. Restructuring/refurbishment of rooms- ensure the availability of adequate rooms to provide standard service. Four rooms( septic room, hot room, nursing station, mothers side/kmc) are ideal ii. HRH train NICU nurses (usually 5 nurses for each) based on national standard. In addition on site trainings (usually 3 days) for medical staff represented from Gy/labor ward, pediatric ward and NICU section are required to attend. The aim is to ensure interdepartmental cooperation and reduce risk of newborn at the labor ward. iii. Medical equipment and material supply iv. System strengthening protocols, guidelines, manuals, charts, etc. are adapted and put in place for use to improve nursing care and ensure provision of consistent and reliable treatment and diagnosis v. Evidence, research and documentation planning of the NICU intervention starts with data audit and base line assessment in the targeted facility, followed by proposal development, implementation and monitoring. Outcome of the intervention is measured through research. Results of researches on NICU indicated more than 50% reduction of neonatal mortality and significant cut (over 90%) in referrals to the next higher level of health facility. Increased admission rate is also another significant outcome observed. c. Child health The establishment of HDU was one of the innovations introduced and now being scaled up in different hospitals. A High Dependency Unit, HDU, is a specially staffed and equipped section of a ward which provides a level of care which is intermediate between intensive care and general care available on a ward. It allows for closer monitoring of patients who are at risk of becoming seriously unwell and provides a higher level of clinical care. This intervention proved significant reduction of admission duration for example from 17 days to 5 days on average. It has been a high impact intervention that provided improved care and treatment, Page 6
reduced morbidity and referrals. A 6 bed capacity separate room is designated for the unit, moderately equipped and with nurses trained a competency based training. The unit gives a 24 hour close monitoring to critically ill children. AYSRH Interventions focusing on adolescents and youth are appropriate and suitable given the current dynamics and population structure of the country. This is a new area that we are developing project ideas and moving forward to design a comprehensive program. Further information on VSO s work in each of the countries we work in can be found on the VSO website. Page 7