Job pack: Gynaecologist and Obstetrician Country Ethiopia Employer Asossa Hospital:Benishangul Gumuz Region Health Bureau(BG-RHB) Duration One Year Job purpose The overall placement objective is to contribute to the maternal and child health program by strengthening the labor and delivery wards of Assosa hospital and providing relevant input to the Regional health Bureau as appropriate. Contents: 1. Job Description... 2 2. Personal considerations... 4 3. Background and contextual information... 5 Page 1
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. He/she is also expected to play a role in mentoring junior staff and health officers as well as in internal examination assessment. Moreover, he/she is expected to play a vital role in the following areas: Mentor students at practical training and relevant staff in the department to ensure skill transfer Train local staff in provision of comprehensive emergency obstetric care Support emergency obstetric care service provision Support the facilities in setting up of key maternal health interventions including maternity waiting homes and introduction of magnesium sulphate, Support the development of standards and procedures for handling pregnant women in maternity waiting homes Assess the situation, and provide technical support that improves the service at GYN/OBY department To monitor and mentor in-service staff on Proper Infection control chain in maternity and labor ward. Develop Emergency protocols for Proper handling of Maternal Emergencies. Programmed/scheduled Mentorship and coaching service given to the Medical students(attached to the hospital ) and hospital clinical staff working in the Gy/Ob ward and ensure that they improve in their skills and knowledge to give quality care and improved service Training on B/CEmONC is provided to relevant staff and followed up for improvement in the care and service by the staff trained consequently Relevant and required clinical guidelines, protocols, procedures, etc. are adapted/developed and used or ensure that they are properly practiced if already exist Ability to demonstrate none guided procedures by a trainee under the volunteer s supervision and mentorship. Trainees to and in-service midwives to demonstrate ability managing a safe and clean delivery and post-delivery environment for labouring mothers. 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 analyse problems and develop lasting solutions in line with VSO approaches. Adaptability A flexible approach and the ability to adapt behaviour to different situations. Resilience The self-confidence to work with a variety of situations, diverse people and ambiguity. 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 Prior experience in clinical teaching and working in hospital settings Page 2
Responsibilities Key Performance Indicators Competencies Skills and Knowledge Assess Gynecological elective cases for surgical intervention and advise accordingly or carry out surgical support whenever it necessitates. Develop performance indicators for Inservice staff and trainees to guide qualitative service delivery in place of placement. Additional remarks: This placement is a cluster placement where the volunteer being based in the original placement (that is Asossa hospital) supports other partners, namely, Pawe General Hospital. To a greater extent the work of the volunteer involves capacity building focusing on training of general practitioners and midwives from the above hospital and health centres. The placement also involves setting up essential systems and structures based on the needs of the facilities. New placement and working system is in place to support the volunteer in such new placement model-cluster Placement. Qualitative and simple protocols developed are in use and demonstrable by the trainee. Objectives will be confirmed in a three way discussion between the volunteer, employer and VSO in the first three months of the placement. Due to the nature of our volunteer placements, it is possible that the responsibilities of this role may differ in reality and therefore the postholder will need to be prepared to be flexible and adapt to their environment as necessary. Responsible to: Page 3
2. 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 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 a hospital in Assosa. These health facilities are only able to diagnose and treat minor ailments and problems such as malaria. More advanced health facilities are available in Addis Ababa which is two days by car or 1 hr flight by plane which has three days per week schedule (depending on weather). 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-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: in a large town 681 kms from the capital, Addis Ababa Two days travel on good roads or 1 hour by plane. There are usually 3 days flights per week from here to the capital: flights may be affected by bad weather. Page 4
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. Motorcycle requirements Motorbike riding essential Yes/No Line taxis: hail-and-ride minibuses/taxis running prescribed routes around the city Security information There is no serious security problems and concern of risk in the area. There is continued peace and stability in the region. Assosa is an attractive and peaceful town although minor ethnic clashes occur outside the town and in surrounding rural areas. The situation is closely monitored and managed by the government. To ensure volunteers safety and security VSO hires day and night guards for volunteers who look after their houses. 3. Background and contextual information Ethiopia is one of the countries in the world with high number of child and maternal mortality rate. As Ethiopia s 2009 demographic and health survey showed 25,000 women died every year giving birth, and 400,000 more suffer long-term disabilities due to complications during pregnancy, delivery or postpartum period while 300,000 babies died annually across the country. Recognizing the problem, the Government of Ethiopia has been working aggressively to improve the situation in collaboration with all concerned and meet the MDGs 4 and 5. However, the progress registered so far is not to the required level. The annual performance report of HSDP III (2008/9) also concluded that maternal health coverage is still low in the country, and the national targets set for the year were not achieved (80.5% for ANC coverage and 37.1% for proportion of deliveries with skilled health attendants). The report generally revealed that Maternal mortality is still unacceptably high in the country. The major problems for high maternal and child mortality rate are inadequacy of staff/skilled human power and poor quality services for B/CEmONC (Basic/ Comprehensive Emergency Obstetric and Newborn Care). Recognizing the problem, VSO Ethiopia has developed a five years program area plan with a focus of improving child and maternal health by bridging the shortage of skilled human Page 5
power. To this end, VSO Ethiopia has identified teaching hospitals as strategic partners to support the realization of national targets in area of maternal and child health. This placement will therefore contribute to the Program Area Plan objectives no. 2 of VSO improving child and maternal health. Moreover, it will contribute to the regional HSDP and the MDGs 4 and 5. Benshangul Gumuz Regional State is one of the nine federal states of Ethiopia located in the mid western part of the country and having a total area of 50,832 KM2.According to the 2009 Population and Housing Census of Ethiopia, the total population of Benshangul- Gumuz region was 460,459 which gives a population density of 9/km 2.Assosa zone, one of the three zones and two special Woredas(second from lowest administrative units in government structure) in the region, has a total area of 1,519 km2 and a population of 28,970. The region has two 2 hospitals, 7 health centers, 75 health stations and 44 health posts of 1 hospital,3 health centers and 44 hospitals are located in Assosa zone. In 2009,the top ten causes of morbidity in the region were malaria(43.8%),helminthes(13.6%),respiratory diseases(9.4%),dysentery(6.9%),gastritis and dudenitis (5.5%)rheumatism(5.3%),pyrexia of unknown origin(4.4 %),skin diseases(4.1%),unspecified anaemia (3.8 %) and diseases of the digestive system(3.2 %) The hospital is serving more than 500,000 peoples, 49 % are females, 24 % are women of reproductive age group and 16.18 % are children of under five. The Critical shortage of skilled manpower( midwives, doctors,pediatricians and obstetricians),lack of experience and skill of the existing health professionals, inconsistent use of pantographs for delivery services and overall inefficient skill and management capacity to provide comprehensive emergency obstetric care services have been mentioned as the major bottlenecks for the hospital. There are few number of medical expertise in the regions and in order to avert these, the hospital has put clear targets and deliverables for EFY(Ethiopian Fiscal Year) 2004 that is from July 2011 till June 2012.Achiveing the proportion of the planned focused ANC(ante natal care) to 100 % and those deliveries attended by skilled health professionals to 100 % are some of the set targets for this year.(source: Benshangul Gumuz Regional State Health Bureau, Assosa Hospital Annual Plan). Further information on VSO s work in each of the countries we work in can be found on the VSO website. Page 6