Medical Doctor- Antimicrobial at Medecins Sans Frontieres (MSF)

Main Purpose

• Lead an antimicrobial stewardship (AMS) program in a medical and surgical humanitarian hospital. Médecins Sans Frontières (MSF) / Doctors Without Borders has increased its focus on the problem of antibiotic resistance. Antimicrobial resistance (AMR) is growing rapidly in low and middle-income countries and MSF faces ongoing challenges managing antibiotic resistant infections in hospitalized patients particularly in patients with burns, trauma, hospital infections and in pediatric and neonatal care. AMR threatens patient outcomes, makes hospitals less safe and increases costs. MSF is committed to responding and one part of this response is to increase efforts to conserve the effectiveness of antibiotics through antibiotic stewardship.

Accountabilities

• Medical doctors tasks In addition to Antimicrobial Stewardship Focal Point tasks
• Leading, promoting and supporting antimicrobial stewardship efforts in the healthcare facility(s) across the spectrum of healthcare.
• Establish and participate in a multidisciplinary Antimicrobial Stewardship (AS)committee (that meets regularly with Terms of Reference).
• Identify antimicrobial stewardship priorities together with the AS committee and the mission.
• Monitor, collect and analyze the antimicrobial data reported to the multidisciplinary AS committee.
• Conduct regular audits relevant to stewardship priorities. This might include audits of antibiotic use, treatment of select conditions, indications for microbiology testing, and communication of results.
• Provide feedback to the project and the mission regarding results of audits and plan improvements.
• Co-ordinate and deliver education to other medical, nursing and pharmacy staff around stewardship.
• Support other clinical staff regarding antibiotic choices and regularly participate in clinical rounds.
• Liaise with the laboratory for timely communication of results (where relevant), interpretation of results and feedback to clinicians.
• Collaborate with lab + IPC to prospectively monitor pathogens of concern and respond to hospital outbreaks including outbreaks of multidrug resistant organisms/bacteria (MDRO).
• Identify opportunities to improve stewardship in the project (e.g., therapeutic drug monitoring, OPAT).
• Participate in relevant project level committees (e.g., IPC, Quality improvement, Morbidity + Mortality reviews).
• In collaboration with IPC and the clinical team, participate in detection, management and prevention of healthcare associated infections.

Requirements

Education:

• Essential: Medical Doctor degree registered with the Kenya Medical Practitioners and Dentists Council (KMPDC) with a valid practicing licence.
• Desirable: Completed on-line training in Antimicrobial stewardship [e.g. BSAC (British Society of Antimicrobial Chemotherapy) and/or WHO (World Health Organisation)]

Experience:

• Essential: At least 5 years’ experience in working as a medical doctor in inpatient settings.
• Desirable: Experience in reviewing medical records/reviewing appropriateness of antimicrobials

Languages:

• English Essential & Swahili Desirable

Knowledge:

• Essential: Have a working understanding of key pathogens, their usual antibiotic susceptibilities, typical clinical presentations, and empiric or targeted treatment.
• Have a working understanding of the modes of action of antimicrobials including their spectrum of activity.
• Have a working understanding of the key principles of infection prevention and control (IPC) and the relationship between IPC and AMR (Antimicrobial Resistance).
• Have a working understanding of the appropriate use of antimicrobials to prevent the emergence of resistance and avoidance of adverse effects.
• Have a working understanding of the use of diagnostic tests in the investigation and management of infectious diseases. How to use data for feedback and reporting.

Desirable: 

• Understanding of behaviour change principles.
• Able to provide face to face feedback to prescribers about antibiotic prescriptions.