Midwife at Medecins Sans Frontieres (MSF)

Main Purpose

Provide obstetrical care to pregnant women and their babies, doing follow up before, during and after delivery, according to MSF obstetrical and reproductive health protocols, universal hygienic and newborn caring standards and under supervision of a specialist doctor, in order to ensure their health conditions and avoid post-delivery complications

Accountabilities

• Ensuring the implementation and continuity of antenatal and postnatal care, family planning, obstetrical care (BEmONC 1 and CEmONC 2), neonatal and comprehensive maternal care, management of victims of sexual violence, reproductive tract infections and Fistula care in accordance with MSF Reproductive Core Package of Activities and reinforce the implementation of standardised protocols. 
• Where PMTCT is implemented, ensuring implementation of the PMTCT protocol in the ANC/delivery and PNC consultations (pre counselling, test and post counselling 
• Collaborating with the medical doctor and /or nurse in the management of Sexual Violence cases 
• Assessing the feasibility for referral of pregnant women from the TBAs to the OPD/MCH for medical evaluation and/or complicated deliveries. 
• Ensuring hygiene and sterilization criteria (including universal precautions) are met according to MSF specifications. 
• Performing cleaning and minor maintenance  for  biomedical equipment used. Following the user manual and  protocols and alert supervisor in case of malfunctioning.
• Guarantee a regular and ongoing supply of drugs and equipment required for maternity activities (including monitoring/consumption control/ordering of orders
• Properly following up all newborn babies from delivery until discharge, informing mothers and relatives about importance of breast feeding, vaccination and possible complications resulting from harmful traditional practices. 
• Ensuring patients’ right to privacy and confidentiality is respected 
• Supervising that administrative procedures of admissions and hospitalizations comply with MSF protocols , as well as verify patients are properly informed and receive the documents required (birth certificate, vaccination card, etc. 
• Participating in the organization of the ward in collaboration with other midwifes and the maternity ward supervisor. Ensure transfer of relevant information to the next shift team (specially identifying risk cases) 
• According to MSF protocols in force, conduct normal deliveries independently Manage obstetric emergencies; identify cases needing referral and send them in time, clean up the newborn, executing and registering first neo-natal medical acts (cutting and cleaning the umbilical cord, vaccination, etc.), detecting possible anomalies/infections of the newborn and reporting them to the doctor, in order to ensure successful interventions 
• Supervises the use of drugs, facilities and obstetric material, in order to ensure in accordance with number of patients and prescriptions, a rational use as well as pharmacy stock levels are permanently updated, kept under appropriate conditions and above minimum safety point.  1 BEmONC = basic emergency obstetric and neonatal care = Administration of antibiotics, oxytocics, anticonvulsants, manual removal of the placenta, removal of retained products following abortion, assisted vaginal delivery, preferably with vacuum extractor and newborn care including neonatal resuscitation.  2 CEmONC = comprehensive obstetric and neonatal care = the full package of BEmONC Plus; surgery (caesarean section, hysterectomy, laparatomy), safe blood transfusion and care to sick and low birth weight newborns

Context specific Accountabilities

• Assess, follow up and evaluate the condition of all admitted patients, and inform the Supervisor and/ or Medical Doctor, MWAM on progress and problems or deterioration in the patient's condition or in case of consent refusal for a medical intervention.
• Correctly fill in patient files; vital signs charts, magnesium sulphate charts, blood transfusion chart, prescription chart, oxytocin administration chart, fluid input/output monitoring etc.
• Assist the medical doctor when interviewing and examining patients if needed and during the in-patient rounds. 
• Collaborate with TBAs and CHWs   for  referral of  mother in labour, postnatal   women from Community for  medical évaluation, and/or deliveries. 
• In case of induction or augmentation of labour with uterotonics, verify the medical prescription and respect MSF protocol.
• In close collaboration with the other midwives, ensure that the delivery room is never left unattended.
• Participating in the organization of the ward in collaboration with other midwives and the maternity ward supervisor. Give written and oral handover report to colleagues about patient's condition, prescribed treatment and laboratory examination to be done by making ward tour during shift exchange.
• Ensuring hygiene and sterilization criteria (including universal precautions) are met according to MSF specifications.
• Perform cleaning and minor maintenance for biomedical equipment used. Following the user manual and protocols and alert supervisor in case of malfunctioning.
• Guarantee  a regular and ongoing supply of drugs and equipment required for maternity activities (including monitoring/consumption control/ordering of orders.
• Proper examination and follow up of all newborn babies from delivery until discharge, informing mothers and relatives about importance of breast feeding, vaccination and possible complications resulting from harmful traditional practices.
• Ensuring patients’ right to privacy and confidentiality is respected.
• Supervising that administrative procedures of admissions and hospitalizations comply with MSF protocols, as well as verify patients are properly informed and receive the documents required (birth certificate, vaccination card, etc
• According to MSF protocols in force, conduct normal deliveries independently.
• Manage obstetric emergencies; identify newborns needing referral to newborn unit and send them in time, clean up the newborn, executing and registering first neonatal medical acts (cutting and cleaning the umbilical cord, vaccination, etc.), detecting possible anomalies/infections of the newborn and reporting them to the doctor, to ensure successful interventions. 
• Ensure high Risk Mother discharged from the ward are booked for appointment at high Risk clinic for MD review as indicated in the file on discharge.
• Supervises the use of drugs, facilities and obstetric material, in accordance with number of patients and prescriptions, a rational use as well as pharmacy stock levels are permanently updated, kept under appropriate conditions and above minimum safety point. 
• Inform the patient/caretaker about the routines in the Hospital; the locations and use of the water sources, latrines, laundry area, feeding times etc
• Participate in  data compilation, regular departmental meetings, CMEs , case review and mortality review.
• Flexible to accept rotations to other hospital departments and delegation of tasks by the Supervisor 

Requirements

Education    

• Essential :Diploma in Kenya Registered Community Health Nurse. qualification. Desired Bachelor’s degree in nursing/midwife.

Experience    

• Essential: working experience of at least two years in midwifery activities related jobs. 

Languages

• English and Swahili,Fluency in Somali language would be an asset.

Competencies 

• Result,teamwork,flexibility,commitment and service