Referral Nurse for Maternal and Child Health (Madagascar)

Title: Referral Nurse for Maternal and Child Health (MCH)
Reports To: Coordinator of Medical Programs
Location: Ranomafana, Madagascar
Percentage Effort: Full-time
Key Words: Global health, maternal and child health, family planning, capacity building.
Start Date: Summer 2018
Expected Commitment: Minimum of 2 years.

Organizational Profile

PIVOT (www.pivotworks.org) is a global health care NGO guided by the principle that all people have intrinsic worth and deserve to live healthy and productive lives. As a social justice organization working in a setting of extreme poverty and disease, PIVOT’s core objective is to address social inequity by advancing universal access to quality healthcare, while creating a health care system that can serve as a model for the country of Madagascar. Since 2014, PIVOT has partnered with the government of Madagascar to strengthen the health system and create a model health district in Ifanadiana district, adjacent to Ranomafana National Park and 11 hours from the capital. The district has a catchment area of 200,000 people, more than 75 percent of whom live in extreme poverty.

PIVOT collaborates directly with the Madagascar Ministry of Health (MoH) to strengthen a district hospital, 21 health centers, and community health programs. The model is advanced across three major components: 1) horizontal readiness (e.g. infrastructure, supply chain, personnel), 2) vertically integrated clinical programs (e.g. maternal and child health, malnutrition, tuberculosis), and 3) data systems and research. Currently, PIVOT is a 187-person organization with 6 international staff in Madagascar, and a United States-based headquarters. 

Position Overview 

PIVOT provides a combination of direct patient care and health system strengthening activities at the community, health center and district hospital level.  The referral nurse for maternal and child health will take on a mentoring role, supporting the implementation, ongoing improvement, and monitoring & evaluation of all activities tied to maternal and child health, as well as reproductive health.

The referral nurse will work directly with the coordinator of medical programs to expand the annual program planning for MCH and reproductive health, including the defining of priorities and activities, the outlining of clinical protocols, and active participation in educational initiatives and social programs for mother and children. 

They will work directly with the medical teams of the district hospital and health centers, as well as the community, social, and reference teams of PIVOT at all three levels of intervention:

Community: PIVOT supports networks of community health workers who serve as liaisons between the rural villages and the health centers, often more than a day’s walk for our patients. Our community teams train the nationally mandated, locally selected volunteers, providing supplies and support to their relationship with the health centers. Community activities include integrated care for children under five, urgent direct patient care, screenings and referrals for tuberculosis, sensitization of the population, and tracking of family planning / reproductive health cases.  

Health centers: PIVOT supports twenty-one health centers in Ifanadiana District through medication reimbursement, training, infrastructure and personnel. In severy key health centers, PIVOT staff directly support malnutrition programs, integrated care for children under five, tuberculosis care, family planning and reproductive health.

Hospital: PIVOT works with MoH partners to transform the district hospital into a dignified life-saving facility by improving the quality of staffing, equipment, facilities and training on procedures and processes. As a result of this strong collaboration, PIVOT and the district hospital have established an action plan for reproductive health and strong governance systems.

Referral system and ambulance network: One of the first of PIVOT’s clinical programs was the establishment of an ambulance referral system for the first time in Ifanadiana District. Currently, the three-ambulance system moves patients in critical need from the community to the health centers, or from the health centers to the hospital.

PIVOT’s clinical staff consists of a team of Malagasy physicians, midwives, nurses and pharmacists, as well as social workers, ambulance drivers, and a handful of expatriate clinicians. The PIVOT teams work side-by-side with Malagasy MoH health staff.

Responsibilities: 

·      Support the conception, implementation and ongoing activity of a maternal and child health program at the three levels of the health system described above.

·      Support training and educational initiatives for PIVOT personnel and the personnel of the Ministry of Health in maternal and child health.

·      Actively participate in the meetings and work sessions of the medical department, as well as the district’s MoH department.

·      Work with the monitoring & evaluation team, to elaborate key performance indicators and activities tied to the maternal and child health program, as well as to analyze the resulting data.

·      Contribute to the reporting structure on a monthly, quarterly and annual basis, including the analysis and interpretation of the results of the program in presentations to the senior management team and the national director.

·      Collaborate with the operations department on improvements to health facilities with respect to the reception and care of mothers and children.

·      Report on the progress of activities to the Manager of Vertical Programs, ensuring the completion of tasks specifically assigned by their team, as well as other horizontal managers.

·      Participate in periodic meetings at the main PIVOT office in Ranomafana.

·      Assure the confidentiality of all patient medical information.   

Qualifications and Competencies:

·      Degree in nursing, specialized in maternal and child health or reproductive health, preferred.

·      Supplementary degree or training in program management or public health, also a plus.

·      Minimum of five years’ experience as maternal and child health nurse.

·      Prior experience with another NGO in a project situated in a developing country, strongly preferred.

·      Detailed mastery of obstetrical ultrasound and ability to instruct others, strongly preferred.

·      Demonstrated capacity to effectively contribute to the definition and implementation of programs.

·      French language proficiency required, English language proficiency preferred. The office operates in French and interactions with headquarters-based staff are in English.

·      Malagasy language ability considered an extraordinary asset, as is any substantial experience in Madagascar or working with the Malagasy public health system.

·      Long-term commitment to living and working in rural Madagascar, minimum of two years. The role requires a full-time presence in the Ifanadiana District.

·      Proven aptitude to work well with a culturally diverse team and to demonstrate personal diplomacy and interpersonal skills.

·      Demonstrated commitment to global health and social justice. It is critically important to believe strongly in the work PIVOT does, to advocate on behalf of the patients, and truly enjoy working to fulfill the mission of the organization.

This is an excellent opportunity for a dynamic, driven and passionate individual to be part of an exciting global health organization that links access to quality health care to research in an ecologically important context.