Midwife

WHAT IS MSF?

Médecins Sans Frontiers/أطباء بلا حدود  (MSF) is an international, independent, medical humanitarian organization that delivers emergency aid to people in 70 countries who are affected by armed conflict, epidemics, natural disasters and exclusion from healthcare. MSF offers assistance to people based on need, irrespective of race, religion, gender or political affiliation and our actions are guided by medical ethics and the principles of neutrality and impartiality.

We offer basic healthcare, perform surgery, fight epidemics, rehabilitate and run hospitals and clinics, carry out vaccination campaigns, operate nutrition centers, and provide mental healthcare. Our activities include the treatment of injuries and disease, maternal care and the provision of humanitarian aid. Where necessary, we set up sanitation systems, supply safe drinking water, and distribute relief to assist survival.

A FEW WORDS ABOUT THE PROJECT

The project started in Sept. 2013 in Shatila, where MSF currently manages an outpatient center for chronic non-communicable diseases (NCDs), vaccination services with transversely integrated mental health services and health promotion, and referrals for patients who require services beyond the scope of MSF activities. Additionally, MSF opened a women’s health center with sexual and reproductive health care.
During 2018, low risk deliveries were relocated from Shatila to Rafik Hariri University Hospital compound, where MSF runs a Birth Centre. MSF took this as an opportunity to work together with external partners as catalyst for change around midwifery model of care and DE medicalization of deliveries. The antenatal care services remain in the camps, to serve the most vulnerable women.
In Bourj el Barajneh camp, besides the above-mentioned activities, MSF provides in addition home-based care for those patients who are housebound or bedridden often due to an advanced NCD disease.

MSF BIRTH CENTER (BC)

The MSF Birth Center is unique in Lebanon, in its objective to develop a midwife led model of care. The midwives are responsible for all of the deliveries and are only required to consult the obstetrician in case of complications. The model focuses on low risk pregnancies. There is an assessment room for all patients being followed in ANC, including the higher risk cases and they may attend at any time to be assessed. The most important role of the obstetrician is to manage any complicated cases either in BC or prior to referral to another hospital, and to be active in teaching, coaching and empowering of the midwives and nurses to help develop the midwife led model of care

Responsibilities:

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 new born 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 (Basic emergency obstetric care “BEmONC” and Comprehensive emergency obstetric care “CEmONC” ), neonatal and comprehensive abortion 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 Prevention of Mother-To-child Transmission “PMTCT” is implemented, ensuring implementation of the Prevention of Mother-To-child Transmission “PMTCT” protocol in the Ante-Natal Care “ANC” /delivery and Post-Natal Care “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 form the Traditional Birth Attendance “TBAs” to the Outpatient Department “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.
• Guaranteeing a regular and ongoing supply of drugs and equipment required for maternity activities (including monitoring/consumption control/ordering of orders.
• Properly following up all new-born 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 organisation 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 new born, executing and registering first neo-natal medical acts (cutting and cleaning the umbilical cord, vaccination, etc.), detecting possible anomalies/infections of the new born 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. Basic emergency obstetric care “BEmONC” = basic emergency obstetric and neonatal care = Administration of antibiotics, oxytocic’s, anticonvulsants, manual removal of the placenta, removal of retained products following abortion, assisted vaginal delivery, preferably with vacuum extractor and new-born care including neonatal resuscitation. Comprehensive emergency obstetric care “CEmONC” = comprehensive obstetric and neonatal care = the full package of Basic emergency obstetric care “BEmONC Plus; surgery (caesarean section, hysterectomy, laparotomy), safe blood transfusion and care to sick and low birth weight new-borns.

Additional Responsibilities:

Pre-natal consultations

• Examinations of patients during consultations, prophylactic treatment according to MSF protocol, counselling and health education
• Identification of high-risk women and referring in close collaboration with gynecologist
• Updating the patients’ register and follow up forms

Postnatal care

• Offer a complete follow up of the mothers and their newborns according to protocols including clinical examination and preventive and curative treatments (prescribing of medicine strictly within MSF protocol), counselling and health education

Family planning

• Ensure appropriate individual or couple counseling (information) in order for women and men to choose the method of their choice according to MSF protocol

Care of surviors of Sexual and Gender Based Violence

• Ensure appropriate medical care to survivors of SGBV according to MSF protocols including providing preventive treatments and care of injuries

Care during labour, delivery and post-partum

• Provide the women with quality care during all phases of pregnancy, labour, delivery and post-partum period according to MSF protocols.
• Monitor and conduct normal deliveries including immidiate care of the newborn after delivery including resuscitation if needed
• Detect complications, inform the obstetrician and support referral according to MSF criteria
• Counselling and health education of mothers and families
• Document all aspect of the work accordingly in the patient file

Rotation flexibility in IPD and OPD for the continuous improvement on the SRH activities.

Qualifications:

Education:

• Essential midwifery diploma,

• MoPH’s license to practice Midwifery in Lebanon,
• Certificate of registration at the Lebanese Order of Midwives.

Experience:

• Desirable - working experience of at least two years in midwife activities related jobs.
• Experience in MSF or other NGO’s is desirable

Languages: Good level of communication in English, and Arabic

Soft Skills: Compassion and patient friendliness, Results and Quality Orientation, Teamwork and Cooperation, Commitment to MSF Principles. Behavioural Flexibility, Service orientation