MdM has been working in Pakistan since 1995 through various projects: Mother and Child Health programs (1996-2004), Primary Heath Care for IDPs due to Earthquake (in 2005-2006), Smile operation (surgery), Gender Based Violence in Punjab (2004-2015), IDPs of military conflict (2009 - current) and IDPs of floods (2010).
In June 2009, MdM first started primary health care activities in 8 health units through 3 mobile teams in Swabi and Buner. As the conflict spread across FATA (esp. Orakzai, Kurram, South Waziristan) causing further civilian displacements, MdM responded by expanding primary health services to Kohat (March 2010), Hangu (April 2011), and Dera Ismail Khan (July 2011).
MdM worked for the last 10 years on gender-based violence in Punjab supporting 35 Dar-Ul-Aman (shelter homes for women victims of violence) working closely with Social Welfare Department (SWD). After 7 years of project implementation, MdM introduced a set of minimum standard and Action Planning cycle. Minimum standards covered: security and safety, clean drinking water and food, provision of medical, legal, and psychological service, beneficiaries’ rights and basic needs, documentation and record keeping.
One of the five prioritized thematic area of MdM is to improve access to Sexual and Reproductive Health. Since 2010, Sexual and Reproductive Health (SRH) has been one of the four priority areas of intervention adopted by Médecins du Monde (MdM). Preventing and managing unwanted pregnancies (UWPs) has been selected as a priority operational area under the 2014-2017 SRH Strategy. The SRH strategy for 2014-2020 includes a specific work in crisis settings with the objective to provide the SRH minimum package and respond to GBV.
MDM is currently providing PHC and Rh services including BEmONC in Kohat, Hangu (Naryab)and another BEMONC center is already in Pipeline to start in TANK ,DI khan in collaboration of MOH. The post abortion care is an essential component of BEmONC. A comprehensive training on PAC is essential for medical staff working in RHC Naryab as well as staff working in other location. The medical staff will be sensitized and trained on PAC according to international guidelines of PAC. This is including Infection Control Prevention (ICP), family planning counseling, the updated medical and surgical treatment on abortion specifically Manual Vacuum Aspiration (MVA).
The main objective of this consultancy is to provide sensitization and training on PAC model, which will mainly focus on improving the knowledge, skills and thus the participants' job performance. This training is involving reinforcing the skills of the medical staff. The medical staff will be sensitized and trained on PAC according to international guidelines of PAC .This is including Infection Control Prevention (ICP), family planning counseling, the updated medical and surgical treatment on abortion specifically Manual Vacuum Aspiration (MVA) provision and the referral system to PHCC.
SPECIFIC OBJECTIVE :
At the end of the training, participants should be able to:
1. Correctly use the definitions referring to the issues of abortion or termination of pregnancy.
2. Understand the negative consequences of unwanted pregnancies and unsafe abortions.
3. Understand the objectives of care for unwanted pregnancies and unsafe abortion
4. Understand their role in counseling and provision of family planning as the core component of PAC.
Correctly deliver the key interventions of post abortion care including medical and surgical methods specifically MVA as well as preventing and managing complications related to the procedure.
1. To have positive attitudes toward post abortion care services.
2. Respect confidentiality and protect medical data at all times.
3. Ensure good communication when providing post abortion care.
4. Ensure good counselling when providing post abortion family planning
Scope and Methodology
The methodology to be used during the training should be participative and interactive with key theoretical input. In other meaning, Competency- Based Training (CBT) on the specific knowledge, attitudes and skills needed to carry out a procedure or activity. The consultant is expected to work in close collaboration with the SRH supervisor to provide 3-days capacity building of 15-20 staff of MDM and MOH staff on Post abortion Care/MVA by Power Point Presentations, Group Work and Group discussions, hands on practice on dummy and clinical exposure at health facility level. The training contents should include following topics.
- Definition and types of abortion
- Consequences of unwanted pregnancies and unsafe abortion and situation in Pakistan
- PAC model and core component of PAC
- Medical and surgical management of abortion.
- Procedure of Manual vacuum aspiration.
- Complication of MVA and protocols for management of common complication
- Pain management & Infection prevention during MVA procedure.
- Post abortion family planning
- Hands on practice on Dummy and clinical exposure in health facility
· To meet and stay in regular contact with MdM SRH Supervisor in Pakistan and to clarify the objectives of the training and to discuss needs, expectations and training module.
· To build the training course and use of Well-designed teaching aids and audiovisual materials, such as videos, anatomic models and other training aids according to the TOR.
· The trainer should demonstrate the required skills and client interactions several times and to supervise the participants using the model and the actual instruments in a simulated setting that is as similar as possible to the real situation.
· To prepare an initial draft Agenda for 3 days (8 hours per day) of training.
· To develop the training kit which should include: Final draft agenda, theoretical presentations, methods used during the training, and evaluation tools (pre and post testing questionnaires)
· To share the final agenda, the planned activities, the theoretical presentations and the evaluation tools (PRE & POST-TEST) in advance, according to the schedule, with the RH supervisor (one week before starting the facilitation of the training).
· To share training module in advance to be approved by MDM medical advisor.
· To conduct training/facilitate the sessions (3 days) for maximum 10-15 persons
· Minimum one day clinical exposure of participants in health facility to ensure Clinical practice to focus on family planning and MVA procedure.
· To provide a final report IN ENGLISH (between 5 and 10 pages) MAXIMUM 10 days (including 1 weekend) after the training: including:
a. Outcomes of Pre and post testing including comments and knowledge gain
b. Acquired skills and skills to be improved
c. Recommendations for further training sessions
d. Annexes: final agenda, methodology and presentation handouts.
· An advanced degree in Gynae & obstetric and public health
· Proven experience in maternity care.
· Proven experience in providing similar consultancy services
· Proficient in the PAC skills of the sessions will facilitate.
· Previous experience as a master trainer in PAC/MVA will be an asset
· Able to guide clinical activities (e.g performing vacuum aspiration, family planning counseling)
· Formally trained in adult learning principles and participatory learning skills.
· Valuable experience in training and supervising medical staff.
· Demonstrate experience in designing training agenda, manage group dynamics and enable groups to learn together based on their field experiences.
· Minimum 5 years of working experience in the relevant field.