RESPONSIBLE for curative and preventive care with a focus on MCH/FP program-related activities. Actively participates in the implementation of Maternal, Newborn, and Child Health Care Program (MNCH) to include activities such as: family planning and immunization activities; health promotions and prevention activities; antenatal and postpartum care; normal and complicated vaginal deliveries; immediate care of the newborn and resuscitation; management of post-partum hemorrhage, AND immediate identification of complicated pregnancies/deliveries for emergency obstetric care and management.
All MNCH related activities are implemented according to MSF policies, procedures & protocols, guidelines, and standards, in order to ensure the quality and continuity of care for the target population and avoid delays in the management of obstetric emergencies.
Ensures clean and safe environment for patients and staff
Provides necessary support and care or advise the patients.
Explains patients and their care takers about patient’s condition and the need of staying in the hospital
Ensures and supervises the proper follow up of all newborn babies from delivery until discharge
Ensures and supervises integrated health education within all activities, to patients and their families on topics such as importance of breast feeding, weaning, child spacing, hygiene, child and family health, vaccination and possible complications resulting from harmful traditional practices
Responsible for MSF equipment and materials and their correct use
Adhere to and reinforce the implementation of MSF obstetrical and reproductive health protocols, clinical guidelines, essential medicine practical guidelines, universal hygienic standards and newborn caring standards and any other MSF protocols in force at all time
Comply with MSF Health Care Waste Management, hygiene and sterilization procedures.
Accurate reporting and timely consultation, following the orders of the doctors and/or supervisors
Ensure complete transfer of relevant information to the next shift team (specially identified risk cases)
With the LHV supervisor, review, give suggestions, and develop the guidelines and protocols to benefit patient care and the smooth running of the health facility.
Medical Functions: Curative Care
Ante-Natal Care (ANC) – see MSF ANC Protocol
DIAGNOSIS AND MONITORING OF NORMAL PREGNANCY: ANC visits
pregnancy confirmation; estimate gestational age and due date;
antenatal care (history, focused physical examination, basic screening laboratory tests, and counseling; TT vaccination, etc); Malaria and infectious disease screening in pregnancy
Identification of high risk factors; identify coexisting disease and commence 1st line treatment;
Educate women about dangers signs in pregnancy and support them with creating a birth plan
Normal Deliveries (NSVD) – managing normal spontaneous vaginal deliveries and the usual procedures for various problems
Recognizing true/false labour; identify onset of labour
Monitoring progress of active labour by abdominal & pelvic examinations
Maintaining and interpreting partograms +++ active management of the 3rd stage of labour
Monitoring maternal and foetal well-being during labour;
Recognizing signs of fetal distress, stabilize and immediate referral
Recognizing signs of maternal distress, stabilize and immediate referral / Recognizing prolonged and obstructed labour and for immediate referrals
Perform various procedures as required: amniotomy/episiotomy; prolapsed cord/nuchal cord;
Proper induction/augmentation of labour: the rational use of oxytocin and prostaglandins
Provide active 3rd stage management;
Inspect placenta and membranes for intactness
Immediate Care of the Newborn and/or Resuscitation/Referral for Neonatal Emergencies
Initial rapid assessment of the newborn baby
Cleaning baby’s airways; Cord-cutting and care
APGAR scoring @ 1, 5, and 10 minutes
Immediate neonatal resuscitation for a depressed newborn (cardio-respiratory depression)
Initiate and establish breastfeeding as much as possible and promote mother-child bonding
Care of the perineum
Care of the breast/lactation management - Promoting immediate breast-feeding and maternal/baby bonding
Monitor possibility of post-partum hemorrhage
Checking completeness of placenta / no retained products of conception, otherwise immediate referral to LHV/Supervisor/Women Medical Officer/Medical Specialist/Expat Midwife
Stabilizing and immediate referrals of convulsing patients
Postnatal visits (PNC) - See MSF PNC Protocol
History and assessment focused on mother and child
Identifying and treating/referring postnatal complications
Education and counseling on breastfeeding and proper weaning habits
Contraception and child spacing
Management of post-partum hemorrhage
Controlled cord-traction to deliver placenta and/or uterine massage after placenta delivery
Correct use of drugs/rationale administration of oxytocin
Initial management of shock with fluids; IV access
Early Identification of Complicated Pregnancies/Deliveries and Immediate Referrals
Bleedings during pregnancy
Medical termination of pregnancy: Misoprostol regimen
Pregnancy-related pathologies and pathological pregnancies
Iron-deficiency anemia management
Pre-eclampsia and eclampsia management
Premature rupture of membranes, management
Threatened pre-term delivery management
Intra-uterine foetal death management
Special deliveries; Mal-presentations and labour dystocia
Recognize, manage, and refer complications arising in all stages of labour and IMMEDIATELY call the ATTENTION OF SUPERVISOR-ON-DUTY.
Seek immediate assistance from senior medical staff in complicated deliveries
Participate in the organization and preparation of referrals:
Ensure stabilization of mother and newborn
Ensure that all patients are referred on time to adequate health structures
Ensure that the administrative procedures are properly followed
Ensure that referral forms are correctly filled in and sent with the patient.
Ensure follow up of the referred patient.
Assist the doctor or nurse in the management of victims of sexual violence, if needed
Provide psychosocial support as needed
Assists in intra-uterine procedures
Administration, Reporting and Data Collection
Makes accurate and timely reports, written and verbal, about patient condition, or the drug consumptions to the relevant supervisor when/however required.
Ensures the collection of correct data, as required/requested by the supervisor.
Carry-out administrative procedures and maintain correct documentation at all times (fill in patient’s files, forms, registration books, consumptions, statistics, etc.)
Ensures that administrative procedures of admissions and hospitalizations comply with MSF protocols and attendants are properly informed and receive the documents required (birth certificate, vaccination card, etc.
Participates in the organisation of the ward in collaboration with other LHVs, midwifes and the maternity ward supervisor.
Attends required trainings, workshops, lectures etc. in service or external and possibly able to give training and workshops to other staff, within the framework of her role, on request and with the help or guidance of her supervisor.
pMedecins Sans Frontieres Doctors Without Borders (MSF) is an independent medical humanitarian association providing medical assistance to people in need, irrespective of race, religion, creed or political conviction. MSF has started work in Pakistan since 1986 as an independent, self-governed organ ...Read More