Anaesthesiologist - CEmONC Capacity Building for Healthcare Workers Consultancy at Jhpiego - John Hopkins University

Background

• Maternal and Perinatal Mortality are Obstetric and neonatal tragedies worldwide. Of the global Maternal Mortality occurrences, the vast majority occur in low-resource settings and Nigeria accounts for nearly 20% of the global death. 
• The lifetime risk of dying in Nigeria is 1 in 22 during pregnancy, childbirth or postpartum period compared to 1 in 4,900 in most developed countries. 
• The causes of maternal mortality include Pre-eclampsia/Eclampsia (PEE), obstructed labor, postpartum hemorrhage, puerperal sepsis and abortion complications.
• These causes are treatable and preventable when labour is supervised by Skilled Birth Attendants (SBAs). 
• Perinatal morbidity and mortality are closely related to events during pregnancy and labor. 
• The high rate in Nigeria is a result of poor maternal health, sub -optimal
• care during pregnancy and childbirth, and lack of newborn care. 
• The major causes of newborn deaths are birth asphyxia, neonatal sepsis and prematurity. 
• Universal access to Comprehensive Emergency Obstetrics and Neonatal Care (CEmONC) services is one of the strategies that can reduce these deaths and sufferings along with the ten core signal functions of the services. 
• Improving access to quality Comprehensive emergency obstetrics and newborn care is critical to reducing these preventable maternal and newborn deaths and is a top priority of the Government of Nigeria. 
• Therefore, as part of the commitment of the Federal Ministry of Health and Social Welfare (FMOHSW) to ensure that there are well equipped CEmONC facilities throughout the country to provide quality healthcare services, a nationwide CEmONC health facility assessment was conducted to identified existing gaps. 
• As part of the efforts to bridge the identified gaps in healthcare workers competencies, Jhpiego, in collaboration with the FCT, Ebonyi and Kebbi State Governments, through funding from USG in Nigeria, provides technical assistance to GoN to bridge the capacities of doctors, nurses, midwives, anaesthetic nurses, laboratory scientists/assistants inselected health facilities inthethree states.

Purpose of the CEmONC interventions

• This intervention aims to bridge existing gaps in the identified competencies of healthcare workers to provide quality CEmONC services during the recently concluded CEmONC health facility assessment in at least one CEmONC public facility per LGA in the selected states to
• improve quality services for women during pregnancy, labour, childbirth and postnatal period.

Specific Objectives:

• By the end of each 2-day safe obstetric anaesthesia training session, learners will demonstrate competency at a minimum standard in the following areas:
• Evidence-based management of anaesthesia and analgesia for planned/emergency Caesareans and emergency Caesarean hysterectomies, including pre-operative assessment, planning and care, anaesthesia management and monitoring during surgery and post-operative care
• Evidence-based management of anaesthesia for women with specific obstetric complications including pre-eclampsia/eclampsia and severe obstetric haemorrhage.
• Appropriate use of Lignocaine and Ketamine in obstetric analgesia and anaesthesia resp.

Appropriate technique forthefollowing clinical procedures:

• High and total spinal anaesthesia.
• Difficult airway management, including failed intubation.
• Maternal life support.
• Use of Lignocaine with or without adrenaline in obstetrics.
• Preparation of lignocaine.
• Prevention of complications.
• Diagnosis of lignocaine allergy and toxicity.
• Management of lignocaine allergy.
• Management of lignocaine toxicity.

General principles of analgesia and anesthesia in obstetrics, including:

• Team-based pre-operative assessment and care.
• Anesthesia management and monitoring during surgery and postoperative care.

Anaesthetic considerations in special obstetrics conditions:

• Pre-eclampsia/Eclampsia
• Major obstetrics haemorrhage.
• High and total spinal anaesthesia.
• Difficult airway management, including failed intubation.
• Maternal life support.

Responsibilities
In collaboration with Jhpiego staff:

• Each consultant willparticipate inaonedayvirtualskills standardization andpretraining planning workshop tobeorganize by Jhpiego.
• Conduct an on-site capacity building of an average of 8 healthcare care workers, which would include doctors, nurses (including peri-ops and anaesthetic nurses) and midwives.
• Conduct follow up mentoring of the trained healthcare workers to strengthen their confidence and competence in using the newly acquired knowledge and skills.
• Conduct pre- and post-test assessment for each of the modules of the training package.
• Compile and submit acomprehensive report of thetraining within 5 working days after completion of the training.
• Participate in a one day post-training debrief meeting with key stakeholders in the state.

Required Qualifications

• Registered and practicing anaesthesiologist with at least 5 years post-qualification working experience.
• Evidence of previous and ongoing work experience providing anaesthesia services for obstetric conditions in afacility delivering CEmONC services.
• Evidence of previous experience conducting training on anaesthesia component of CEmONC or a similar training especially within the last 24 months or current/recent faculty member/trainer in anobstetric and/or anaesthesiology residency or nurse anaesthetist training program
• Evidence ofhaving up-to-date annual practicing license with Medical and Dental Council of Nigeria.
• Evidence of strong coaching, mentoring and facilitation skills
• Evidence of strong analytical and communication skills.
• Travel: Ability to travel -70%, particularly to Facilities in the work location.
• Evidence ofhaving up-to-date annual practicing license with Medical and Dental Council of Nigeria.
• Evidence of strong coaching, mentoring and facilitation skills.
• Evidence of strong analytical and communication skills.