Obstetrician / Gynaecologist Consultant Trainer in Comprehensive Emergency Obstetrics and Newborn Care (CEmONC) at Jhpiego - John Hopkins University

Slots: 5 - 6 trainers per state
Reports to: Technical Lead, Maternal and Newborn Health/Family Planning and Reproductive Health
Project: USAID-funded Integrated Health Program being implemented in Bauchi (T03), Kebbi (TO4), Sokoto (TO5), Ebonyi (TO-6) and FCT (TO-7)*

Project

• USAID-funded Integrated Health Program being implemented in Bauchi (T03), Kebbi (TO4), Sokoto (TO5), Ebonyi (TO-6) and FCT (TO-7)**

Subject RFP #

• TO3/217727/Consultancy/Fixed Price Contract-2021-0001
• TO4/217727/Consultancy/Fixed Price Contract-2021-0001
• TO7/217727/Consultancy/Fixed Price Contract-2021-0001
• TO6/217727/Consultancy/Fixed Price Contract-2021-0001
• TO7/217727/Consultancy/Fixed Price Contract-2021-0001

Purpose

• Jhpiego invites applications from qualified OB/GYN training consultants to organize and facilitate six-day trainings on CEmONC for doctors and midwives from selected Secondary hospitals / General Hospitals (GHs) in two IHP-supported states: Bauchi (6 GHs), Sokoto (12 GHs), Kebbi (12 GHs), Ebonyi (10 GHs) and FCT (14 GHs)
• IHP is seeking 5 - 6 CEmONC consultant trainers per State.

Brief Background
USAID Integrated Health Program in Bauchi, Kebbi, Sokoto Ebonyi State and FCT:

• The USAID Integrated Health Program (IHP) task orders 3, 4, 5, 6 and 7 are multi-year, reproductive health/family planning, maternal, newborn and child health, and nutrition (RMNCH+NM) programs being implemented in Bauchi, Kebbi, Sokoto, Ebonyi States and the FCT respectively.
• Bauchi, Kebbi, Sokoto, Ebonyi State and FCT have poor maternal and perinatal health indices due in part to low coverage and poor quality of antenatal, intrapartum, and postnatal, routine and complications care.
• IHP aims to contribute to State level reductions in maternal and child morbidity and mortality and to increase the capacity of health systems (public and private) to sustainably support quality primary health care (PHC) services for RMNCH+NM, including linkages to high-quality secondary healthcare services for women, newborns and children with complications requiring higher-level care. The three objectives of IHP are to:
  • Strengthen systems supporting primary health care services
  • Improve access to primary health care services
  • Increase the quality of primary health care services
• To improve quality of primary health care services (objective 3), IHP is supporting the State Government, SPHCDA and other partners in Bauchi, Kebbi, Sokoto, Ebonyi State and FCT to implement a range of activities in selected Primary Health Centers, including building the capacity of PHC providers (training, mentoring, supervision) to provide essential RMNCH care including prompt recognition, stabilizing measures and referral of women and newborns with complications.
• As a complement to providers’ capacity building, IHP is also supporting local health system strengthening and QI efforts to improve RMNCH care in PHCs, including linkages to secondary care for women and newborns with complications.
• In collaboration with Bauchi, Kebbi, Sokoto, Ebonyi State government and FCT administrators, IHP intends to conduct onsite competency-based CEmONC training for medical officers and midwives (80 per state) working at selected general hospitals, with a special focus on safe caesarean (including emergency caesarean hysterectomy) and safe blood transfusion. The training will take place in 6GHs in Bauchi, 12GHs in Kebbi, 12GHs in Sokoto,10 GHs Ebonyi and 15 GHs FCT.
• IHP is seeking 5 - 6 CEmONC MNH training consultants in Bauchi, Kebbi, Sokoto, Ebonyi States and FCT. As a member of a team, the consultant will lead an on-site 6-day CEmONC training session to build the capacity of medical officers and midwives on CEmONC in selected IHP supported general hospitals in one of the 2 IHP supported states.
• Each consultant trainer will conduct 6-day CEmONC training in 2-3 GHs.
• There will be approximately 6-8 participants in each CEmONC training; thus, each of the 5-6 CEmONC training consultants per state will train approximately 12-24 doctors/ midwives/ nurses in each state.

Scope of Work

• The scope of the consultancy is to build the capacity of an average of 8 (eight) healthcare workers (doctors, nurses and midwives) onsite at their health facilities (General Hospitals), to provide evidence based CEmONC services with special focus on safe caesarean surgery, emergency caesarean hysterectomy, uncontrolled postpartum hemorrhage (PPH), newborn care including helping babies to breathe, and pre-eclampsia/eclampsia (PE/E).
• The participants will be selected from IHP supported General Hospitals (GHs) in the 4 IHP focus states and FCT. Each consultant will be required to conduct this onsite training at 2 – 3 GHs in the selected state of choice. Each cohort of healthcare workers will be trained onsite for 6 days per training session.

Specific Objectives
By the end of each 6-day CEmONC training session learners will demonstrate competency at a minimum standard in the following areas:

• Provision of safe caesarean surgeries, including emergency caesarean hysterectomy and clinical decision-making to determine when these interventions are appropriate and needed.
• Knowledge and demonstrated skills to prevent promptly detect and manage post-partum hemorrhage.
• Knowledge and demonstrated skills to detect and promptly manage pre-eclampsia/ eclampsia.
• Early detection and management newborns with asphyxia, including resuscitation with bag and mask
• Demonstrated skills to provide respectful maternity care for women and newborns, including effective communication with women and families, emotional support and respect for the dignity and rights of women and newborns including consented care and absence of mistreatment (e.g. verbal abuse)

Key Tasks

• Actively participate in an IHP organized one-week training-of-trainers’ competencies standardization workshop.
• Work with IHP to develop Operational Training Plan (as per the deliverable requirements below). Work closely with the technical IHP staff (RMNH/FP technical lead, State Technical Directors, Integrated PHC Advisors, Integrated Supportive Supervision and Quality Improvement Specialists) to develop the Operational Training Plan and any follow-on support.
• Use the IHP training preparation checklist to support advance preparation for the training
• In conjunction with IHP conduct an advance visit to clinical training site the day before the training.
• Set up simulation stations as required for the training.
• Facilitate the clinical skills training using ‘hands-on’, interactive, competency-based, training approaches and methodology.
• Identify a peer practice coordinator (a high performing participant in each health facility) and orient this person to provide continuing post-training support in each facility.
• Administer pre and post knowledge, questionnaire, and skills’ assessment to assess knowledge and skills of learners before and after the training.
• Carry out any other related tasks that may be necessary to facilitate the training activity and delivering high-quality training.
• Knowledge and skills scope of training
• Provision of Respectful maternity care during antenatal, intrapartum, and postnatal periods.
• Immediate recognition and management of neonates with asphyxia, including resuscitation with bag and mask
• Early detection and management of pre-eclampsia/eclampsia during antenatal, intrapartum and postnatal period, including evidence-based clinical decision-making based on severity of PE/E, health status of woman and fetus and gestational age, with use of parenteral anticonvulsants and timely delivery for women with severe pre-eclampsia or eclampsia
• Evidence-based safe caesarean and caesarean emergency hysterectomy including pre and post-operative care, team-based intrapartum care and appropriate surgical technique:
  • Pre-operative preparation
  • Caesarean Section
  • Caesarean hysterectomy
  • Post-operative care

Early detection and prompt management of Pre-eclampsia/eclampsia including:

• Assessment and management of PE/E risk factors during ANC (e.g. chronic and gestational hypertension, diabetes, anemia, obesity).
• Prompt recognition of PE/E symptoms and appropriate diagnosis of PE/E severity based on health status of woman and fetus, during the antenatal, intrapartum, and postnatal period.
• Appropriate management of PE/E based on maternal and foetal status and gestational age.
• Provision of parenteral Magnesium Sulphate for severe PE/E and eclampsia and timely delivery of pregnant women with severe PE/E and unstable status.

Prevention and Management of post-partum hemorrhage including:

• Provision of high-quality ANC services, including assessment and control of anemia and other preventable risk factors for PPH.
• Active management of 3rd stage of labor (prophylactic uterotonic immediately after delivery).
• Non-pneumatic Anti-shock garment.
• Bimanual uterine compression (Internal and external).
• Repair of genital lacerations.
• B-Lynch suture.
• Emergency hysterectomy (uncontrolled PPH despite all other measures).

IHP Responsibilities:

• IHP will provide a training curriculum and learning resource package, including agenda, power point presentations, checklists, pre- and post-tests, anatomical models, and simulation exercises.
• IHP in collaboration with State Ministry of Health will identify trainees at the selected health facilities in advance of the training.
• IHP will provide a training of trainers to standardize skills of selected expert trainers and familiarize trainers with learning materials.

Required Qualifications

• Registered and practicing Obstetrician/Gynecologist with at least 5 years post-qualification working experience.
• Previous and ongoing provision of CEmONC services in a facility.
• Previous experience conducting CEmONC training especially within the last 24 months or a current faculty member/trainer in an obstetrics residency training program.
• Up-to-date annual practicing license with Medical and Dental Council of Nigeria.
• Strong coaching, mentoring and facilitation skills.
• Strong analytical and communication skills.