Pediatric Clinical Mentor At PIVOT

Title: Pediatric Clinical Mentor

Reports To: Manager of Child and Adolescent Health

Location: Ranomafana, Madagascar

Percentage Effort: Full-time

Key Words: Global health, clinical mentorship, health system strengthening

Start Date: August to October 2021, flexible to candidate availability

Expected Commitment: 1 year

Organizational Profile

PIVOT (www.pivotworks.org) is a global health care NGO guided by the principle that all people have intrinsic worth and deserve to live healthy and productive lives. As a social justice organization working in a setting of extreme poverty and disease, PIVOT’s core objective is to address social inequity by advancing universal access to quality healthcare, while working within the government health care system to create a model for district health care that can be used across the country of Madagascar. Since 2014, PIVOT has partnered with the government of Madagascar to strengthen the health system and create a model health district in Ifanadiana district, adjacent to Ranomafana National Park and 11 hours from the capital. The district has a catchment area of 200,000 people, more than 75 percent of whom live in extreme poverty. In its initial years, PIVOT had largely focused on the 6 most accessible communes in the district. The primary objective for 2021 is to ensure the expansion of PIVOT programs to all areas of the district regardless of accessibility.

PIVOT collaborates directly with the Madagascar Ministry of Public Health (MoPH) to strengthen a district hospital, 22 health centers, and community health programs. The model is advanced across three major components: 1) facility readiness (e.g. infrastructure, supply chain, personnel), 2 integrated clinical programs (e.g. maternal and child health, malnutrition, tuberculosis), and 3) data systems and research. Currently, PIVOT is a 225-person organization with 7 international staff in Madagascar, and a small support team based in the U.S.

Position Overview

• Work in a mentorship role for Malagasy clinicians (PIVOT and MOPH doctors, nurses and midwives) primarily at the primary health center level supporting continuous education (through informal and formal teaching) in pediatric care and transferring specialist knowledge and skills to effect long-term, sustainable improvements in the quality of care provided.
• Provide formal and informal training to PIVOT’s ‘equipe terrains.’ There are satellite teams of PIVOT nurses, midwives and social workers who act in a supporting role for distant primary health centers.
• Be a member of PIVOT’s ‘Cellule Clinique’ (a group of in-country senior clinicians) and be a key contributor to discussions around management of complex patients and how to optimize their care. As part of this role, the pediatric mentor is expected to act in a consultancy role for complex pediatric patients and be willing to be involved in their direct clinical care if needed. They are also expected to contribute to discussions around adult patient care as appropriate.
• Participate in multi-disciplinary discussions with a range of team members including, but not limited to, PIVOT’s social, sensitization, biomedical and pharmacy, and monitoring and evaluation teams, to improve the quality of pediatric care in the district.
• Support the implementation of PIVOT’s child and adolescent health program focusing on aspects related to the improvement of clinical care for children in primary health centers. Examples of projects might include (but are not limited to) health-worker education on how to examine children, improving the application of protocols on the Integrated Management of Childhood Illness (IMCI) and optimizing the management of neonatal and pediatric emergencies in health centers.
• Have the opportunity to contribute to the design and implementation of clinical programs and research projects relating to pediatric care in discussion with the manager for pediatric care and medical team leadership.

Key Relationships

• Reports directly to the PIVOT manager for child and adolescent health and is supported by the deputy director of primary care and the medical director as needed.
• Works closely with other members of the PIVOT medical team
• Should develop a working relationship with pediatric specialists at national tertiary centers and collaborate with national and international specialists to optimize and coordinate the management of complex patients.
• Mentors, advises and accompanies PIVOT and ministry health workers (primarily in primary health centers but also in the hospital).
• Partners with district-level Ministry of Public Health managers for child and adolescent health.

Qualifications

• M.D. required, as well as completion of residency training (at least 3 years of postgraduate training) in pediatrics.
• Experience with medical education and clinical program design, and deep commitment to mentorship.
• Professional French language proficiency required including reading, writing and conversing – proficiency in English considered a plus.
• Malagasy language ability is considered an extraordinary asset, as is any substantial experience in Madagascar or working with the Malagasy public health system.
• Demonstrated commitment to global health, social justice and working in solidarity with the rural poor. It is critically important to believe strongly in the work PIVOT does, to advocate on behalf of the patients, and truly enjoy working to fulfill the mission of the organization in accordance with our values.

Requirements

• Commitment to living and working in rural Madagascar with a willingness to travel to remote parts of the district where modern amenities are limited for at least one week at a time.
• A self-starter who is able to identify priorities for work and organize their time independently whilst also being an effective team member and asking for support when needed.
• Ability to embrace Malagasy culture and customs with the goal of mentoring other Malagasy and international staff on high-quality clinical care for infants and children.
• Embrace fully the “mentorship” and capacity building approach.
• Strong written and oral communication skills.
• Flexibility, patience, and ability to adapt to a rapidly changing environment and changing job needs over time.
• Ability to recognize their own limitations and seek help when it is needed.

Desirable assets

• Willingness to learn basic Malagasy to improve communication with patients and health workers.