Madagascar: Clinical Team Leader (Madagascar)

Organizational Profile

PIVOT (www.pivotworks.org), a global healthcare NGO launched in January 2014, has established a health system strengthening (HSS) effort in rural Madagascar to support the existing public health system and aims to serve as a model for health system strengthening for the rest of the country. Eleven hours from the capital by car, PIVOT works in the Ifanadiana district, adjacent to Ranomafana National Park with a catchment area of nearly 200,000 people, more than 75 percent of whom live in extreme poverty. PIVOT collaborates directly with the Madagascar Ministry of Health (MoH) to strengthen a district hospital, 20 health centers, and community health programs. PIVOT also benefits from strategic partnerships from mission partner Partners in Health, Centre ValBio, Stanford University, Stony Brook University and Harvard Medical School. In addition to strengthening the public health system, PIVOT conducts monitoring and evaluation and supports research. Currently PIVOT is a 140-person organization with 8 international staff in Madagascar, and a United States based headquarters.

Job Description Overview

PIVOT provides a combination of direct patient care and health systems strengthening programs at the community, health center and hospital level. PIVOT’s clinical staff consists of a team of Malagasy physicians, midwives, nurses and pharmacists, as well as social workers, ambulance drivers, and a handful of expatriate clinicians. The PIVOT clinical teams work side-by-side with Malagasy MoH health staff.

The Clinical Team Leader is expected to improve quality of clinical care through excellent patient care, supportive mentorship, design of program and clinical protocols, and educational initiatives. S/he will work closely with, and under the umbrella of, the Medical Program Coordinator, to help improve the medical programs. S/he will work directly with the hospital, health center and community PIVOT medical teams, referral and social workers, as well as MoH staff in all three levels of intervention:

Hospital: PIVOT is working with MoH partners to transform the district hospital into a dignified, life-saving facility by improving the quality of staffing, equipment, facilities, and training on procedures and processes. With this strong collaboration, the district hospital has recently inaugurated a new laboratory and upgraded emergency services. Plans for 2017 include inpatient malnutrition treatment and improving care for patients with tuberculosis.

Health Center: PIVOT supports 20 health centers in Ifanadiana District through medication reimbursement, training, infrastructure and personnel. In several key health centers, PIVOT staff directly support malnutrition and other clinical programming. In 2017, Pivot will work to improve screening, referral and treatment of patients with tuberculosis at the health center level.

Community: PIVOT supports networks of community health workers who serve as liaisons between the rural villages and the health centers, often more than a day’s walk for our patients. Our community teams train the nationally mandated, locally selected community volunteers, provide supplies and support their relationships with the health system. Pivot’s community activities include community IMCI for patients under 5 years old, urgent direct patient care and screening and referral for tuberculosis.

Referral system and ambulance network: One of the first of PIVOT’s clinical programs was the establishment of an ambulance referral system for the first time in Ifanadiana District. Currently the 3-ambulance system moves patients in critical need from the community to the health center or from the health center to the hospital. A key aspect of the Clinical Team Leader’s role will be to improve patient flow and communication between the community, health center and hospital levels.

Responsibilities:

• Serve as a clinician. The first responsibility of the Clinical Team Leader is to be a strong, compassionate, and committed physician, spending substantial time working alongside other clinical staff at District Hospital and Health Centers
• Serve as a mentor and support to PIVOT and Ministry of Health clinicians, including Malagasy clinical teams (both PIVOT and MoH), medical students, residents, and volunteers from the international medical community. The Clinical Team Leader should demonstrate through action and teaching, spending a high percentage of his/her time in the field.
• Support training and educational initiatives: PIVOT supports training initiatives at the district level. The Clinical Team Leader will work with PIVOT and MoH staff to design and implement quality training programs. The Clinical Team Leader will also be responsible for implementing didactic training and structural bedside supervision of clinical staff.
• Ensure Quality of Care of clinical services by conducting regular assessment at health facilities, supporting elaboration and analysis of the monthly reports of the clinical team, and designing with the Medical Program Coordinator a quality improvement plan.
• Provide input in the design of medical programs and clinical protocols: PIVOT supports MoH protocols in most cases. However, there are many areas in which there are no existing MoH clinical protocols (for example, management of epilepsy in children); the Clinical Team Leader will thus be expected to create and implement clinical protocols.
• Participate in the planning of activities and adjustments of the Action Plan. The Clinical Team Leader will work closely with PIVOT’s National Director, Medical Program Coordinator and the other team members on the Action Plan with an emphasis on expanding to new clinical areas, increasing the geographical reach and improving the integration of PIVOT activities into MoH activities.

Qualifications:

• Medical Degree. The Clinical Team Leader must be a doctor.
• At least three years of clinical experience in a resource-poor international setting similar to the working conditions in Ifanadiana.
• French and English language proficiency required including reading, writing and conversing. The office operates in French and interactions with headquarters-based staff are in English.
• Malagasy language ability considered an extraordinary asset, as is any substantial experience in Madagascar or working with the Malagasy public health system.
• Long-term commitment to living and working in rural Madagascar- minimum of two years. The role requires relocation to Ranomafana full-time.
• Experience as a relationship builder. The Clinical Team Leader will be perceived as the organization’s clinical leader. Thus, a substantial component of the position is to build relationships across a broad spectrum – most essential is building a well-working, committed, and supported team. Also essential is a strong collaborative relationship with the MoH on clinical program implementation.
• Ability to oversee work in multiple domains. The Clinical Team Leader is a doctor as well as a leader for setting direction and delivering results across multiple programs. This requires regular meetings and accompaniment with the medical team.
• Demonstrated commitment to global health and social justice. It is critically important that the Clinical Team Leader believes strongly in the work we do, advocates on behalf of our patients, and truly enjoys working to fulfill the PIVOT mission.

This is an excellent opportunity for a dynamic, driven and passionate individual to be part of an exciting global health organization that links access to quality health care to research in an ecologically important context.

Please submit your CV and letter of interest to jobs@pivotworks.org before March 15, 2017. Applications will be reviewed and interviews scheduled on a rolling basis. Please refer to the job title in the title of your email.

For more information on PIVOT, please visit our website at www.pivotworks.org.