Position: Medical Program and Nursing Coordinator

Start date: Winter/Spring 2016

Reporting to: Medical Director

Background

PIVOT’s mission is to combine accessible and comprehensivehealth care services with rigorous scientific researchto save lives and break cycles of poverty and disease.

As one of the ten poorest countries in the world with among the most under-resourced health systems, Madagascar suffers from an unjust burden of disease. PIVOT works in direct collaboration with the Madagascar Ministry of Health to enhance healthcare delivery at the community, health center and hospital levels. In addition to providing direct health care services, PIVOT engages in poverty alleviation initiatives, conducts monitoring and evaluation of health systems strengthening (HSS) activities, and supports research. The HSS efforts led by PIVOT aim to directly relieve unnecessary suffering and death among the population near Ranomafana National Park and to serve as a model for national scale up. The organization is partnered with and modeled after Boston-based NGO, Partners In Health, which implements similar projects in twelve countries.

Launched in January 2014, PIVOT now has a staff of more than 80 employees in the Ranomafana office (currently including seven expatriate staff members) and five in the Boston office. The leadership team is made up of 3 directors and an additional 10 managers. Ifanadiana district has one district hospital and 19 health centers of which PIVOT currently supports 4 and aims to support all 19 within the next 3-5 years. The annual operating budget is $3.5M including the research-granting arm of the organization. Ranomafana is an 11-hour drive from the capital, Tana, and 1.5 hours from Madagascar’s forth-largest city, Fianarantsoa. PIVOT’s office operates in French with the local employees speaking both French and Malagasy.

Position Description

The Medical Program and Nursing Coordinator is a new position created to serve as right-hand person to the Medical Director. The Medical Director oversees implementation of all clinical programs. PIVOT’s programs and activities to date have included: 1) establishing an ambulance network with four ambulances and ambulance nurses, 2) reimbursing pharmaceuticals and supplies for patients at health centers and hospitals, 3) providing health center renovations and hygiene and waste management systems, 4) providing direct patient care in the health centers and at the district hospital, 5) financing and conducting trainings and follow-up supervisions on pediatric, adult, emergency, and maternal health topics, 5) working with partner organizations such as UNFPA and USAID to improve the health care of the district, 6) coordinating patient care with global health organizations such as Mercy Ships, Medecins du Monde and Operation Smile, 7) social work programs to decrease economic, social and cultural barriers to health care, 8) a comprehensive malnutrition programat the health center, hospital and community level and 9) a community health program. The clinical teams are grouped around those elements of the health system as follows:

  1. Community health: Beginning in October, PIVOT nurses, midwives and doctors supervise, train, equip and work alongside a government network of community health workers. We have conducted a thoroughbaseline needs assessment with the nurse supervisors going on multiple-week expeditions to gather the necessary information and team to launch this community work.
  1. CSB (health centers):PIVOT currently supports 4 of the district’s 19 health centers by providing additional clinical support, reimbursing medicines and supplies at the patient level, training PIVOT and Ministry of Health staff and renovating the facilities. We intend to draft a “health center package” that lays out the timeline and plans for the model intervention we will roll out in the additional 15 health centers (all more remote than our first 4).
  1. CHRD (district hospital):PIVOT currently supports the district hospital with clinical staff, infrastructure support, an ambulance network, payment of all hospital medical care for each patient, and supplies and equipment as needed. We are working on a comprehensive plan to transform the CHRD into a dignified, life-saving facility and have begun work on initial components of the plan.
  1. CHU (university hospital) and beyond: When patients need care that cannot currently be provided in our district, they are referred tothe University Hospital 1.5 hours away in Fianarantsoa. PIVOT provides ambulance transport, payment for all hospital medical costs, and provision of food and lodging for family members. At any given time we average 20-25 patients hospitalized as “PIVOT patients” at the CHU. When needs are greater than CHU can meet or an opportunity such as Mercy Ship or a medical brigade is present, PIVOT coordinates care farther afield to the capital Antananarivo and beyond.
  2. Ambulance Network: PIVOT provides free emergency transfer of patients with a PIVOT ambulance system and PIVOT ambulance nurses to transport patients from the community to the health facilities and between health facilities.

The Medical Director is supported with two Malagasy physicians and one Malagasy nurse manager via teams that are well organized with additional nurses and midwives on each (16 total clinical team members currently). A strong Madagascar and US-based advisory network provides remote support to the Medical Director on clinical protocols, training and workshops, clinical program development and other topics. The Medical Program and Nursing Coordinator position is being created to offer the Medical Director the missing on the ground support in the following manner:

  • Direct support to Medical Director in implementation of clinical programs
  • Programmatic support to clinical teams
  • Training support to clinical team
  • Accessing remote support from advisory network
  • Other as needed

Qualifications and competencies

  • Professional working French (required) and English (preferred)
  • Nurse Practitioner (NP) degree or Registered Nurse (RN) degree
  • Relevant professional experience preferably within a health or development setting, in international projects, with demonstrated progressive management responsibility
  • Ability to follow through on work plans
  • Ingenuity and problem solving approach
  • Proven team builder
  • Flexibility (as things change quickly and job descriptions evolve over time)
  • Sense of humor and positive attitude
  • Commitment to working in solidarity alongside the rural poor

Employment details

  • 6 weeks annual vacation in addition to sick time and public holidays
  • 6 months housing after which employee is responsibility for finding housing in the community
  • Annual home leave plane ticket
  • Salary based on PIVOT international salary scale and available upon request
  • Minimum commitment of 2 years

To apply

  • Please submit your CV and cover letter to
  • Application deadline is January 31, 2016
  • Email subject should be Medical Program and Nursing Coordinator
  • Applications without a separate attached cover letter will be disregarded
  • Please share how you found the job posting in the text of your email