2. Purpose of the Position
The Midwife will provide essential maternal, newborn, and reproductive health services at the assigned project-supported health facility in Kunar Province. The position aims to improve the availability, accessibility, safety, and quality of maternal and neonatal healthcare in accordance with Afghanistan Ministry of Public Health (MoPH) standards, the Basic Package of Health Services (BPHS), approved clinical protocols, and HDDO policies.
The Midwife will deliver antenatal care (ANC), postnatal care (PNC), safe delivery services within the facility's approved service capacity, family planning counseling, newborn care, identification of obstetric and neonatal danger signs, and timely referral of complicated cases. The Midwife will also maintain accurate patient records, support the Medical Doctor and other health personnel, promote infection prevention and control, and contribute to improved maternal and newborn health outcomes.
3. Key Responsibilities
3.1. Maternal Health Services
- Provide routine antenatal care to pregnant women in accordance with approved MoPH guidelines and clinical protocols.
- Assess maternal health status, monitor pregnancy progress, and identify potential risk factors and complications.
- Provide counseling on nutrition, personal hygiene, birth preparedness, danger signs during pregnancy, and the importance of skilled birth attendance.
- Develop and communicate appropriate follow-up plans for pregnant women according to clinical needs and established protocols.
- Identify high-risk pregnancies and ensure timely consultation with the Medical Doctor or referral to an appropriate higher-level facility.
- Maintain accurate and confidential antenatal care records and registers.
3.2. Safe Delivery and Intrapartum Care
- Provide skilled delivery care within the scope of professional competence, facility capacity, and approved clinical protocols.
- Monitor the progress of labor and assess maternal and fetal well-being using approved methods.
- Recognize complications and obstetric danger signs, including prolonged or obstructed labor, severe bleeding, hypertensive emergencies, and signs of fetal distress.
- Initiate appropriate first-line emergency measures within the Midwife's competence while arranging urgent medical assistance and referral when required.
- Follow established infection prevention and control procedures during labor, delivery, and immediate postpartum care.
- Provide immediate newborn care and assess newborn condition in accordance with approved protocols.
- Ensure that necessary delivery documentation is completed accurately and promptly.
- Support respectful maternity care, protecting women's dignity, privacy, informed choice, and confidentiality.
3.3. Postnatal and Newborn Care
- Provide postnatal assessments and care for mothers following delivery in accordance with national guidelines.
- Monitor mothers for postpartum complications, including excessive bleeding, infection, and other danger signs.
- Assess newborn health, identify signs of illness or distress, and arrange timely referral when indicated.
- Counsel mothers and caregivers on breastfeeding, thermal care, newborn hygiene, cord care, immunization, and recognition of newborn danger signs.
- Promote early and exclusive breastfeeding in line with approved national guidance.
- Encourage timely postnatal follow-up for mothers and newborns.
- Record postnatal and newborn care services in the appropriate registers and patient files.
- Coordinate with the Medical Doctor and other relevant health personnel to ensure continuity of maternal and newborn care.
3.4. Family Planning and Reproductive Health
- Provide accurate, respectful, and confidential family planning information and counseling.
- Explain available contraceptive methods, including their benefits, limitations, and potential side effects, in accordance with national guidelines and available services.
- Provide family planning services only within the Midwife's authorized scope of practice and documented competency.
- Support informed and voluntary decision-making without coercion or discrimination.
- Identify reproductive health concerns requiring additional assessment and refer clients to appropriate services.
- Promote birth spacing and awareness of available maternal and reproductive health services.
- Maintain confidential family planning and reproductive health records.
- Ensure that all reproductive health services are provided in a culturally appropriate and respectful manner.
3.5. Emergency Obstetric and Newborn Care
- Recognize maternal and newborn danger signs requiring immediate clinical intervention.
- Provide initial emergency assessment and stabilization within professional competence and approved protocols.
- Coordinate promptly with the Medical Doctor and other qualified health personnel when emergencies arise.
- Arrange timely referrals for complicated pregnancies, obstructed labor, severe bleeding, hypertensive emergencies, newborn complications, and other conditions beyond the facility's capacity.
- Communicate essential clinical information to the receiving facility and referral team.
- Document emergency assessments, interventions, referrals, and follow-up actions.
- Ensure that referral decisions prioritize patient safety and are not unnecessarily delayed by administrative procedures.
- Participate in emergency preparedness activities and clinical drills when organized by HDDO or the health facility.
3.6. Health Education and Community Engagement
- Provide individual and group health education sessions on maternal, newborn, and reproductive health.
- Educate pregnant women and caregivers about pregnancy danger signs, safe delivery, postpartum care, newborn health, breastfeeding, nutrition, and family planning.
- Promote timely attendance at antenatal and postnatal appointments.
- Encourage families to seek qualified medical care promptly when maternal or newborn danger signs occur.
- Support community awareness activities organized by the project and coordinate with community health workers where applicable.
- Address questions and concerns respectfully, using language and communication methods that community members can understand.
- Promote inclusive access to maternal health services for women and girls, including persons with disabilities and other vulnerable groups.
- Collect and communicate community feedback and service-access barriers through established HDDO mechanisms.
3.7. Clinical Quality and Patient Safety
- Deliver services in accordance with MoPH guidelines, BPHS standards, approved clinical protocols, and professional ethical requirements.
- Maintain respectful, non-discriminatory, patient-centered care at all times.
- Obtain informed consent where required and explain procedures and care options in an understandable manner.
- Protect patients' privacy and confidentiality during consultations, examinations, childbirth, and recordkeeping.
- Apply infection prevention and control measures, including hand hygiene, appropriate use of personal protective equipment, safe handling of sharps, and proper waste segregation.
- Ensure the safe handling, cleaning, and use of clinical equipment and delivery materials.
- Report clinical incidents, near misses, and patient-safety concerns through established facility procedures.
- Participate in supportive supervision, case reviews, clinical meetings, and quality-improvement activities as required.
- Identify service-delivery gaps and communicate recommendations to the Medical Doctor or designated supervisor.
3.8. Coordination with Medical and Health Facility Staff
- Work closely with the Medical Doctor, nurses, vaccinators, nutrition personnel, and other assigned health facility staff.
- Support coordinated care for pregnant women, postpartum mothers, newborns, and clients requiring additional health services.
- Share relevant patient information with authorized healthcare providers when necessary for continuity of care, while maintaining confidentiality.
- Participate in health facility meetings, case discussions, and coordination activities.
- Communicate supply shortages, equipment problems, staffing concerns, and service-delivery challenges to the designated supervisor.
- Support the implementation of agreed clinical action points and recommendations from supervision visits.
- Coordinate with relevant referral facilities and service providers to facilitate continuity of care.
3.9. Patient Records, HMIS, and Reporting
- Maintain accurate, complete, legible, and timely maternal, newborn, and reproductive health records.
- Complete ANC, delivery, PNC, family planning, referral, and other applicable registers and forms.
- Record service statistics in accordance with MoPH Health Management Information System (HMIS) requirements and approved project reporting formats.
- Prepare routine activity summaries and submit reports to the designated supervisor within established deadlines.
- Check records for completeness and consistency before submitting monthly statistics.
- Support authorized data verification, routine monitoring, and data-quality assessments.
- Correct identified documentation errors in accordance with approved procedures while preserving the integrity of the original records.
- Protect patient files and electronic records from unauthorized access, disclosure, loss, or misuse.
- Provide accurate service data for project monitoring and donor reporting through authorized channels.
3.10. Referral and Follow-up
- Identify patients requiring services beyond the capacity or scope of the assigned health facility.
- Explain the reason for referral to the patient and, where appropriate, the accompanying caregiver.
- Complete referral forms and communicate relevant clinical information to the receiving facility.
- Coordinate with the Medical Doctor and designated project staff to facilitate timely referrals.
- Maintain referral records and document follow-up outcomes where information is available and follow-up is appropriate.
- Respect patient confidentiality and obtain consent for information-sharing in accordance with applicable procedures.
- Escalate barriers to referral, including transport, access, or communication difficulties, to the designated supervisor.
3.11. Accountability to Affected Populations
- Treat all patients and community members with dignity, respect, fairness, and professionalism.
- Explain available services, eligibility criteria, and limitations clearly to patients and caregivers.
- Ensure that services are provided without discrimination based on gender, disability, ethnicity, displacement status, economic circumstances, or other protected or vulnerable status.
- Inform patients about available feedback and complaints channels.
- Receive concerns respectfully and refer complaints through HDDO's established Community Feedback and Complaints Mechanism (CFCM/CRM).
- Never promise assistance, services, or benefits beyond the approved project scope.
- Support community trust by maintaining professional boundaries and communicating honestly about available services.
3.12. Safeguarding, PSEA, and Professional Conduct
- Comply with HDDO's Code of Conduct, safeguarding policies, and Prevention of Sexual Exploitation and Abuse (PSEA) requirements.
- Maintain appropriate professional boundaries with patients, caregivers, colleagues, and community members.
- Never engage in sexual exploitation, abuse, harassment, discrimination, intimidation, or any form of misconduct.
- Never request money, gifts, favors, or other benefits in exchange for healthcare services or preferential treatment.
- Report safeguarding concerns through designated HDDO reporting channels in accordance with organizational procedures.
- Protect children and vulnerable adults from harm and ensure that interactions are consistent with safeguarding requirements.
- Respect patient confidentiality and handle sensitive information responsibly.
- Participate in mandatory safeguarding, PSEA, infection prevention, and other relevant training
4. Key Deliverables
The Midwife is expected to contribute to the following deliverables throughout the nine-month implementation period:
- Maternal health services: Timely and appropriate antenatal care provided to eligible pregnant women in accordance with national guidelines.
- Safe delivery services: Quality delivery care provided within the facility's capacity and the Midwife's authorized scope of practice.
- Postnatal care: Appropriate postnatal assessments and counseling provided to mothers and newborns.
- Family planning services: Accurate, voluntary, and confidential reproductive health information and services delivered within approved competencies.
- Emergency identification and referral: Obstetric and neonatal complications identified promptly, with appropriate initial management and timely referral.
- Health education: Regular maternal, newborn, and reproductive health counseling conducted for patients and caregivers.
- Complete documentation: Patient files, clinical registers, referral records, and applicable HMIS forms maintained accurately and on time.
- Routine reporting: Required service statistics and activity reports submitted within established deadlines.
- Clinical quality and infection prevention: Compliance with approved clinical protocols, infection prevention standards, and patient-safety procedures.
- Coordination and follow-up: Effective collaboration with the Medical Doctor and other health facility personnel to support continuity of care.
- Patient accountability: Patient feedback and complaints handled or referred through approved organizational mechanisms.
- Safeguarding compliance: Full adherence to HDDO policies, professional ethics, confidentiality, and PSEA requirements.
