Sierra Leone has the highest maternal mortality in the world estimated at 1165/100.000 live births before the Ebola outbreak according to Sierra Leone Demographic Health survey (SLDHS, 2013).
Recent estimations - based on the loss of health care workers following Ebola - project a rise of maternal mortality to 1900/100.000 live births. Maternal death account for 36% of death of women aged 15 - 49 years in Sierra Leone (D. Evans et al, 2015).
Likewise, the under 5 mortality –rate was estimated at 156/1000 live births before the Ebola outbreak (SLDHS, 2013). It is among the highest in the world and projected to increase to 191/1000 live births as a consequence of the Ebola outbreak (UN, 2015). Furthermore, severe acute malnutrition of 5.3% and general acute malnutrition of 20.9% were shown in a district wide MUAC screening conducted in Kenema district (April 2015).
The rationale for MSF OCB to intervene in Kenema/ Sierra Leone
• Sierra Leone has among the highest child and maternal mortality rates in the world.
• Sierra Leone faces a critical shortage in human resources for health (in quantity and quality); which was further worsened by the Ebola outbreak causing many losses of life amongst the health workers.
• Operational interest of MSF OCB to work in Kenema district - a Lassa endemic region – to continue building knowledge and experience in Lassa (VHF) management and the ability to respond in case of emergencies/outbreaks.
The main objective of the MSF OCB project in Kenema (composed by a hospital and a primary care component) is to reduce child and maternal mortality. To achieve this, 2 specific objectives have been identified with equal importance:
• To provide safe quality pediatric and obstetric care complementary to existing services at Kenema Government Hospital.
• To contribute to the development of the health work force competencies
Description of the project
The MSF Kenema Emergency Pediatric Hospital opened its doors in Kenema District, Sierra Leone on the 6th March 2019. There are currently 2 wards of 35 beds in total to treat acutely malnourished children, 20 beds for non-malnourished children, an 8-bed intensive care unit (ICU) for both non-malnourished and malnourished children and a 4-bed ward to test and support suspected lassa patients. The next phase of development of this hospital will be to expand the ICU and pediatric wards and the final stage will be to open a maternity unit with an accompanying neonatal unit. The hospital monthly average admission is 150 patients with a sharp increase during the malaria season up to 400 admissions per month.
As part of the same project, there are extensive community-based activities and follow-up of patients; as well as assessing needs and gaps in local Ministry of Health (MoH) health facilities to see if MSF can support these.
This hospital, as well as serving the vital needs of the pediatric population in this area, will also act as a training centre for both national and international staff with intensive support from the MSF Academy for Health. Furthermore, it also has the intention in the long term to be a centre for innovation in clinical practice and research.
One of these innovations is to introduce and then create a sustainable play therapy program for the patients and their caretakers. This program can then hopefully be rolled out in other MSF projects (after being adapted to context).
Main objectives of the Play therapy program
The “ART and PLAY THERAPY for children in MSF hospitals” program’s main goal will be to provide therapeutic play activities and foster play sessions to children and their families and to raise the general awareness and appreciation of the importance of play to a child’s development and recovery.
Purpose of the Play Therapist post
The objectives of the Play Therapist will be to:
• design and pilot a high-quality program of normal and therapeutic play activities for children in both inpatient and outpatient settings, which can then be rolled out in all appropriate MSF OCB projects.
• define, coordinate and monitor the activities of the Play Therapy program including management f staff, ensuring the quality of care and the provision of the most appropriate support to the atients.
• organize and facilitate trainings and technical supervision of staff involved in play activities and educate teams about the benefit of play therapy in the care of children
Play Therapy Program Design.
• Design, and implement an evidence-based program of normal and therapeutic play activities for children in both inpatient and outpatient settings within MSF OCB projects. The program must be designed to be realistically implemented by national staff in a wide-range of projects. It must also have enough flexibility to be adapted to the cultural context and have guidance on how to do this adaption.
• Create written/audio-visual resources to support the program implementation in collaboration with appropriate people from HQ, coordination and project level.
• Contribute to producing performance indicators and a method of documenting the performance of the program(likely operational research) so that the program can be improved upon and potentially rolled out in all appropriate OCB projects
• Implement and coordinate a play therapy program of activities (individual and group sessions) in the project by proposing an intervention strategy adapted to children’s needs, their psychological status, emotions, age and culture.
• Propose and provide technical guidance regarding the space, play equipment and material necessary to perform play activities, (purchase of toys and games, toy making, define spaces….).
• Ensure play equipment provision in all areas are appropriate to the child’s age and development, complying with safety standards.
• Supervise and train project staff so that they can provide therapeutic play interventions for children whilst in hospital (and potentially outpatient settings) so as to help development, express emotions, process stress, alleviate anxiety and fear.
• Organise play activities in the wards and outpatient departments (and in a play area, if available).
• Advise and support parents and caretakers in play needs of children in hospital.
• Participate in the pre-admission preparation of children, thereby reducing the fear and anxiety of hospitalisation.
• Prepare children medical procedures (e.g. IV cannula insertion, naso-gastic tube insertion, etc).
• Attend and offer information when needed for discharge planning meetings and case conferences.
• Ensure all reusable toys are cleaned regularly and cleaning documented to ensure compliance with MSF IPC guidance.
• Communicate with and participate as a member of the multidisciplinary team (including medical and HP) in the total care of children, advising on play and communication with children.
• Ensure good communications are upheld between staff and children, and their families; as well as staff and visitors.
• Produce an analysis report of this pilot project with recommendations for further iterations
• Specific degree or certification as Play Therapist/Child Life Specialist or masters level degree in psychology with a particular focus on play therapy/paediatric psychology
• Experience as Play therapist/Child Life Specialist for at least 2 years.
• MSF experience preferable
• Experience implementing pedagogical methods in collaboration with medical staff
• If possible; experience from living/working in countries where resources are limited and where a creative mind-set is necessary. Experience mentoring and training different cadres of staff
• People Management and Development
• Commitment to MSF Principles
• Behavioral Flexibility
• Results and Quality Orientation
• Teamwork and Cooperation
• Fluency in English (reading, writing, speaking)
• Expected starting date: 4 May 2020.
• 12months fixed-term field contract, based in Kenema, Sierra Leone.
• Salary according to MSF-OCB Field salary scale. Transport, accommodation, vaccinations are taken in charge by MSF. Per diem + medical insurance.
• Adhere to the MSF principles and to our managerial values: Respect, Transparency, Integrity, Accountability, Trust and Empowerment.
• Adhere to the MSF Behavioral Commitments .
• No family position.
• A dynamic and stimulating work environment alongside multicultural colleagues
How to apply
Application (CV + cover letter) to be sent before the 14th of March 2020, to firstname.lastname@example.org while mentioning “Play Therapist” in the subject of your email.
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