CERVICAL CANCER & CLINICAL SERVICES MENTOR NURSES x3 – Zimbabwe Association Of Church-Related Hospitals (ZACH)

The main responsibilities for the CC nurse will be to provide cervical cancer screening for women living with HIV (WLHIV) as guided by the Ministry of Health and Child Care Strategic Plan. The responsibilities extend to include the treatment of precancerous lesions using cryotherapy and thermal ablation. In consultation with the client, the nurse will develop a treatment plan for each client that includes subsequent follow-up and necessary investigations. The nurse will be responsible for managing and reporting ALL adverse events experienced by the client during screening and treatment. In cases where the treatment goes beyond the scope of the nurses’ training and experience, he/she shall refer all clients to the next level of care and ensure that the client completes the referral by conducting the necessary follow-up. Adherence to the MOHCC and ZACH SOPs and guidelines shall be critical to ensure that all clients receive the best quality treatment and care.

Reporting:

Record and maintain the filing system for all client records as per MOHCC procedures
Prepare monthly report on services rendered for submission to supervisor
Report to the MOHCC RHO on monthly progress copying PTO and APTO
Routine feedback reports as required.
Location: Mashonaland East, Nhowe Mission Hospital & St Paul’s Musami; Mashonaland West, Sanyati Baptist Mission Hospital

DUTIES

Conduct cervical cancer screening for WLHIV aged 25-49 years using VIAC as per national guidelines:
Work with health care workers at the facility to identify HIV-positive women 25-49 years old for cervical cancer screening.
Counsel client on the benefits and potential side effects of cervical cancer screening so the client can give informed consent.
Register eligible clients in the electronic and paper-based registers before client is screened.
Conduct VIAC for each client in a safe, private, confidential and dignified environment for every client.
After screening the client, treat the client using the provided SOPs and algorithms.
The nurse will be expected to offer treatment to clients with STIs, cervicitis or genital ulcer disease incidentally diagnosed during the screening process. STI contact tracing to be conducted for clients found to be having STIs. Adherence to the STI treatment guidelines is of paramount importance.
In consultation with the client, the nurse will be responsible for drawing up a follow-up plan/schedule and book the client in the provided diary.

Conduct treatment for precancerous cervical cancer lesions:

For all clients who screen positive for precancerous lesions the nurse will provide treatment using cryotherapy or thermal ablation, depending on the availability of the treatment method.
For ALL patients with precancerous lesions, the nurse will be expected to use the see-and-treat approach to avoid missed opportunities.
Treat and monitor all clients for adverse events. It is the responsibility of the nurse to report all adverse events to the ZACH and MOHCC databases.
Clients with suspected invasive cancer shall be referred to the next level of care in consultation with the hospital doctor and/or mentor. The nurse shall be responsible for follow-up of the client and calling the receiving facility to ensure client completes referral. Documentation of the patient referral outcome shall also be done by the nurse.
Where applicable, the nurse shall be responsible for issuing client with suspected invasive cancer with biopsy and/or transport coupons in consultation with the supervisor.
Monitor and ensure availability of consumables and functional equipment with the support of the supervisor.

Outreach, community mobilisation, and demand creation:

Work with the health workers (Primary Counsellors, Village Health Workers, Community Referral Facilitators, nurses and Health Centre Committees etc.) at the health facility to sensitise and mobilise clients within the facility and community for cervical cancer screening.
Conduct outreach VIAC visits to screen women in hard-to-reach areas. In consultation with the District Health Executive (DHE) a schedule for outreach visits to identified sites should be developed and adhered to. The nurse should also compile a list of names for the outreach team and a duty roster developed as well.
Schedule follow-up visits for all clients screened and treated during outreach visits. Support identification of clients who are defaulting for tracking and tracing.

Strategic Information and Evaluation (SIE):

Registration of all clients screened for cervical cancer in provided standard MOHCC electronic and paper registers.
Record and maintain filing system for all client records as per MOHCC procedures.
Prepare monthly report on services rendered for submission to supervisor.
Using the relevant primary data sources the nurse will be responsible for timeously collecting, compiling and reporting to MOHCC and ZACH monthly.

Provide HIV Care and Psychosocial Support:

Facilitate linkage between HIV testing, diagnosis, care, support, and treatment.
Provide adherence counseling and initiate clients on ARV treatment.
Link and refer clients to facility and community-based Psychosocial Support Services.
Provide routine follow-up and monitoring of clients (including scheduling interpreting Viral Load and CD4 tests) and provide adherence support as per client’s result.

Qualifications and Experience

Minimum of a Registered General Nurse qualification with minimum 5 years post qualification in midwifery.
Any other relevant post-basic will be an added advantage.
VIAC training and experience are a must.
HIV Rapid testing qualification is a distinct advantage.
More than 5 years of progressive responsibility in HIV and AIDS programming.
Previous mobilizing Linkages, HIV testing and M&E experience, TB and VIAC experience is a distinct advantage.
Good standing with the community being served is a must.
Good interpersonal skills and ability to navigate through different cultures and religions during the execution of duties.

Policy compliance – Mandatory Reporting Policy (MRP)

Abide by and ensure any violations of the ZACH Child Protection Policy are disclosed and reported to the Executive Director. The reporting of violations is an obligation on the part of all staff members.

Confidentiality:

Ensure compliance with finance/admin/programme and other organisational policies at his/her level.
Ensure the non-disclosure of any information whatsoever relating to the practices and business of ZACH acquired in the course of duty, to any other person or organisation without authority, except in the normal execution of duty.
Note: All duties will be performed within an integrated system; i.e. HIV treatment and care, family planning, MCNH and cervical cancer services must be offered to the client under one roof where possible. Where not possible, it is the nurse’s responsibility to ensure that the client is linked to all the other services. The nurse might be asked to perform other duties that contribute to the achievement of the cervical cancer targets and improve the quality of care for the clients.