Cervical Cancer Nurse: Zimbabwe Health Interventions (ZHI)

Deadline: 15 October 2021

Location: Buhera, Chipinge, Makoni, Mutasa, Mutare, Kwekwe, Gweru, Mberengwa, Gokwe South

Type of Contract: Fixed Term Contract

About

Zimbabwe Health Interventions is a not for profit human development organisation which is registered as a Trust under the Zimbabwe Deeds Registries Act (Chapter 20:05). ZHI’s mission is to develop and deliver innovative and sustainable high impact integrated health interventions with local communities while working with and strengthening existing institutions.

Basic function

The Cervical Cancer Nurse (CCN) will be responsible for the implementation of high-quality cervical cancer services to increase access to screening and treatment services for women living with HIV. S/He will be seconded to cervical cancer or VIAC (Visual Inspection with Acetic acid and Cervicography) clinics within designated public health care facilities. The CNN will work at a heath facility under the guidance and technical supervision of the health facility leadership team and directly reporting to the designate District Cervical Cancer Officer The responsibilities include but not limited to providing cervical cancer screening for women living with HIV (WLHIV), treatment of precancerous lesions using cryotherapy and thermal ablation, design treatment plans, referrals and managing client condition during screening and treatment as guided by the MoHCC SOPs and guidelines.

Job description

1. Conduct cervical cancer screening and treatment of precancerous lesions for women living with HIV (WLHIV) between the ages of 25-65 years per national guidelines; Work with the health care workers at the health facility to identify HIV positive women between the ages of 25-65 years for cervical cancer screening; Register eligible clients in the electronic and paper-based registers before client is screened; Counsel client on the benefits and potential side events of cervical cancer screening so that client can give informed consent; Expansion of same day/fast track cervical cancer screening and treatment of pre-invasive lesion services in high volume antiretroviral treatment clinics in alignment with the algorithm for cervical cancer screening approach in PEPFAR programs; Conduct VIAC for each client in a safe, private, confidential and dignified environment for every client; After screening client, treat client using the provided SOPs and algorithms; track and re-screen WLHIV with negative cervical cancer screening results every two years in order to closely monitor outcomes in the context of HIV-related immunosuppression; The nurse will be expected to offer treatment to clients with STIs, cervicitis or genital ulcer disease incidentally diagnosed during the screening process. Adherence to the STIs 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.

2.Conduct treatment for precancerous cervical cancer lesions; For clients who screen positive for pre-cancerous lesions the nurse will provide treatment using cryotherapy or thermal ablation, depending on availability of treatment method; For ALL clients with precancerous lesions, the nurse will be expected to use treat and see 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 FHI360 and MoHCC databases; Ensure referral of women with ablative-ineligible lesions for LEEP (when applicable); women with suspected cervical cancer should be referred for additional evaluation and treatment at established referral sites in the country that are identified during the planning process; 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 will be responsible for following 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;

3. Outreach, community mobilisation and demand creation; Conduct educational awareness within facilities and community groups to enhance accurate sensitization to cervical cancer and the necessity of screening and treatment among WLHIV; link clients with unknown HIV status who present with cervical cancer to HIV testing services and follow-on care and treatment if positive for HIV; Demand creation for cervical cancer screening for women living with HIV, targeting WLHIV between 25-65 years, particularly leveraging on existing community and facility-based activities, and engaging members of the target audience in the development of appropriate messaging; 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 CC nurse will 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;

4. Strategic Information and Evaluation (SIE); Registration of all clients screened for cervical cancer in the 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 FHI360 Facilitate linkage between HIV testing, diagnosis, care, support and treatment; Provide adherence counselling 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 to clients issued with results; All the duties will be performed within an integrated system; i.e. HIV care and treatment, family planning and cervical cancer services must be offered to the client under one roof where possible. Where not possible, it is the CC nurse’s responsibility to ensure that the client is linked to all the other services as required; The nurse might be asked to perform other duties that contribute to the achievement of cervical cancer targets and improve the quality of care for the clients.

Qualifications and experience

RGN/PCN/Primary Care Nursing or equivalent with a minimum of 2 years of relevant experience; Certificate in Rapid HIV Testing and Counselling; Registration with Nurses Council of Zimbabwe; License to practice as a nurse in Zimbabwe; Class 3 license or willingness to ride a motorbike is a must; Motorbike riding experience is an added advantage; Training, knowledge and experience in cervical cancer screening and Cervicography is an added advantage; Training in Advance HV management is an added advantage; Sound knowledge and experience in M&E is an added advantage; Proficiency in English and relevant local language; Knowledge of community health practices and general medical ethics; Demonstrated ability to work effectively and efficiently within a team; Working under minimal supervision, self-motivation and self-driven to achieve set goals and targets; Ability to analyze and report relevant activities; Sound knowledge of HIV care and treatment practices in Zimbabwe; Results oriented and able to meet project deliverables; Computer literacy is a must.