Job Description and Person Specification: Standards-based Audit Facilitator: Patient-centred sickle cell disease management in Africa (PACTS)
Background and aims of study
In Sub-Saharan Africa, around 1/50 babies have sickle cell disease (SCD) and 50–90% die
before the age of 5 years. SCD is a genetic abnormality of red blood cells and a major public
health priority. It causes anaemia, sudden severe pain, and eventually damages organs (lungs,
brain, kidneys). In high-income countries, most SCD patients survive well into middle age
because they are diagnosed early and given treatments to prevent infections, anaemia and
organ damage. Though these treatments are available in most countries in Africa, they are not
taken up by most patients and are not systematically provided by clinicians. SCD patients, their
carers and health workers will be our co-researchers, exploring why SCD patients do not get
these treatments and testing out solutions to increase uptake of care, to drive evidence-based
clinical practice, and to increase patient-centredness of SCD care.
We will select six different types of health facilities (clinics/hospitals) that provide SCD care. For
each facility we will create two research teams. One will be from a community within the
catchment area of the health facility, comprised of SCD patients, carers, and other community
members. The second will be comprised of health workers providing SCD care from the facility.
The community-based team will be capacitated to use community-led participatory action
cycles( e.g. a problem- solving approach where local issues related to SCD knowledge and
uptake of care are identified and solutions to these are generated by community members with
support from a community facilitator) to identify and overcome local barriers to the timely uptake
of SCD care. The facility-based team will be capacitated to use standards-based audit ( e.g. a
type of clinical practice and to increase its use, led by a clinical facilitator) to increase use of
evidence-based international best practice for SCD care. Both teams will come together to
identify to co-design a model of “patient-centred” SCD care, ensuring that care provided centres
the needs of patients and carers. We will carefully document these processes, decisions made,
and outcomes arising. Our aim is for this model of patient-centred, evidence-based SCD care to
be reflected in SCD policy at the conclusion of the study.
This study is funded by the National Institute for Health Research in the UK. We are looking to
recruit two facilitators to work with the in-country principal investigator to support the
participatory research. One facilitator will lead the participatory action cycles with community
members, and the other will lead standards-based audit cycles with clinicians. This period of
full-time employment will last from November 2022 until July 2026, at approximately full-
time equivalent.
Core Tasks
– Gain facility entry and recruit participate in the study (providing study information,
carrying out informed consent).
– Leading participants through safeguarding principles( e.g. processes that will be in place
to ensure no participants come to any harm throughout the course of the study’s
activities) and the creation of privacy and confidentiality agreements prior to beginning
activities.
– Facilitating capacity-strengthening activities to ensure participants are well-capacitated
to carry out standards-based audit.
– Working with participants to, where they may not exist, develop clear standards of care
for SCD.
– Facilitating standards-based audit cycles with participants.
– Carrying out monthly mentorship to facility-based teams.
– Working with the community-based staff member to facilitate quarterly joint community-
health facility activities to generate a model of patient-centred SCD care.
– Transcription of group discussion notes.
– Monthly collation and submission of process data for the implementation of participatory
research approaches (including circulation of fieldnotes and mentorship remarks;
updating key study monitoring and evaluation registers on SBA progress—e.g. decisions
made and activities carried out and run charts documenting changes in health outcomes
or other information on changes resulting from activities), to be uploaded and shared
with the study team.
– Participate in monthly update meetings with the wider study team.
– Quality assurance of all collected data (e.g. reviewing transcripts of focus group
discussions and interviews against original audio; reviewing translation where relevant;
validating quantitative data on outcomes).
– Develop quarterly summaries of activities (what was carried out, challenges
experienced, successes experienced).
– Support contextual documentation. ( e.g. ongoing changes in the community or wider
context that might affect the study activities or its outputs)
– Ensuring that data are collected, complete and readied for analysis within agreed
timelines.
Essential Qualifications
– Medical doctorate (MBBS or MD)
– Experience:
o Prior experience carrying out clinical audit
o Prior experience using participatory research approaches
o Prior experience carrying out qualitative data collection and analysis
o Prior experience working within SCD
– Knowledge of the Zambian health system
– Excellent facilitation skills
– Language: Fluency in English (written and spoken) and local languages
(Bemba/Nyanja).
Desirable Qualifications
– Specific experience leading standards-based audit
– Specific experience facilitating health-promoting community-led projects or interventions
– Expertise in safeguarding
Application: If you are interested in applying, please submit:
1) An ‘expression of interest’ letter detailing how you meet the listed ‘person specification’
criteria
2) A curriculum vitae.
3) Two academic/clinical references and
4) Copies of certified tertiary level educational certificate
5) Cover application letter
6) Copy of ID-NRC/passport
All documents should be submitted by email to:
Please use the subject heading ‘Standards-based Audit Facilitator – PACT, Zambia’.
Deadline for applications is: 31st October, 2022
