Quality Assurance Specialist - Health Programming
Background****: The International Rescue Committee (IRC), one of the world’s largest humanitarian agencies, provides relief, rehabilitation, and post-conflict reconstruction support to people affected by natural disaster, oppression, and violent conflict in 42 countries. The IRC is committed to bold leadership, innovation, and creative partnerships. Active in public health, education, livelihoods, women's empowerment, youth development, and protection and promotion of rights, the IRC assists people from harm to home. The IRC launched an emergency health response in Libya in September 2016 as the humanitarian situation in the country was deteriorating following the 2014 civil war. Since then, the IRC has broadened its portfolio with health, protection, and governance programs aiming to employ a holistic approach to meeting the needs of crisis affected and vulnerable communities to survive, recover, and gain control of their futures.
The IRC has been working to expand its multi-sectoral reach in areas of critical need in Libya, and this includes programming in western, southern, and eastern Libya building on past and ongoing health interventions. Contributing to these efforts is the European Union (EU)-funded “Advancing Capacity for and Coverage of the Essential services package through Systems Strengthening” (ACCESS) program starting up in Ain Zara, Shahhat and Wadi Alshati Baladiyas. IRC Libya works with Libyan national and local health authorities to provide quality, inclusive health services to vulnerable populations and strengthen the overall health system. Since 2018, the IRC has collaborated with the EU Delegation in Libya and the Ministry of Health (MoH) to develop and pilot the Essential Service Package (ESP), aiming to strengthen existing delivery systems and providing a standardized package of primary health care services to Libyans and non-Libyans.
The ESP—composed of two service delivery levels – primary care at Primary Health Care Centers (PHCCs) and secondary care at hospitals—is foundational to the MoH’s strategic reform program, and a key tool in reaching Universal Health Coverage (UHC) for people living in Libya. The ACCESS program is designed to address the need for quality delivery of the ESP and related policies and strategies, and for strengthening management capacity, accountability, and transparency at the District Health Office (DHO) level to oversee and coordinate health services in the municipality in close coordination with other services provided by humanitarian and development actors, while engaging communities to promote health seeking behaviors and ensure services meet their needs. While treatment and prevention of communicable diseases remains a priority for the country, attention to common non-communicable diseases (NCD) will also be given. ACCESS will ensure the rollout of the Libyan NCD Health Promotion Strategy (2020 – 2025) (developed through prior EU funding) at all supported facilities and support increased awareness and improved capacities through on-the-job training on case management, diagnosis and treatment at the primary level, prevention through health education at the community and health facility level, and support to MoH campaigns.
Job Overview: The integration of a quality assurance and continues quality improvement approaches are part of the EPHS and will be instituted in a bottom-up approach first only at facility level, as a dedicated QA program overseeing all district health services is not yet in place. Important to note is that the proposed QA activities will initially only focus on performance improvement with the aim to detect weaknesses and to identify opportunities for quality improvement. Therefore, when considering Quality of Care (QoC) at the primary health care level, for example, the focus would be solely on the ‘micro-level’, that is, on elements of practice which are under an individual facility’s direct control.
With this, the roving Quality Assurance Specialist (QAS) will be supporting quality improvement projects and initiatives at health facilities, through the DHOs, Primary Health Care Institution (PHCI) and MoH. A team of national mentors/supervisors from key programs such as e.g., reproductive health, mental health, emergency health, NCD, etc., as per EPHS conducts joint integrated supportive supervision to measure gaps, understand and address those gaps as they emanate. Through the EU ACCESS program, the IRC, DHOs, PHCI and MoH will initiate an innovative performance and QoC improvement approach expected to strengthen facility and community-based service delivery. The QAS will work with the DHOs, DHTs, PHCI, MoH and health workers to design and unleash the innovative potential of front-line health workers to develop, test, and implement strategies to improve the health system’s performance, attain better health outcomes, and ensure the quality improvement domains are articulated as an integral part of the service delivery mechanisms. . In addition, to strengthen management, clinical governance and supervision systems at the community, facility, district, and organizational levels.
The QAS will integrate chart review, direct observation assessments and patient and provider interviews into regular supportive and joint supervision using clinical guidelines, also, will liaise with MOH units and PHCI to train staff on QoC improvement guidelines. The QAS is dedicated to the EU ACCESS program, but learning and good practices identified through the implementation process might be applied or leveraged in other areas of IRC health interventions. The QAS will report directly to the Health Coordinator.
· Work closely with the health team members and MOH stakeholder to develop and adapt the quality improvement assessment tools.
· Support the process of conducting a baseline quality assessment in the targeted health facilities, and work with the team to analyze the data and development of the required corrective action plans.
· Ensure the targeted health facilities have the minimum functioning systems and safe infrastructure.
· Provide staff the training and tools to measure and improve quality of care.
· Use a team-based approach to prioritize improvements and implement them.
· Develop and agree on a plan on how the improvement activities will be implemented at the center and as guide by the developed corrective action plans, who will lead them, and how they will be started, as well as follow up the implementation.
· Involve patients since they bring valuable ideas based on their experiences in receiving services at your HF.
· Establish a QoC Improvement Collaborative (community-facility) Initiative at selected health facilities, focused on engaging communities in improving community health and holding health facility accountable for quality of services. QoC teams will include two health facility staff and community representatives (constitution and ToR to be discussed with the Health Coordinator, PHCI & MoH).
· With collaboration with the health facilities SMT , identify the quality improvement projects, and work closely with health teams to prioritize the projects and initiatives to be implemented, such as improve the patient’s waiting time, completeness of patient’s assessment, rational use of medication and antibiotics, and etc, and advise on the best quality improvement methodologies to improve the quality such as FOCUS-PDSA.
Support quality improvement: Work with the DHOs, Mentors/Supervisors, health facility staff and IRC’s Senior Medical Team Leaders (SMTLs), Senior Community Health Officers (SCHOs) and Senior Health Management Information System Assistants (SHMISAs) to:
· Introduce the IRC QoC framework to the MOH stakeholders, and support the process of adapting the QoC framework based on the package of services.
· Create a vision for QoC improvement by setting shared goals for performance.
· Build staff capacity for QoC improvement by making sure that staff understand what QoC improvement is about and how to do it. Training opportunities about (QoC) should be available for all staff, and it should be included as part of their routine job expectations.
· Build staff motivation for QoC improvement and encouraging them to set time aside to talk about QoC and make it part of their jobs.
· Establish a QoC improvement committees to manage this process at the HFs, and ensure the committees; members are supported with the required training and capacity building, as well as meeting regularly and document their meeting minutes.
· Involve all staff who work at the clinic
· Ensure staff dedicate time to measure clinic performance and stress the importance of complete documentation to help determine whether or not patients are getting the care they deserve.
· Provide time to openly discuss both successes and failures.
· Make sure that the ‘voice’ of the patient is heard and acted on through surveys, exit interviews, suggestion boxes or other means.
· Involve staff and patients in understanding data and making decisions based on it.
· Use available existing resources to strengthen QoC improvement activities.
· Include a budget for QoC that provides for training in all improvement activities.
· Work closely with the MOH stakeholders and IRC health teams to develop and pilot tools to be used to review the medical records.
· Develop and pilot the risk management program at health facilities, with more focus on incident report & advers reaction mechanisms at health facilities, analysis and regularly develop the required corrective actions, regular process of risk assessment.
· Advocate and support innovative approaches to conduct the quality assessments at health facilities by using online methodologies such as but not limited to ComCare.
· As required, work with health facilities and IRC health teams to development the required quality improvement plans, such as medical equipment plan, hazard material plan, safety and security plan, and water and sanitation plan, and etc.
· Work with the IRC and MOH stakeholder to agree on the list of quality improvement indicators to be measured regularly by the targeted health facilities, and ensure the process of data review and analysis is regularly applied and corrective actions are regularly adapted.
Implement QoC improvement at the health facility: Work with the DHOs, Mentors/Supervisors, HF staff and IRC’s SMTLs, SCHOs, and SHMISAs to:
· Set priorities to identify specific areas for improvement.
· With support from the health coordinator, deputy health coordinator and HMIS manager, define a performance measurement method for the improvement and use existing data or collect data that will be used to monitor successes.
· Understand the processes of the underlying system of care so that improvements can be implemented to effectively address problems.
· Make changes to improve care, and continually measure whether those changes produce the improvements in service delivery that wished to be achieved.
· Ensure appropriate and effectively representation and visibility of the IRC.
· Undertake any specific duties as delegated by Health Co and Deputy Health Co.
· When relevant, represents IRC at coordination meetings, as designated by the Health Co and Deputy Health Co
· Support evidence and learning initiatives related to IRC health programming.
· Due to the nature of this position, there may duties assigned which may initially appear to be outside the remit of this job description and may involve additional working hours.
Key working relationships:
The QAS will not supervise staff directly but will work in close collaboration with the IRC Deputy Health Coordinator, Health Manager, Senior Medical Team leader, Senior Community Health officers, HMIS manager and HMIS Assistants. Additionally, it will be paramount to maintain positive working relationships with other program stakeholders, e.g., MoH and its line offices, DHOs, PHCs.
Working Environment: This position will be based in the IRC field office in Tripoli, Libya with 30% travel to Shahhat and 30% to Wadi Alshati municipalities.
· University degree in Medicine & Surgery or related health background
· Demonstrated experience delivery public health specialized trainings is an advantage.
· Minimum of 5 years’ work experience in health/medical fields, preferably in the NGO sector or UN agencies.
· Strong skills in building the capacities, coaching, and mentoring others.
· Fluent in Arabic and English (Writing, Speaking, and Listening).
· Computer literate with significant experience in using Microsoft Office (Word, Excel, and Power Point).
· Excellent interpersonal communication skills and possess stamina to work under pressure.
· Oriented to the health systems in Libya with at least foundational knowledge about the EPHS in Libya.
· Excellent negotiation skills.
· Willingness to work beyond working hours (on call services).
· Self-directed, able to independently set priorities and solve problems with minimal guidance
· Ability to work effectively and harmoniously with colleagues from varied cultures and professional backgrounds.
· Strong organization and time management skills.
The IRC and IRC workers must adhere to the values and principles outlined in IRC Way - Standards for Professional Conduct. These are Integrity, Service, and Accountability. In accordance with these values, the IRC operates and enforces policies on Beneficiary Protection from Exploitation and Abuse, Child Safeguarding, Anti Workplace Harassment, Fiscal Integrity, and Anti-Retaliation