Terms of Refrences - Nurse/Midwife

DOCUMENT 1: ToR — Nurse/Midwife (Household Visits, Community-Level Deployment)

1. Background and Rationale

The Government of Nepal has declared 15 local governments across Rasuwa, Nuwakot, Dhading, Tanahun and Gorkha as disaster crisis-affected. Pregnant and postpartum women and newborns in these areas face disrupted access to maternal and newborn health services. MIDSON is deploying one nurse or midwife per selected local government to conduct household visits and support community-level identification, referral and follow-up of pregnant and postpartum women and newborns.

2. Position Details

3. Scope of Work

The Nurse/Midwife will:

• Conduct regular household visits in the assigned local government to identify pregnant women, postpartum women and newborns, including those in remote and disaster-affected wards.
• Provide basic maternal and newborn health information, danger sign counselling, and birth preparedness and complication readiness (BPCR) counselling.
• Screen for danger signs and complications during pregnancy, childbirth and postpartum period and refer to appropriate BEmONC/CEmONC facilities.
• Support follow-up of referred women and newborns, including postpartum home visits and newborn care follow-up.
• Maintain up-to-date line lists, referral slips/registers, and household visit records.
• Support community-level health education, awareness and demand generation activities.
• Coordinate with FCHVs, Mothers' Groups, Health Facility In-Charges, and Palika health sections for service linkage and follow-up.
• Support identification and follow-up of GBV survivors and referral to appropriate services where relevant, following MIDSON protocols.
• Collect and report data as required by MIDSON and the Palika.

4. Key Responsibilities

• Household identification and registration of pregnant, postpartum women and newborns.
• Counselling on maternal, newborn and family planning services.
• Danger sign screening, referral and follow-up.
• Community mobilization and coordination with FCHVs and community structures.
• Data recording and reporting (daily/weekly/monthly as required).
• Participation in MIDSON review meetings, trainings and coordination meetings.
• Any other tasks assigned by the Project Coordinator within the scope of the project.

5. Expected Outputs

• Number of households visited (monthly target as agreed with MIDSON/Palika).
• Number of pregnant women identified, counselled and referred as needed.
• Number of postpartum women and newborns followed up.
• Number of referrals completed with documented feedback.
• Updated line lists and registers maintained at assigned local government.
• Monthly activity and data reports submitted on time.
• Documentation of at least one case study/success story per quarter (as requested).

6. Qualifications and Experience

• Registered Nurse (RN) or Registered Midwife with valid NNC registration.
• Minimum 2-3 years of experience in maternal and newborn health, community health or hospital setting.
• Experience in community-based maternal and newborn health programming preferred.
• Good communication and interpersonal skills; ability to work in remote and disaster-affected areas.
• Willingness to travel extensively within the assigned local government.
• Local candidates from the assigned district/local government will be given priority.

7. Supervision and Reporting

• Administrative supervision: Project Coordinator, MIDSON.
• Technical supervision: MIDSON central office (program and technical team).
• Field coordination: Palika Health Section, Health Facility In-Charge, and relevant local stakeholders.
• Reporting: Monthly activity report and data report to Project Coordinator; immediate reporting of critical incidents/emergencies.

8. Duration and Deployment

• Until end of December 2026.
• Deployment per selected local government as listed above.

DOCUMENT 2: ToR — Nurse/Midwife (BEmONC/CEmONC Facility Deployment)

1. Background and Rationale

To strengthen emergency obstetric and newborn care in disaster-affected districts, MIDSON is deploying two nurses/midwives per selected BEmONC/CEmONC facility in Rasuwa, Nuwakot and Dhading. The deployment aims to ensure continuous skilled birth attendance, emergency obstetric care, and newborn care at facility level.

2. Position Details

Special notes:

Dhading, Gauri PHC: Two nurses will also support two holding centres (Galudi and Ratmate).

Trishuli Hospital: One nurse will be deployed to OCMCs (One-Stop Crisis Management Centres).

3. Scope of Work

The Nurse/Midwife will:

• Provide skilled antenatal, intrapartum, immediate postpartum and newborn care at the assigned facility.
• Support 24/7 skilled birth attendance and emergency obstetric and newborn care as per facility level (BEmONC/CEmONC).
• Identify danger signs and complications, initiate timely management and refer/escalate as per protocol.
• Provide respectful maternity care and support infection prevention and control practices.
• Support newborn care, including essential newborn care, resuscitation, and Kangaroo Mother Care where applicable.
• Maintain accurate clinical records, registers and reports.
• Support OCMC services where assigned, including care and referral for GBV survivors.
• Support holding centre services where assigned 
• Coordinate with Palika, facility staff and MIDSON for service continuity and reporting.
• Participate in mentoring, on-the-job coaching and review meetings.

4. Key Responsibilities

• Clinical care for pregnant, labouring, postpartum women and newborns.
• Emergency obstetric and newborn care support.
• Referral and counter-referral coordination.
• Documentation and data reporting.
• Coordination with facility, Palika and MIDSON.
• Participation in trainings, drills and review meetings.
• Any other tasks assigned by the Project Coordinator/Facility In-Charge within scope.

5. Expected Outputs

• Continuous skilled birth attendance coverage at assigned facility.
• Number of deliveries attended, complications managed and referrals made.
• Newborn care services provided and documented.
• OCMC/holding centre support services documented (where applicable).
• Monthly clinical and activity reports submitted.
• Participation in at least monthly coordination/review meetings.

6. Qualifications and Experience

• Registered Nurse (RN) or Registered Midwife with valid NNC registration.
• Minimum 3 years of experience in maternal and newborn health, preferably in BEmONC/CEmONC settings.
• Skilled birth attendance training and/or BEmONC/CEmONC training preferred.
• Experience in OCMC/GBV response preferred for OCMC-assigned positions.
• Ability to work in shifts, including nights and emergencies.
• Local candidates from the assigned district will be given priority.

7. Supervision and Reporting

• Administrative supervision: Project Coordinator, MIDSON.
• Technical/clinical supervision: Facility In-Charge and MIDSON technical team.
• Coordination: Palika health section, facility staff, and MIDSON central office.
• Reporting: Monthly report to Project Coordinator; immediate reporting of critical incidents.

8. Duration and Deployment

• Until end of January 2027.
• Deployment per facility as listed above.