Dear Applicant,

This checklist is intended for midwives, and for doctors who may be expected to have responsibilities in obstetrics/reproductive health. It should be filled
according to your current practice level. Part 1 covers basic skills and key competencies while Part 2 includes emergency obstetrical procedures; these sheets
are to be completed by midwives and MDs with an active role in obstetric care. Part 3 covers surgical procedures; it should be completed by doctors of any
specialty who may be expected to perform the procedures during their mission. This information will be useful for better matching of staff to postings, and to
identify specific training/coaching needs. It may also be used as a tool for follow up of personal development of our expats during their MSF career.

The skills listed here may be required in any MSF mission at any time in an emergency. The purpose of this assessment is to establish current knowledge/skill
level in order to facilitate the most appropriate placement. Lack of competency will not prevent you departing on mission, so please be honest in your self-
assessment.

Applicant name: orienny mosquera

Date checklist completed: 25/12/2019

Profession/specialty: Gynecologist and obstetrician

Country where you qualified: Cuba

Are you certified in Advanced Life Support in Obstetrics (ALSO) or similar? (if yes, indicate whether you are certified as an instructor) yes but not like instructor

Please read the attached leaflet on pregnancy termination and give a statement regarding your personal position on providing this care.

E:\01 DKC ref\02

RH ref\Abortion\
Leaflet\Abortion
leaflet
_inte
Sexual & Reproductive
rnal_2015_ENG.pdf Health working group, 7 January, 2016
Instructions:
The checklist covers levels of competency, including theoretical knowledge, practical clinical experience (under supervision), competence to perform
independently, and confidence to train others. Please fill the columns according to your current level. Mark "1" for yes or "0" for no.
In column F we ask for the date (year) you last performed that function. Use the comments column to give detail if needed.

Competent Confident to
Theoretical Practical Date last
to perform train to
PART 1: BASIC MIDWIFERY / OBSTETRIC SKILLS knowledge clinical performed Comments
indepen- others in
to be completed by midwives and MDs with an active role in obstetric care only experience (year)
dently the field
Mark "1" for yes or "0" for no
Antenatal consultation
Antenatal Skills: pregnancy confirmation; estimate gestational age and due date;
antenatal care (history, focused physical examination, ordering and interpreting
results of basic screening laboratory tests, and counseling); educate women about
dangers signs in pregnancy and support them with creating a birth plan
1 1 1 17/11/2018 I'm still on the field and finish
Identify co-existing disease; commence first line treatment according to protocol
for antenatal complications 1 1 1 24/12/2019 I'm still on the field and finish
Basic ultrasound skills, e.g. foetal position, placental location, foetal viability 1 1 1 24/12/2019 I'm still on the field and finish
Malaria and infectious disease screening in pregnancy 1 1 1 22/12/2019 I'm still on the field and finish
Labour, delivery, and immediate postpartum care
Labour Management: identify labour onset; identify coexisting disease and
commence 1st line treatment; monitor maternal and foetal well-being during
labour; manage a normal delivery; provide active 3rd stage management; inspect
placenta and membranes for intactness 1 1 1 24/12/2019
Follow labour progress using a partograph (WHO or other) 1 1 1 24/12/2019 I'm still on the field and finish
Stimulate labour using physiologic measures, e.g., ambulation/position changes,
shower, massage, etc. 1 1 1 10/10/2018 I'm still on the field and finish
State here the number of deliveries you have conducted independently in the number (give best estimate): 300
past 2 years
Maternal basic life support (CPR) 1 1 1 09/07/2019 I'm still on the field and finish
Identify complications in labour and birth, e.g. abnormal presentation, prolapsed
cord, haemorrhage, failure to progress 1 1 1 21/12/2019 I'm still on the field and finish
Initial management in case of complications, e.g. IV access, bladder
catheterisation 1 1 1 22/12/2019 I'm still on the field and finish
Management of mild/moderate postpartum haemorrhage, fluid resuscitation
(large bore IVs x 2), administration of uterotomic agents, fundal massage,
bimanual compression 1 1 1 20/12/2019 I'm still on the field and finish
Stabilise mother and newborn for transfer to a higher level facility 1 1 1 24/12/2019 I'm still on the field and finish
Perform episiotomy 1 1 1 24/12/2019 I'm still on the field and finish
De-infibulation and post-delivery repair (NOT re-infibulation!) in presence of
female genital cutting 1 1 1 13/10/2019 I'm still on the field and finish
Repair of episiotomy or 1st /2nd degree tear 1 1 1 19/12/2019 I'm still on the field and finish
Obstetric fistula care: secondary prevention of fistula (bladder catheter routinely
after obstructed labour); conservative management of small, fresh fistula
(catheter as long as fistula seems to become smaller) 1 1 1 26/19/2018 I'm still on the field and finish
Neonatal skills
Assess newborn's vital signs; identify need for and manage resuscitation 1 1 1 10/03/2019 I'm still on the field and finish
Perform initial (basic) physical exam of the newborn 1 1 1 12/04/2019 I'm still on the field and finish
Provide routine newborn care, including administration of prophylactic eye
ointment, Vitamin K, and birth (first) doses of vaccines 1 1 1 12/04/2019 I'm still on the field and finish
Initiate and establish breastfeeding 1 I'm still on the field and finish
Identify complications, e.g. infections, and provide first line treatment 1 I'm still on the field and finish
Instruct in and support use of kangaroo mother care 1 I'm still on the field and finish
Postnatal consultation
Postnatal skills: Postnatal care (history, physical examination of mother and
infant, and counseling); identify postnatal complications in mother and baby;
educate women about danger signs for self and child 1 1 1 24/12/2019 I'm still on the field and finish
Provide first line treatment for postnatal maternal complications, e.g. infection,
postpartum depression, etc. 1 1 1 24/12/2019 I'm still on the field and finish
Other sexual and reproductive health care
Prevention of mother-to-child transmission of HIV (PMTCT) -- provide care during
pregnancy, childbirth, and the postnatal period 1 1 1 I'm still on the field and finish
Perform a vaginal speculum exam 1 1 1 I'm still on the field and finish
Manage sexually transmitted infection using syndromic approach 1 1 1 I'm still on the field and finish
Contraceptive counseling and prescription 1 1 1 I'm still on the field and finish
Insertion of contraceptive implant 1 1 1 I'm still on the field and finish
Insertion of intra-uterine contraceptive device 1 1 1 I'm still on the field and finish
Perform termination of pregnancy on request, including pre- and post-procedure
counseling 1 1 1 I'm still on the field and finish
Provide care for sexual assault (rape) survivors, including history, physical
examination, preventive treatment, and counselling 1 1 1 09/09/2018 I'm still on the field and finish
Perform visual inspection of cervix for cervical cancer screening 1 1 1 12/10/2018 I'm still on the field and finish
Provide treatment of early stage / non-invasive cervical cancer (cryotherapy) 1 1 1 12/10/2018 I'm still on the field and finish
Management and supervision
Supervise appropriate measures for infection prevention and control practices,
including use of universal precautions, basic hygiene (e.g. cleaning of patient care
areas), and sterilisation of instruments 1 1 1 I'm still on the field and finish
Collect and analyse data relating to sexual and reproductive health services;
report-writing 1 1 1 I'm still on the field and finish
Participate in mortality and near miss case review 1 1 1 24/12/2019 I'm still on the field and finish
Set up or evaluate a clinic / obstetric service 1 1 1 I'm still on the field and finish
Teach on seminars / formal courses 1 1 12/03/2019 I'm still on the field and finish
Human resources management: hire staff, coach them, and evaluate their
performance 1 1 1 I'm still on the field and finish
I'm still on the field and finish my mission on January 2

I'm still on the field and finish my mission on January 2

I'm still on the field and finish my mission on January 2
I'm still on the field and finish my mission on January 2

I'm still on the field and finish my mission on January 2

I'm still on the field and finish my mission on January 2

I'm still on the field and finish my mission on January 2

I'm still on the field and finish my mission on January 2

I'm still on the field and finish my mission on January 2

I'm still on the field and finish my mission on January 2

I'm still on the field and finish my mission on January 2
I'm still on the field and finish my mission on January 2

I'm still on the field and finish my mission on January 2

I'm still on the field and finish my mission on January 2

I'm still on the field and finish my mission on January 2

I'm still on the field and finish my mission on January 2

I'm still on the field and finish my mission on January 2

I'm still on the field and finish my mission on January 2

I'm still on the field and finish my mission on January 2
I'm still on the field and finish my mission on January 2
I'm still on the field and finish my mission on January 2

I'm still on the field and finish my mission on January 2

I'm still on the field and finish my mission on January 2

I'm still on the field and finish my mission on January 2

I'm still on the field and finish my mission on January 2
I'm still on the field and finish my mission on January 2
I'm still on the field and finish my mission on January 2
I'm still on the field and finish my mission on January 2
I'm still on the field and finish my mission on January 2

I'm still on the field and finish my mission on January 2

I'm still on the field and finish my mission on January 2

I'm still on the field and finish my mission on January 2
I'm still on the field and finish my mission on January 2

I'm still on the field and finish my mission on January 2

I'm still on the field and finish my mission on January 2

I'm still on the field and finish my mission on January 2
I'm still on the field and finish my mission on January 2
I'm still on the field and finish my mission on January 2

I'm still on the field and finish my mission on January 2

 Competent Confident to
Theoretical Practical Date last
to perform teach to
PART 2: LIFE-SAVING OBSTETRICAL SKILLS knowledge clinical performed Comments
indepen- others in
to be completed by midwives and MDs with an active role in obstetric care only experience (year)
dently the field
Mark "1" for yes or "0" for no
1st trimester pregnancy complications
Post-abortion care, medical method: Misoprostol / Mifepristone 1 1 1 22/12/2019 I'm still on the field and finish
Uterine evacuation using Manual Vacuum Aspiration (MVA) 1 1 1 12/11/2019 I'm still on the field and finish
Intrapartum complications
Management of pre-term labour 1 1 1 I'm still on the field and finish
Induction/Augmentation of labour, including Oxytocin/prostaglandin regimen 1 1 1 I'm still on the field and finish
Management of (pre-)eclampsia, including MgSO4 regimen 1 1 1 I'm still on the field and finish
Advanced ultrasound skills, e.g. for assessment of gynaecologic / obstetric
complications 1 1 1 I'm still on the field and finish
External cephalic version 1 1 1 I'm still on the field and finish
Internal version manoeuvre (e.g. transverse lie of 2nd twin) 1 1 1 I'm still on the field and finish
Malpresentation deliveries, including face or brow presentation 1 1 1 I'm still on the field and finish
Breech delivery 1 1 1 I'm still on the field and finish
Twin delivery (also triplets, etc) 1 1 1 I'm still on the field and finish
Shoulder dystocia 1 1 1 I'm still on the field and finish
Vacuum extraction (ventouse) 1 1 1 I'm still on the field and finish
Forceps delivery 1 1 1 I'm still on the field and finish
Symphysiotomy 1 I'm still on the field and finish
Craniotomy (destructive delivery) 1 1 1 I'm still on the field and finish
Monitoring patient under anaesthesia 1 1 1 I'm still on the field and finish
Anaesthesia management
- local
- paracervical, pudendal
- other (specify) 1 1 1 I'm still on the field and finish
First Assist in Caesarean Section 1 1 1 I'm still on the field and finish
Immediate postpartum complications
Manual removal of placenta, uterine exploration for fragments 1 1 1 I'm still on the field and finish
Correcting uterine inversion 1 1 1 I'm still on the field and finish
Management of severe postpartum haemorrhage, including institute massive
transfusion protocol, uterine packing / balloon tamponade (e.g. Bakri) 1 1 1 I'm still on the field and finish
Repair of 3rd / 4th degree laceration 1 1 1 I'm still on the field and finish
Repair of anal sphincter rupture 1 1 1 I'm still on the field and finish
I'm still on the field and finish my mission on January 2
I'm still on the field and finish my mission on January 2

I'm still on the field and finish my mission on January 2

I'm still on the field and finish my mission on January 2
I'm still on the field and finish my mission on January 2

I'm still on the field and finish my mission on January 2

I'm still on the field and finish my mission on January 2
I'm still on the field and finish my mission on January 2
I'm still on the field and finish my mission on January 2
I'm still on the field and finish my mission on January 2
I'm still on the field and finish my mission on January 2
I'm still on the field and finish my mission on January 2
I'm still on the field and finish my mission on January 2
I'm still on the field and finish my mission on January 2
I'm still on the field and finish my mission on January 2
I'm still on the field and finish my mission on January 2
I'm still on the field and finish my mission on January 2

I'm still on the field and finish my mission on January 2

I'm still on the field and finish my mission on January 2
I'm still on the field and finish my mission on January 2
I'm still on the field and finish my mission on January 2

I'm still on the field and finish my mission on January 2

I'm still on the field and finish my mission on January 2
I'm still on the field and finish my mission on January 2
 Number of
procedures
Competent to Confident to performed Date last
PART 3: SURGICAL SKILLS
perform teach to others independently in performed Comments
to be completed by doctors who may be expected to perform these
indepen-dently in the field the past 2 years (year)
procedures*
(give best
estimate)
Mark "1" for yes or "0" for no
Uterine evacuation using Dilation & Curettage (D&C) 1 1 250 23/11/2019 I'm still on the field and finish my mission
Ectopic management 1 1 35 22/12/2019 I'm still on the field and finish my mission
Culdocentesis 1 1 62 17/09/2019 I'm still on the field and finish my mission
Forceps delivery 1 1 34 14/11/2019 I'm still on the field and finish my mission
Caesarean section 1 1 252 23/12/2019 I'm still on the field and finish my mission
Foetal extraction in case of obstructed labour neglected for days 1 1 65 21/12/2019 I'm still on the field and finish my mission
Arterial ligation (ovarian/uterine/internal iliac) 1 1 15 12/07/2019 I'm still on the field and finish my mission
B-Lynch brace suture 1 1 10 11/06/2019 I'm still on the field and finish my mission
Repair of uterine rupture 1 1 15 07/08/2019 I'm still on the field and finish my mission
Emergency hysterectomy for uterine rupture, heamorrhage, or
infectious post-partum or post-abortum complications 1 1 30 26/11/2019 I'm still on the field and finish my mission
Uterine/bladder repair 1 1 10 13/05/2019 I'm still on the field and finish my mission
Tubal ligation 1 1 322 23/12/2019 I'm still on the field and finish my mission
Formal vesico-vaginal fistula (VVF) repair 1 1 15 22/11/2018 I'm still on the field and finish my mission

* e.g, gynaecology/obstetrics, general surgery, family practice,

tropical doctor, etc.