District hospitals in Afghanistan, provide essential curative services and act as the first level referral site for the BPHS network; they deliver the most complicated cases referred from CHCs/BHCs, including major surgery under general anesthesia and emergency obstetric care.
Overall purpose of the position: To provide high quality, safe, and timely surgical care to patients at the district hospital; to lead the surgical service, ensure emergency and selective surgical coverage according to BPHS/EPHS standards, mentor and supervise clinical staff, support referral pathways, maintain clinical management and reporting, and ensure surgical services are delivered in accordance with MoPH clinical guidelines and national standards.
Key responsibilities and duties:
- Provide clinical assessment, investigation, diagnosis and management of surgical cases (selective and emergency) across general surgery, trauma, and where indicated, basic specialized procedures.
- Perform surgical operations expected at district hospital level (Appendectomy, hernia repair, wound debridement, emergency abdominal surgeries, basic orthopedic procedures, surgical care for obstetric emergencies if required).
- Provide safe peri-operative care: pre-op assessment, intraoperative leadership, and post-op follow-up including pain management, wound care and complications management.
- Oversee and participate in emergency on-call roster for surgical and major emergency cases (24/7 coverage as per hospital need).
- Provide support to Comprehensive Emergency Obstetric & Newborn Care, where required; including management of surgical obstetric emergencies, in coordination with OBGYN staff.
- Ensure informed consent is obtained and documented for all surgical procedures (Clinical duties to follow MoPH/WHO clinical protocols and standards).
- Lead, organize and supervise the surgical unit (operating theatre, recovery room, surgical wards) ensuring safe workflows, infection prevention and control (IPC) and patient safety.
- Maintain effective referral and counter-referral communication with CHCs/BHCs and provincial hospitals.
- Coordinate with hospital administration for theatre scheduling, staffing, supplies (surgical instruments, sutures and consumables), sterilization and maintenance.
- Participate in hospital management meetings and contribute to service planning, budgeting inputs and resource prioritization.
- Supervise, mentor and train junior doctors, medical officers, anesthesia providers, nurses and mid-level providers in surgical care, triage and emergency procedures.
- Promote continuous professional development (Conduct morbidity & mortality meetings, clinical audits, case reviews and implement improvements).
- Ensure adherence to clinical guidelines, surgical checklists and sterilization/IPC standards.
- Ensure accurate and timely patient records, operative notes, theatre registers and discharge summaries.
- Report surgical service statistics, key performance indicators and HMIS data to hospital HMIS focal person and/or ARSDO HMIS department
- Report notifiable surgical/communicable events and adverse events following national guidelines.
- Ensure medico-legal documentation is complete when required like death certificate and Etc.
- Support outreach and referral strengthening activities.
- Adhere to MoPH, ARSDO and UNICEF code of conduct, patient confidentiality, gender-sensitive service provision and safeguarding policies.
