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How to use this Learning Station

On this Learning Station, you can read and test your knowledge. Tap on a book to open its chapter list. In each chapter, you can take a quiz to test your knowledge.

To take tests, you must register with your email address or cell number. It is free to register and to take tests.

For help email info@bettercare.co.za or call +27 76 657 0353.

Printed books

Learning is easiest with printed books. To order printed books, email info@bettercare.co.za or call +27 76 657 0353.

Visit bettercare.co.za for information.

Introduction

Contents

About the Bettercare series

Bettercare in an independent, registered Non-Profit and Public Benefit Organisation. At Bettercare, our aim is to create accessible educational resources that improve the quality of healthcare in even the most challenging circumstances.

Bettercare learning material is constantly updated to ensure all healthcare professionals have access to high-quality, affordable and up-to-date training in every facility, regardless of its history, resources or geographical location. Additions and changes are informed by ongoing feedback from healthcare workers, educators and participants; findings on new and better methods of diagnosing and treating patients and the latest developments in child, perinatal and HIV care.

Bettercare learning programmes grew out of the ongoing work of the Perinatal Education Programme (PEP). PEP began in 1989 when a small team of paediatricians, obstetricians and nurses came together to develop a consensus document on best practice care for mothers and infants. The PEP method of self-directed, decentralised learning has been proven in controlled studies to improve knowledge, attitudes, skills and patient care practices in health professionals.

Why decentralised learning?

Continuing education for health professionals traditionally consists of courses and workshops run by formal trainers at large central hospitals. These courses are expensive to attend, often far away from the health professionals’ families and places of work, and the content frequently fails to address the biggest healthcare challenges of poor, rural communities.

PEP developed the self-help, decentralised learning method in response to these problems and address the needs of all professional healthcare workers, especially those in under-resourced regions. Working closely with PEP, all Bettercare learning programmes follow this basic, proven learning methodology. A learning programme is the curriculum and study material you need to run a course, all in one book. Whether you lead a study group or manage formal training, Bettercare learning programmes make your job simpler and easier. We provide the learning programme, you run the course. You can implement Bettercare learning programmes in your institution right now.

Each chapter of a Bettercare learning programme contains the most relevant and up-to-date information health professionals rely on to provide excellent and appropriate care to their patients. Learning material is presented in a question-and-answer format. Each chapter has a multiple-choice test consisting of 20 questions. Usersfore studying a chapter to identify gaps in knowledge and to test their learning at the end of each chapter.

Participants study one chapter at a time on their own and then meet colleagues to discuss what they have learned. The formation of study groups encourages co-operative learning where colleagues share their knowledge and understanding. While the role of a facilitator can be useful, a formal teacher is not needed. The question-and-answer method makes learning effective and enjoyable.

There is no need to wait for acceptance to a centralised training programme. Manage your own continuing education and invite your colleagues to join you. Bettercare learning programmes have helped thousands of nurses, midwives, doctors and students increase their knowledge, boost their confidence, and improve patient care.

Bettercare Online Learning Station

The Bettercare Learning Station is a simple website that can be used on tablets, computers or phones. It can also be set up as a dedicated touchscreen Learning Station in your institution. The material on the Learning Station is always the most up-to-date, and includes the full course content and the multiple-choice tests for each chapter.

The Learning Station is freely accessible online and includes all of the current Bettercare courses. All students are able to make use of this to supplement their studies. Students using Bettercare books can benefit from video clips addressing diagnosis and management which are attached to some of the chapters on the website.

By registering on the Learning Station site, students can also complete the multiple-choice chapter tests. Registering is free, quick and only requires a cellphone number or email address and a password. On completing each test, users receive their results and advice on where they may have gone wrong. At the bottom of the results page, each user will have the option to submit their results for development points.

This methodology allows users control over their studies without feeling as though they are being watched. Users can submit their results only when feel they have mastered a section, empowering them with learning skills and encouraging self-motivation. The Bettercare Learning Station privacy policy includes the clause that only information which users have agreed to make available may be used to generate reports.

You can access the learning station here: ls.bettercare.co.za

Books in the Bettercare series

Adult HIV

Adult HIV covers an introduction to HIV infection, management of HIV-infected adults at primary-care clinics, preparing patients for antiretroviral (ARV) treatment, ARV drugs, starting and maintaining patients on ARV treatment and an approach to the prevention of opportunistic infections. Adult HIV was developed by doctors and nurses with wide experience in the care of adults with HIV, in collaboration with the Desmond Tutu HIV Foundation.

Breast Care

Breast Care was written for nurses and doctors who manage the health needs of women from childhood to old age. It covers breast examination, the assessment and management of benign breast conditions, the diagnosis and management of breast cancer and palliative care. The book is used for training by The Breast Course for Nurses, an NGO established to improve the care of women with breast problems.

Child Healthcare

Child Healthcare addresses all the common and important clinical problems in children, including immunisation, history and examination, growth and nutrition, acute and chronic infections, parasites, skin conditions, and difficulties in the home and society. Child Healthcare was developed by a number of experienced paediatricians and paediatric nurses for use in primary-care settings.

Childhood HIV

Childhood HIV enables nurses and doctors to care for children with HIV infection. It addresses an introduction to HIV in children, the clinical and immunological diagnosis of HIV infection, management of children with antiretroviral treatment, antiretroviral drugs, opportunistic infections and palliative care.

Childhood TB

Childhood TB was written to enable healthcare workers to learn about the primary care of children with tuberculosis. The book covers an introduction to TB infection, and the clinical presentation, diagnosis, management and prevention of tuberculosis in children and HIV and TB co-infection. Childhood TB was developed in collaboration with the Desmond Tutu Tuberculosis Centre.

Congenital Disorders (previously Birth Defects)

Congenital Disorders was written for healthcare workers who look after individuals with congenital disorders, their families, and women who are at increased risk of giving birth to an infant with a congenital disorder. Special attention is given to modes of inheritance, medical genetic counselling, and congenital disorders due to chromosomal abnormalities, single gene defects, teratogens and multifactorial inheritance. This book is being used in the Medical Genetics Education Programme which trains healthcare workers in genetic counselling in South Africa. It is also endorsed by Genetic Alliance SA, a support organisation for families affected by congenital disorders.

Ebola Prevention and Control

Ebola Prevention and Control was written for all healthcare workers and administrators managing, preventing and controlling viral haemorrhagic diseases. Chapters cover virology and epidemiology, patient management, support systems and documentation and communication and community engagement. There is a strong emphasis on the protection of healthcare workers in the field, particularly in resource-limited settings.

Infection Prevention and Control

Infection Prevention and Control was written for nurses, doctors, and health administrators working in the field of infection prevention and control, particularly in resource-limited settings. It includes chapters on infection prevention and control programmes, risk management, health facility design, outbreak surveillance and antimicrobial stewardship. The book is supported by the Academic Unit for Infection Prevention and Control (UIPC) at Tygerberg Academic Hospital.

Intrapartum Care

Intrapartum Care was developed for doctors and advanced midwives who care for women who deliver in level 2 hospitals. It contains theory and skills chapters adapted from the labour chapters of Maternal Care. Particular attention is given to the care of the mother, the management of labour and monitoring the wellbeing of the fetus. Intrapartum Care was written to support and complement the national protocol of intrapartum care and the essential steps to manage obstetric emergencies (ESMOE) in South Africa.

Maternal Care

Maternal Care addresses all the common and important problems that occur during pregnancy, labour, delivery and the puerperium. It covers the antenatal and postnatal care of healthy women with normal pregnancies, monitoring and managing the progress of labour, specific medical problems during pregnancy, labour and the puerperium, family planning and regionalised perinatal care. Skills chapters teach clinical examination in pregnancy and labour, routine screening tests, the use of an antenatal card and partogram, measuring blood pressure, detecting proteinuria and performing and repairing an episiotomy. Maternal Care is aimed at health workers in level 1 hospitals or clinics.

Maternal Mental Health

Maternal Mental Health was written for doctors, nurses and social workers caring for women before and after birth. It includes an introduction to maternal mental health and illness, making referrals for maternal mental illness, helping mothers with mental health problems and special issues in maternal mental health. It includes a resource section for assessing, referring and supporting mothers in the perinatal period. The book is supported by The Perinatal Mental Health Project of the Department of Psychiatry and Mental Health at the University of Cape Town.

Mother and Baby Friendly Care

Mother and Baby Friendly Care describes gentler, kinder, evidence-based ways of caring for women during pregnancy, labour and delivery. It also presents improved methods of providing infant care with an emphasis on kangaroo mother care and exclusive breastfeeding.

Newborn Care

Newborn Care was written for health workers providing special care for newborn infants in level 2 hospitals. It covers resuscitation at birth, assessing infant size and gestational age, routine care and feeding of both normal and high-risk infants, the prevention, diagnosis and management of hypothermia, hypoglycaemia, jaundice, respiratory distress, infection, trauma, bleeding and congenital abnormalities, as well as communication with parents. Skills chapters address resuscitation, size measurement, history, examination and clinical notes, nasogastric feeds, intravenous infusions, use of incubators, measuring blood glucose concentration, insertion of an umbilical vein catheter, phototherapy, apnoea monitors and oxygen therapy.

Perinatal HIV

Perinatal HIV enables midwives, nurses and doctors to care for pregnant women and their infants in communities where HIV infection is common. Special emphasis has been placed on the prevention of mother-to-infant transmission of HIV. It covers the basics of HIV infection and screening, antenatal and intrapartum care of women with HIV infection, care of HIV-exposed newborn infants, and parent counselling.

Primary Maternal Care

Primary Maternal Care addresses the needs of health workers who provide antenatal and postnatal care, but do not conduct deliveries. It is adapted from theory and skills chapters from Maternal Care. This book is ideal for midwives and doctors providing primary maternal care in level 1 district hospitals and clinics, and complements the national protocol of antenatal care in South Africa.

Primary Newborn Care

Primary Newborn Care was written specifically for nurses and doctors who provide primary care for newborn infants in level 1 clinics and hospitals. Primary Newborn Care addresses the care of infants at birth, care of normal infants, care of low-birth-weight infants, neonatal emergencies, and common minor problems in newborn infants.

Saving Mothers and Babies

Saving Mothers and Babies was developed in response to the high maternal and perinatal mortality rates found in most developing countries. Learning material used in this book is based on the results of the annual confidential enquiries into maternal deaths and the Saving Mothers and Saving Babies reports published in South Africa. It addresses the basic principles of mortality audit, maternal mortality, perinatal mortality, managing mortality meetings and ways of reducing maternal and perinatal mortality rates. This book should be used together with the Perinatal Problem Identification Programme (PPIP).

Well Women

Well Women was written for primary health workers who manage the everyday health needs of women. It covers reproductive health, family planning and infertility, common genital infections, vaginal bleeding, and the abuse of women.

Format of the courses

Objectives

The learning objectives are clearly stated at the start of each chapter. They help the participant to identify and understand the important lessons to be learned.

Pre- and post-tests

There is a multiple-choice test of 20 questions for each chapter at the end of the book. Participants are encouraged to take a pre-test before starting each chapter, to benchmark their current knowledge, and a post-test after each chapter, to assess what they have learned. Participants are provided with the correct answers so that they can mark their tests. Self-assessment allows participants to monitor their own progress through the course.

Question-and-answer format

Theoretical knowledge is presented in a question-and-answer format, which encourages the learner to actively participate in the learning process. In this way, the participant is led step by step through the definitions, causes, diagnosis, prevention, dangers and management of a particular problem.

Participants should cover the answer for a few minutes with a piece of paper while thinking about the correct reply to each question. This method helps learning.

Simplified flow diagrams are also used, where necessary, to indicate the correct approach to diagnosing or managing a particular problem. Each question is identified with the number of the chapter, followed by the number of the question, e.g. 5-23.

Important practical lessons are emphasised like this.

Note
Additional, non-essential information is provided for interest and given in notes like this. These facts are not used in the case studies or included in the multiple-choice questions.

Case studies

Each chapter closes with a few case studies which encourage the participant to consolidate and apply what was learned in the chapter. These studies give the participant an opportunity to see the problem as it usually presents itself in the clinic or hospital and integrate their new theoretical knowledge into practice. The participant should attempt to answer each question in the case study before reading the correct answer.

Practical skills

Some Bettercare books include workshops on practical skills that need to be practised, preferably in groups. These skills workshops list essential equipment and present step-by-step instructions on how to perform each task, often with pictures. If participants are not familiar with a practical skill, they should ask an appropriate medical or nursing colleague to demonstrate the clinical skill to them. In this way, senior personnel are encouraged to share their skills with their colleagues. Some of the skills are demonstrated in video clips on the website.

Bettercare tests and examinations

Self-evaluation is the most important part of learning. For every chapter, participants take a short self-test before and after studying each chapter. This way participants can see their knowledge improve and can address specific weaknesses.

Tests are included in all our printed books and ebooks. Participants can take them for free on our Learning Station for instant results.

Bettercare also offers a final examination for each book. Participants need to achieve at least 80% in the final examination in order to successfully complete the learning programme. Successful candidates will be sent a digital certificate stating that they have successfully completed that learning programme.

Contributors

The developers of our learning materials are a multi-disciplinary team of nurses, midwives, obstetricians, neonatologists, general paediatricians and other medical specialists. The development and review of all course material is overseen by the Editor-in-Chief, emeritus Professor David Woods, a previous head of neonatal medicine at the University of Cape Town who consulted to UNICEF and the WHO.

Perinatal Education Trust

The Perinatal Education Trust (PET) is a non-profit organisation which aims to improve the care of pregnant women and their newborn infants, especially in poor, rural communities. The Perinatal Education Trust produces and distributes all Perinatal Education Programme (PEP) material.

PEP presents a unique form of self-help training for health professionals which places the responsibility for continuing education on the participants themselves. It is cheap, appropriate, practical and does not require a teacher. Since 1989 over 100 000 health workers have used PEP course books in South Africa.

Breast Course for Nurses

The Breast Course for Nurses (BCN) combines distance education with a residential course. The emphasis is on learning rather than teaching. The Breast Course for Nurses can be adapted to suit the needs of the healthcare providers being trained.

Academic Unit for Infection Prevention and Control at Stellenbosch University

The Academic Unit for Infection Prevention and Control (UIPC) is based at Tygerberg Academic Hospital and the Stellenbosch University Faculty of Medicine and Health Sciences (FHMS). It resides under the Division of Community Health and is also a member of the Centre for Infectious Diseases.

The UIPC focuses on integrated research, training and service provision. The unit offers a range of tailor-made courses in Infection Prevention and Control (IPC) as well as decontamination and sterilization for Sterile Service Departments (SSDs). In addition, courses are offered for specialities such as operating theatres, renal dialysis units, intensive care units and infectious disease management and control.

Eduhealthcare

Eduhealthcare is a non-profit organisation based in South Africa. It aims to improve health and wellbeing, especially in poor communities, through affordable education for healthcare workers. To this end it provides financial support for the development and publishing of the Bettercare series.

The Desmond Tutu HIV Foundation

The Desmond Tutu HIV Foundation at the University of Cape Town is a centre of excellence in HIV medicine, building capacity through training and enhancing knowledge through research.

The Desmond Tutu Tuberculosis Centre

The Desmond Tutu Tuberculosis Centre at Stellenbosch University strives to improve the health of vulnerable groups through the education of healthcare workers and community members, and by influencing policy based on research into the epidemiology of childhood tuberculosis, multi-drug-resistant tuberculosis, HIV and TB co-infection, and preventing the spread of TB and HIV in southern Africa.

Perinatal Mental Health Project

The Perinatal Mental Health Project of the Department of Psychiatry and Mental Health at the University of Cape Town aims at improving the mental health of women both during pregnancy and in the months afterwards. The project targets women who are at risk of depression and anxiety.

The Infection Control Africa Network

The Infection Control Africa Network (ICAN) promotes and facilitates the establishment of infection control programmes. This includes promotion of surveillance for and reduction of healthcare-associated infections, and antimicrobial stewardship activities through education. ICAN works with infection prevention structures in Africa and other international health-related associations.

Updating the course material

Bettercare learning materials are regularly updated to keep up with developments and changes in healthcare protocols. Course participants can make important contributions to the continual improvement of Bettercare books by reporting factual or language errors, by identifying sections that are difficult to understand, and by suggesting additions or improvements to the contents. Details of alternative or better forms of management would be particularly appreciated. Please send any comments or suggestions to the Editor-in-Chief, Professor David Woods.

Contact information

Bettercare

Perinatal Education Programme

Exams

Support

Please contact us if you would like to know which learning programmes are available in print, ebook or online format. A list is available on www.bettercare.co.za/learning-programmes.

For information on learning programmes pending funding for development, publication and addition to the free online Learning Station, please email us at info@bettercare.co.za.

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