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Bettercare publishes an innovative series of distance-learning books for healthcare professionals, developed by the Perinatal Education Trust, Eduhealthcare, the Desmond Tutu HIV Foundation, the Desmond Tutu TB Centre, the Perinatal Mental Health Project, the Academic Unit for Infection Prevention and Control at Stellenbosch University, and the Infection Control Africa Network, with contributions from numerous experts.
Our aim is to provide appropriate, affordable and up-to-date learning material for healthcare workers in under-resourced areas, so that they can learn, practise and deliver excellent patient care.
The Bettercare series is built on the experience of the Perinatal Education Programme (PEP), which has provided learning opportunities to over 60 000 nurses and doctors in South Africa since 1992. Many of the educational methods developed by PEP are now being adopted by the World Health Organisation (WHO).
Continuing education for health workers 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 workers’ families and places of work, and the content frequently fails to address the biggest healthcare challenges of poor, rural communities.
To help solve these many problems, a self-help decentralised learning method has been developed which addresses the needs of professional healthcare workers, especially those in under-resourced regions.
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 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.
Birth Defects was written for healthcare workers who look after individuals with birth defects, their families, and women who are at increased risk of giving birth to an infant with a birth defect. Special attention is given to modes of inheritance, medical genetic counselling, and birth defects due to chromosomal abnormalities, single gene defects, teratogens and multifactorial inheritance. This book is being used in the Genetics Education Programme, which trains healthcare workers in genetic counselling in South Africa.
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.
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 for use in primary-care settings.
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 and without antiretroviral treatment, antiretroviral drugs, opportunistic infections and end-of-life care.
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/TB co-infection. Childhood TB was developed in collaboration with the Desmond Tutu TB Centre.
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, protection of healthcare workers, support services 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 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 IPC programmes, risk management, health facility design, outbreak surveillance and antimicrobial stewardship.
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 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 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.
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 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 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 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 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 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 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.
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.
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. Self-assessment allows participants to monitor their own progress through the course.
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, for example 5-23.
Important practical lessons are emphasised like this.
Each chapter closes with a few case studies which encourage the participant to consolidate and apply what was learned earlier in the chapter. These studies give the participant an opportunity to see the problem as it usually presents itself in the clinic or hospital. The participant should attempt to answer each question in the case study before reading the correct answer. Case studies without the correct answers are also used at the start of some chapters to identify common clinical problems that need to be addressed.
Some Bettercare books include chapters on practical skills that need to be practised, preferably in groups. These skills chapters 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.
On completion of each course, participants can take a 75-question, self-managed multiple-choice examination.
All the exam questions will be taken from the multiple-choice tests from the book. The content of the skills chapters will not be included in the examination.
Participants need to achieve at least 80% in the examination in order to successfully complete the course. Successful candidates will be sent a certificate which states that they have successfully completed that course. South African doctors can earn CPD points on the successful completion of the CPD test at the end of each chapter.
The developers of our learning materials are a multi-disciplinary team of nurses, midwives, obstetricians, neonatologists, and general paediatricians. The development and review of all course material is overseen by the Editor-in-Chief, emeritus Professor Dave Woods, a previous head of neonatal medicine at the University of Cape Town who now consults to UNICEF and the WHO.
Books developed for the Perinatal Education Programme are provided as cheaply as possible. Writing and updating the programme is both funded and managed on a non-profit basis by the Perinatal Education Trust.
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 at the University of Cape Town, South Africa, is a centre of excellence in HIV medicine, building capacity through training and enhancing knowledge through research.
The Desmond Tutu TB Centre at Stellenbosch University, South Africa, 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/TB co-infection and preventing the spread of TB and HIV in southern Africa.
The Perinatal Mental Health Project of the Centre for Public Mental Health in the Department of Psychiatry and Mental Health at the University of Cape Town, South Africa, aims to improve the mental health of women during pregnancy and in the months afterwards. The project targets women in low-resource settings who are at risk of depression and anxiety.
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.
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 Dave Woods.