About Bettercare

We create coursebooks for healthcare professionals, so that they can learn and deliver excellent patient care. You can use our books in your study groups or formal training.

Our books are designed for peer learning in study groups. Their clear, step-by-step approach and simple language also make them great as textbooks.

You can read them online for free. And you can buy printed copies, too. Read about how to use our books.

We believe:

• Traditional training is too expensive and takes staff away from their patients.
• Peer-learning is the best learning: it is more motivating and effective to learn among trusted colleagues.
• Health professionals care deeply about their own development, and can be inspired and empowered to learn on their own.
• Health professionals need material that is appropriate to the places they live and work, especially in low-resource settings.

Read more below about our background, our team, research and impact, and what others have said about Bettercare.

Background

Many healthcare professionals know our books as the ‘PEP manuals’, originally developed as the Perinatal Education Programme. We have improved our books constantly for over thirty years, and they are widely used in state and private hospitals, non-profit organisations and training institutions in South Africa and many other countries. Read more about our PEP history.

Our books bring the latest developments in child, perinatal and HIV care to healthcare professionals working in challenging circumstances. We make high-quality, affordable and up-to-date training possible in every facility, regardless of its history, resources or geographical location.

Team

Bettercare is a registered non-profit run entirely by a volunteer board.

Prof David Woods is our Chairperson and Editor-in-Chief. He was the head of Neonatal Medicine at the University of Cape Town, and is now Emeritus Associate Professor. He has presented papers at over a hundred local and international conferences, has had seventy articles published in peer-reviewed journals and is the author of nineteen chapters or books. He is currently the Chairman of the Perinatal Education Trust and Eduhealthcare, a Director of Power-free Education and Technology, and consulted to UNICEF and the WHO. He is a past-President of the International Association for Maternal and Neonatal Health.

Prof Gerhard Theron is Emeritus Professor of the Department of Obstetrics and Gynaecology, Tygerberg Hospital and Faculty of Medicine and Health. He is highly involved in postgraduate training and serves on the faculty board at Stellenbosch University. Outside the university he is involved in ongoing research, serves on various committees and has won numerous awards including the Albert Strating prize for Preventative Medicine. He serves on the FIGO Committee for Safe Motherhood and Newborn Health, with dedicated goals to more effectively implement the PMTCT programme for the benefit of both mothers and children.

Prof Angela Dramowski is a Paediatric Infectious Diseases specialist with a passion for infection prevention. After sub-specialty training she worked at the Tygerberg Hospital Unit for Infection Prevention and Control. During her time at the UIPC Angela developed an interest in medical education, authoring two books with Bettercare on IPC for healthcare workers in resource-limited settings. Angela is also a founding member of the public benefit organisation TB Proof, which advocates for improved implementation of TB-IPC and creates awareness of occupational TB among healthcare workers.

Arthur Attwell manages our technology, licensing and business affairs. He has co-founded several acclaimed publishing initiatives, including Electric Book Works and Book Dash. Electric Book Works delivers high end book design with its own innovative publishing system. He is a Shuttleworth Foundation Fellow alum. He is online at arthurattwell.com.

Research and impact

Our methodology, developed originally by the Perinatal Education Trust since 1989, has been proven in controlled studies to improve knowledge, skills and patient care practices in health professionals.

• Farber, S.A. 1994. The effectiveness of the Perinatal Education Programme as a distance education programme for senior medical students. Postgraduate diploma in tertiary education. University of South Africa. (Unpublished).
• Field S, Abrahams Z, Woods DL, et al. Accessible continued professional development for maternal mental health. Afr J Prm Health Care Fam Med. 2019; 11(1), a1902.
• Rundare A, Goodman S. An outcome evaluation of a perinatal education programme. S Afr J of Human Resource Management 2012; 10: 424-431.
• Theron GB. Improved cognitive knowledge of midwives practising in the Eastern Cape Province of the Republic of South Africa through the study of a self-education manual. Midwifery 1999; 15: 66-71.
• Theron GB. Effect of the maternal care manual of the Perinatal Education Programme on the ability of midwives to interpret antenatal cards and partograms. J Perinatol 1999; 19: 432-435.
• Theron GB. Effect of the maternal care manual from the Perinatal Education Programme on the quality of antenatal care and intrapartum care rendered by midwives. _S Afr Med J_1999; 89: 336-342.
• Theron, GB. Improved practical skills of midwives practicing in the Eastern Cape Province of the Republic of South Africa through the study of a self-educational manual. J Perinatol 2000; 3: 184-188.
• Theron GB. The effect of the maternal care manual of the Perinatal Education Programme on the attitude of midwives towards their work. Curationis 2000; 22: 63-68.
• Woods DL. A distance learning programme in maternal and newborn care. Perinatology 2000; 2: 283-285.
• Woods DL. A self-directed learning course for midwives to improve the care of pregnant women and their newborn infants with HIV infection in South Africa. Nursing Update 2000; 24: 4.
• Woods D, Cope F, Eley B. The challenge of providing HIV training to health professionals. Southern African Journal of HIV Medicine 2008; 31: 23-25.
• Woods D. Appropriate technology and education for improved intrapartum care in under-resourced countries. S Afr J Obstet Gynaecol 2009; 15: 78-79.
• Woods DL, Greenfield DH. Teaching in under-resourced hospitals: Experience from South Africa. NeoReviews 2010; 11: 5-11.
• Woods DL. IMCI revisited. South African Journal of Child Health 2010; 4: 28-30.
• Woods DL, Attwell A, Ross K, Theron G. Text messages as a learning tool for midwives. SAMJ 2012; 2/102. Also see this magazine article (PDF).
• Woods DL. Improving neonatal care in district and community health facilities in South Africa. Paediatric and International Child Health 2015; 35: 187-191.
• Woods DL and Theron GB. The Perinatal Education Programme. S Afr Med J 1994; 84: 61.
• Woods DL and Theron GB. The impact of the Perinatal Education Programme on cognitive knowledge of midwives. S Afr Med J 1995; 85: 150-153.
• Woods DL. An innovative programme for training in maternal and newborn care. Semin Neonatol 1999; 4: 209-216.

Testimonials

Lloyd Kaseke, Medical Advisor at Life Healthcare, writes:

A colleague introduced me to PEP in 1993 while I working as a medical officer in a rural hospital in Limpopo.

Though I never formally assessed the impact PEP had on our outcomes at the hospital, I noticed three specific changes: there was an increase in rapport between myself and the maternity unit staff; patients in the maternity ward were properly handed over to the next shift and staff better understood what needed to be done to ensure the best possible outcomes; and the quality of clinical information conveyed over the phone now allowed me to make clinical decisions faster, saving time especially when urgent intervention was required. The manual was written in easy language and I found the self-assessment pages at the end of each section were an excellent gauge of progress made. I would later use the same questions to test if my team had been listening during the bedside tutorials in the antenatal clinic and in the maternity ward.

Going through the PEP manuals myself helped me pass the College of Medicine’s Diploma in Obstetrics examination and increased my confidence to do more and share what I knew with the teams I worked with.

More recently in my current management position at Life Healthcare, we had 252 maternity nurses completing PEP in 2012 and aim to have 300 complete PEP in 2013. We are determined that by the end of 2014, every one of our maternity nurses must have completed the Maternal Care and Newborn Care courses. We believe this is the least we can do to help South Africa achieve its Millenium Development Goals with respect to maternal and perinatal mortality.

Ruth Davidge is a Registered Nurse and Registered Midwife, certified Neonatal Intensive Care. She is the founding President of the Neonatal Nurses Association of South Africa (NNASA), Director-at-Large of the Council of International Neonatal Nurses (COINN), and Neonatal Co-ordinator for Western Kwazulu-Natal. She says about the PEP range of Bettercare books:

Around the world 40% of the children that die before they are 5 years old die in the first month of life-the neonatal period. It is the most vulnerable period of one’s life and one when brain growth and development is most active. It is critical that the health care workers caring for these precious babies have the knowledge, skills and resources they need in order to deliver top quality and holistic health care and to improve the health outcomes for this vulnerable population. Currently in South Africa no stand-alone neonatal nurse training is offered or recognised. There are less than 100 neonatologists in the whole country. The PEP course offers basic, simple to use, self-study educational resources primarily in maternal and neonatal care that can be used at any level. It has been used by thousands of health care workers in South Africa and beyond to improve their knowledge and skills. In the last couple of years I have incorporated it into our basic neonatal training course in Kwazulu-Natal with good effect. Doctors and nurses train together and even a nursing assistant achieved 92% on the final exam!

Eckhart Buchmann qualified as a specialist obstetrician and gynaecologist in 1993. He has worked at Chris Hani Baragwanath Hospital ever since and was appointed Head of the Department of Obstetrics and Gynaecology in 2005 until 2012. The hospital is the busiest maternity centre in South Africa and is the direct referral hospital for seven midwife obstetrics units (MOUs). In 2012 Eckhart was appointed District Clinical Obstetrician for Johannesburg. He says of the PEP range of Bettercare books:

I was introduced to PEP by Professor Bob Pattinson in 1993 and from then up to 2002 I trained over 250 midwives from Chris Hani Baragwanath and the MOUs in PEP maternal care and PEP HIV/AIDS. Administrative commitments in the hospital did not allow me to continue with this commitment. …This year I have taken up the District Clinical Obstetrician post for Johannesburg and will be starting PEP maternal care training again at MOUs and district hospitals. Hillbrow MOU in central Johannesburg has enrolled 18 midwives for the Maternal Care course, which started in November 2012.

Vanessa Booysen is part of the Maternal, Child and Women’s Health Unit (MCWH Unit), which started as a task team in 2011 to investigate the concerning high neonatal mortality and morbidity rates in the Free State (the highest in the country). She is the Provincial Universal Hearing Screening Co-ordinator, Provincial Co-ordinator for Retinopathy of Prematurity Screening, and the Provincial PEP Course Co-ordinator. She is also a lecturer at the University of the Free State in both undergraduate and postgraduate Nursing, Medical and Allied Health Sciences. She writes:

I have made the PEP course a compulsory self-study programme that has to be done by all healthcare workers working with mothers and babies in the Free State… Manapo Hospital in QwaQwa is a success story where we successfully reduced the neonatal mortality rate by 66% in only three months.

Miriam Adhikari was the Head of Department of Paediatrics and Child Health at the University of Kwazulu-Natal. She is a specialist neonatologist. She developed the undergraduate curricula for the Paediatric component of the MB ChB programme. In addition, she has developed training courses for midwives and advanced midwives for the past 20 years and participated in the development of the Neonatal Outreach Programme, accepted by the Department of Health for NICUs in specific areas. She writes:

[The Neonatal Outreach Programme] was finally accepted by the Department of Health and is being conducted for the NICU at IALCH by consultant staff trained for this specific purpose… The PEP programme was suggested for neonatal and maternal care.

Peggy Kannagi Naicker has over twenty years of critical-care nursing experience. She was involved in opening the Heart Centre at Life Westville hospital in 1998 and become the Unit Manager of the Coronary Care Unit in the same year. She joined the Nursing Education Association (NEA) in 2010 and has since run curriculum development and teaching innovation workshops nationally on behalf of the NEA.

We have used the PEP/EBW courses for both our midwives and neonatal nurses and they have been highly beneficial in helping them update their knowledge and skills. We have a CPD programme and the completion of these courses are a requirement for these nurses CPD.