Most previous methods of continuous training, especially for nurses, consisted of instructional courses at central hospitals. These traditional courses were expensive and managed by formal tutors. Frequently participants had to leave their homes and places of employment to attend these courses. The content was often inappropriate to the needs of smaller hospitals and clinics and did not address the health care problems of poor, rural communities. The result commonly was disappointment and frustration. Therefore, traditional training courses were often not accessible to staff working in rural areas where maternal and perinatal mortality rates are the highest. Due to lack of funding, few experienced tutors, long distances and the impracticality of moving essential staff away from their homes and workplaces, what was urgently needed was some form of self-help, distance learning programme.

Beginning in 1989, the first two PEP books were written by a small team of paediatricians, obstetricians and nurses. Later, suggestions and comments by colleagues from all over South Africa were incorporated in an attempt to reach a consensus document on the care of mothers and infants. On an ongoing basis, the results of the final examination in the PEP course, together with ideas from participants, still help to identify minor problems or improvements. As new and better methods of diagnosing and treating patients are found, additions and changes are made to the PEP books. In this way, the PEP courses are revised and updated and able to meet the ever changing needs of perinatal care.

The same PEP format has been used to develop books which address other areas of health care in poor communities.

Many of the educational methods used in the PEP course were inspired by the Perinatal Continuing Education Programme (PCEP), a very successful and internationally used distance learning course in advanced perinatal care developed in the USA (www.pcep.org).

References in peer-reviewed journals

• 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.
• 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.