Effectiveness of a regional self-study perinatal education programme: a successful adaptation in Yucatan, Mexico.

OBJECTIVE: To evaluate the effectiveness of the Perinatal Continuing Education Programme (PCEP) in a Latin American country. METHODS: We carried out a study within secondary and tertiary care, and rural Mexican Institute of Social Security (IMSS) hospitals on the Yucatan Peninsula. Participants were doctors, nurses and nursing assistants working with pregnant women and newborns at each hospital. The PCEP was translated into Spanish and then implemented between January 1998 and December 2001. Two nurses at each hospital were trained to co-ordinate the programme and the personnel were invited to participate. Participation involved purchasing the self-teaching books, study outside work hours and participation in skills demonstration and practice sessions. Evaluation included the percentage of personnel who participated in and those who completed the programme, an opinion survey of the programme, level of pre- and post-intervention knowledge, and the quality of neonatal care according to expert-recommended routines. Results were analysed with chi-square and Student's t-tests. RESULTS: A total of 65.3% of the 1421 people in the study population began the programme and 72% of those completed it. Improvement was observed in 14 of 23 (P<0.05) evaluated neonatal care practices. Participants rated the written material as very clear and useful in daily practice. CONCLUSIONS: The PCEP is an effective strategy for improving the level of knowledge and perinatal care in all regional hospitals on the Yucatan Peninsula, Mexico. This initial application of the PCEP in a Spanish-speaking country was successful.

Regionalized perinatal education.

Despite changes in the organization and financing of healthcare delivery, and dramatic increases in the number and distribution of perinatal facilities and professionals over the past three decades, there remains a continuing need for effective and efficient regionalized perinatal outreach education programmes. Both the organizers and the participants should be multidisciplinary and include both inpatient and outpatient providers. Content should be restricted to issues relevant to participants' practice, and include topics ranging from preconception to postpartum and early infant care. There are various effective formats, but consideration should be given to reaching as many providers as possible simultaneously within a given facility, minimizing expense and economizing on participants' time. Evaluation strategies range from assessment of immediate outcomes, which generally examine programme process, to ultimate outcomes, which measure changes in patient care and patient health.