The number of newborn babies who die at or just after birth in the developing world could be reduced by nearly a third through better basic training, according to researchers at Birmingham University.
A joint study with Liaquat Medical University in Pakistan, involving 20,000 women from rural areas, showed both perinatal and maternal care could be vastly improved.
Most, if not all, births in such areas are overseen by traditional birth attendants, often illiterate women with no education. By giving them basic training, delivery hygiene kits and integrating them into an existing health care system, researchers saw the number of neonatal deaths fall by 30 per cent.
The pioneering study, led by Dr Abdul Hakeem Jokhio - the first to use scientific methods to assess the impact of training - was published in the New England Journal of Medicine.
One in ten babies born in Pakistan will die before or within one month of birth, and one woman in every 250 dies as a result of childbirth.
Dr Jokhio, of the university's Public Health and Epidemiology department, completed the research for his PhD. He said: "The study results will be of interest across the developing world.
"If traditional birth attendants are trained and integrated into the health care system then babies' lives and possibly mothers' can be saved.
"We need to bring rural communities closer to health services, and I would call upon policy makers to encourage traditional birth attendants and skilled health workers to work together."
Dr Jokhio, formerly deputy director of health services in Pakistan's central province, conducted the study with the help of female health workers in the rural region of Larkana.
Traditional birth attendants were given disposable delivery hygiene kits which contained simple items like antiseptic and umbilical cord clamps. They were linked to health workers, health centres and antenatal clinics, and women were encouraged to have antenatal care.