Hospital bosses are determined to help Asian women conquer cultural barriers to health services after visiting Pakistan to see how patients are treated there.

Three executives from Birmingham Women's Hospital were shocked to learn some women in Pakistan "don't see the point" of ante-natal and post-natal care.

One woman they spoke to while visiting Mirpur, in Kashmir, claimed infant mortality was preferable to having a Caesarean performed by a man.

Phil Elliott, director of finance for Birmingham Women's Health Care NHS Trust - which runs the hospital - went on the four-day trip with chief executive Caroline Wigley and board chairman Ann Owen.

"We didn't see the point of going to somewhere like Sweden or Germany to find out how best to treat the Asian population.

"It seemed obvious we should go to Pakistan to look at their healthcare system," said Mr Elliott.

"They have no concept of waiting times as most healthcare is provided in community facilities so there is no real pressure on hospitals.

"Most worrying was the woman who said she would prefer to lose her baby than have a Caesarean carried out by a male gynaecologist.

"Coupled with the fact is many Asian women are not accessing ante-natal and post-natal care, which could be one reason why infant mortality is so high in the Midlands."

Figures published last week by the Office of National Statistics revealed the number of babies that die in England and Wales had risen for the first time in four years.

The West Midlands recorded the worst rate, with two out of three infant deaths occurring in the first month of life.

Mrs Owen said that 45 per cent of all births at the Women's Hospital came from the Asian community and a better understanding of the community's needs was vital.

"There has to be some correlation between the region's high-prenatal mortality rate and the way different communities treat their pregnancy," she said.

"A culture of regular checkups does not exist in Mirpur, and it certainly doesn't exist within Birmingham's Pakistani population.

"There is a lack of research into why infant mortality is so high in the Midlands, but it would appear the two issues could be connected."

Following their fact-finding trip, the team has come up with a number of recommendations for improving the Asian community's access to health services.

Top of the list is the need to recruit more female obstetricians and gynaecologists.

Of the 20 consultants working at the Women's Hospital only two are women. The trust is already targeting women in Sparkbrook, Sparkhill and Small Heath.

Its first community clinic was set up in Green Lane Mosque, in Small Heath, to try and help break down cultural barriers to health.

Mr Elliott said: "We came back with a real need to make some changes, not just to benefit the Asian community but all our patients.

"In Kashmir, men and women live in a heavilysegregated society, so there are real problems around male doctors treating women.

"If they can't come to us, we have got to go to them."