Death rates for newborn children fell by nearly one third in a study in rural Nepal when locally-run women's groups met to talk about safe births. The study in the British medical journal The Lancet is the first of its kind to show that a low-cost, community-based education program aimed at reducing infant deaths can work.

An estimated four million infants die each year, almost all of them in the developing world, largely because mothers don't have access to health care. In the study, respected local women in certain villages were trained to lead group discussions on what problems local women faced in childbirth and how to fix them.

Study author Anthony Costello at London's Institute of Child Health and his colleagues compared these villages to villages that didn't have the group meetings.

"We were really astonished when after a two and a half year period we looked at the data and found a 30 percent reduction in newborn deaths," said Mr. Costello. "And then even more astonished when we found that there was a nearly 80 percent reduction in maternal deaths."

Costello says the reductions in death rates are the result of more pregnant women seeking health care during pregnancy and giving birth in a health facility or with trained birth attendants. And birth attendants were more likely to wash their hands and use a clean blade to cut the umbilical cord. Women's groups also frequently had developed emergency plans to get mothers to a health center and pay for her treatment if problems developed during her pregnancy.

Dr. Costello says experiments are underway to try the same approach in other countries.