PROVO — It takes more than doctors and nonprofit health organizations to raise a child in a Third World country. It takes a whole community, said experts Friday at the 2009 Global Maternal and Child Health Conference at Brigham Young University.

"We can provide the basic training and the technical support, but we can't force the implementation," said Dr. Indira Narayanan, the senior technical adviser for newborn health at BASICS, which is the Global Child Survival Program sponsored by the United States Agency for International Development.

Narayanan was one of five health professionals from groups ranging from the World Health Organization to the March of Dimes who spoke at the symposium. They focused on mother, newborn and child health issues from a family and community perspective.

"I think there are a lot of people in our state who have a lot of skills, energy and desire to make a difference in the world," said Shannon Clegg, a registered nurse who helped organize the conference, which Brigham Young University sponsored. "This conference was about helping those people become aware of the problems we are facing globally so they can get motivated, get involved and make a difference."

Ninety-nine percent of newborn deaths occur in low- to middle-income countries, according to USAID. Most of those deaths occur within the first week.

The key to lowering infant mortality rates, speakers emphasized, is educating not just doctors but also families.

"Around the world, a large percentage of babies are not born in hospitals," Clegg said. "They are born in homes or villages."

Clegg said a lot of the issues babies face at birth can be prevented by teaching mothers four simple steps: (1) dry the baby off quickly, (2) keep the baby warm, (3) clean the nose and mouth, (4) breast feed. Health workers suggest mothers give the baby the "kangaroo treatment" by keeping them close, skin to skin.

Even if mothers have access to a hospital, they may not get the instructions they need to care for their child.

"Doctors are the worst, I'm sorry to say," Narayanan said. "We talk in the medical language and the poor mother just stares at us blankly, not sure if she can ask a question. Then she ends up leaving our office and asking the cleaner, 'What do I do about this?' "

Consequently, Narayanan said, the goal has become to arm not just doctors but community workers with the skills and confidence it takes to get an infant safely through that perilous first week.

"We've made everything simple," Narayanan said of the USAID program. "We don't teach the people theory or background, we just tell them what to do and when to do it."

While infant mortality continues to be a major issue in low-income countries, USAID and similar programs have watched the numbers improve as they've started to educate the community as a whole.

"We always think the facility does everything for the community, but sometimes it's the other way around," Narayanan said. "When it comes to newborn health, one is nothing without the other."

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