NEW DELH Mar 27, 2010: A success story that reduced neonatal mortality in the heart of Uttar Pradesh by 54% in just 18 months - by simply educating pregnant mothers and their in-laws against high risk birth practices - will now spearhead Africa's fight against infant mortality.

According to Melinda Gates, philanthropist and wife of Bill Gates, one of the world's richest men, lessons learnt from the success of Saksham project in Shivgarh district of UP will be emulated in Malawi and other parts of Africa to reduce neonatal mortality there.

The Bill and Melinda Gates Foundation had committed $9.9 million to this project.

"In UP, we found that `kangaroo' caring and early breastfeeding reduced infant mortality by 54%. We will now spread these practices in Malawi," Melinda who arrived in India on Tuesday for a four-day visit, said.

"We need cultural change. We found that in UP, most mothers delivered squatting. The babies therefore fell on the ground. Instead of wiping the baby, many women scrubbed it with clay or soap, causing abrasion leading to injury related infections. Instead of introducing the baby to mother's milk, many were given tea, or goat's mild and sometimes water," she said.

"We told women and their in-laws that simple practices like allowing the mother to hold her child close to her chest, breast-feeding from the first day and wiping not washing the newborn dramatically increased the baby's chances to live. Once these women got on board, the message spread like a virus," Melinda, who spent two days in UP and also met chief minister Mayawati, said.

The Saksham pilot study was conducted in 39 villages and 300 hamlets. Neonatal death rate fell from 81 per 1,000 births to 40 per 1,000 births in just 18 months after mothers started following these simple rules. "We published the data in medical journal Lancet. Interestingly, we have now found that by following risk free birth methods, maternal mortality rate also fell by 34% - a finding which has been sent to Lancet now," said Vishwajeet Kumar, an alumnus of Johns Hopkins University and head of the Saksham project.

According to Melinda, all lives have equal value. Nearly 9 million newborn children die globally before reaching 5 years of age. Around 25% of these are from India, with the majority being from UP and Bihar.

"Such simple interventions like kangaroo care can help neonatal live. Where will you find incubators in Rae Bareli," Melinda said.

According to her, over $1 billion has already been invested in India. "Our money (over $30 billion) looks like a large amount but its actually tiny in face of solving some global health problems. In 1960, 50 million children died before 5 years of age. Now, its 9 million, showing there has been an astronomical drop, thanks to the new vaccines introduced in national programmes.”

Asserting that India's success in reducing maternal and child mortality was absolutely crucial for the world's chances of reaching the Millenium Development Goals by 2015, Gates urged India to increase its health spend from 1% of its GDP at present to 3% as promised.