On the eve of a high-level international summit on maternal and child health being held in Toronto, questions have been raised about Canada’s own infant-health issues on First Nations reserves.

Over the next three days, Prime Minister Stephen Harper will host world leaders, global health experts and philanthropists to discuss efforts to improve immunization and nutrition -- among other key factors in child and maternal health -- in developing countries.

But experts point out that Canada needs to look more closely at the situation within its own borders.

One in four children on Canada's First Nations reserves lives in poverty. Four years ago, an extensive study of infant mortality in Manitoba showed that the death rate for aboriginal babies was more than twice the Canadian average.

Dr. Janet Smylie, a family physician and research scientist at St. Michael’s Hospital in Toronto, said she’s happy that Canada is taking a leadership role on global child and maternal health, but she continues to be “shocked and surprised with respect to the challenges facing our indigenous families right here in Canada.”

Smylie said First Nations infants’ mortality rate is twice as high as the rest of Canada. For Inuit infants, the rate is four times higher, she said.

“If we can’t take care of our own issues domestically, I don't know what we can do internationally,” Smylie said in an interview with CTV News. 

Smylie said there needs to be “an urgent inquiry as to why there are these disparities” in infant mortality rates in First Nations communities.

“There is no reason for these infants to be dying,” she said.

Some reserves, including the Six Nations community near Brantford, Ont., have a physician and good quality health services for mothers and babies.

But most others are plagued by inadequate housing, poor food quality and contaminated water supplies, among other issues.

“We don’t even have clean drinking water in most of our communities,” said Amber Skye, a lecturer on indigenous health at Ontario’s McMaster University. “What does that say about the health of those in our communities?

“I value the position Canada takes in trying to support other countries, but at the same time we need to look what is happening in our country.”

Skye said aboriginal mothers and children are “used to being left out of statistics” when it comes to health and well-being.

But Helen Scott, the director of the Canadian Network for Maternal Newborn Child Health, said aboriginal health “is very much a component” of the summit set to kick off Thursday.

Scott said Canada’s global initiatives on maternal and child health have had a “tremendous impact,” as infant mortality rates decrease around the world and immunization efforts ramp up.

“It’s a reflection of our values,” Scott said. “We are a generous people, though our programs. This is a moment where we can be very proud of the work we are doing collectively.”

In 2010, Harper pushed to make maternal health a main agenda item at the G8 summit and Ottawa pledged $2.85 billion over five years to keep vulnerable moms and babies healthy in the developing world. 

With a report from CTV’s Medical Specialist Avis Favaro and senior producer Elizabeth St. Philip