Racha is a broad-based program that works at the community, health center and hospital levels. It is a strong partner of the Ministry of Health (MoH). Success in partnering with the MoH has come from working at multiple levels, working with elements of both the formal and informal systems and linking them wherever possible. Racha calls this "Whole Health." The objective is to have all systems that contribute to good health function as best they can, within the existing resource limitations. If improvements in health are going to be achieved for the current generation of mothers and children, of necessity, they have to be achieved within the existing resource poor environment.

The Program

There are six focus areas within the Racha program: Child Health, Safe Motherhood, Birth Spacing, STD/HIV/AIDS, Infectious Diseases, and Capacity Building and four supporting units: Health Communications, Monitoring and Evaluation, Information Technology, and Finance and Administration. Each of the support units, besides supporting the Racha program, provide technical assistance and make capacity building contributions to local and international NGOs. Racha has been managed by EngenderHealth but has grown into a Cambodian NGO and received that recognition the first of February 2003.

The People

Racha's staff includes 17 physician, 15 midwives, 12 medical assistants, 9 nurses, and 3 pharmacists. In total the Cambodian staff represents approximately 1,100 years of experience in working with the health system in Cambodian; the senior advisors, working with the Cambodian staff represent over 80 years of international health experience.

The Places

Racha has a central office with a full-time staff of 70 in Phnom Penh. An active intern program that builds the skills of young Cambodians adds 12 additional staff members. There are an additional 32 staff members working from Racha's three provincial offices - Siem Reap, Pursat and Kampot - and two drop-in centers that provide counseling, social development and STD treatment for young women working as indirect sex workers in Siem Reap and Pursat. Two additional provincial offices and two more drop-in centers will be added in 2003.

The Partners

Racha works hand-in-hand with the MoH; its provincial offices are located with the MCH offices. At the same time, Racha works extensively with voluntary and commercial elements of communities, as well as with other NGOs and international agencies.

The Results

The MoH and Racha linked with community resources in health center catchment areas have achieved some very impressive service coverage rates, e.g., as high as 40 percent contraceptive prevalence rates; immediate breast feed feeding at 70 percent; full immunization over 80 percent, and TT2 as high as 70 percent. While far from achieving perfect health, working at all levels of the health system and linking to communities, i.e., using a Whole Health approach, the MoH and Racha have demonstrated that quality service delivery can be achieved in Cambodia's extremely resource-poor rural environment.