Celebrate Solutions: The Reproductive and Child Health Alliance in Cambodia

By: Madeline Taskier, Partnership Coordinator at Women Deliver

The Southeast Asian country of Cambodia borders the South China Sea and is surrounded by Vietnam, Thailand, and Laos. The maternal mortality ratio in 2008 was 290 deaths per 100,000 live births, but has been show to be as high as 493 deaths per 100,000 live births in rural areas.  Over the last decade, the Cambodian government has increased the availability of reproductive health services, but there is still great need for services among expecting mothers in rural areas. A national program is working to narrow the gaps in care, decrease the urban-rural disparities, and educate community-based health workers to provide lifesaving maternal care. The Reproductive and Child Health Alliance (RACHA) was established in 2003 with funding from USAID for 5 years. Since 2008, it has expanded its funding and partnerships to include Population Services International (PSI), the Reproductive Health Association of Cambodia, and University Research Company LLC in their programming.

RACHA directly collaborates with the Cambodian Ministry of Health (MoH) and other partners to strengthen and train the healthcare workforce and disperse community health educators in the rural provinces. The program has set high goals for its target population by 2013: To reduce maternal mortality by 25 percent; to increase modern contraceptive prevalence by 25 percent; and to reduce HIV prevalence in sexually active populations by 10 percent. So far, RACHA has expanded its program coverage from 4 to 8 rural provinces, covering 164 health centers, 2,329 villages, 259 communes, and serving an estimate population of more than 2 million people.

At the core of the RACHA’s safe motherhood program is the Basic Life Saving Skills training (LSS) which trains primary and secondary midwives from rural health centers.  These midwives—the most common maternal healthcare providers outside of hospitals—learn the key maternal health interventions such as nutritional antenatal care, essential newborn care, immediate breastfeeding, trained delivery, referral service communication, and birth spacing. The midwives and the community health workers in the program also encourage patients to get tested for HIV at local sites and educate about PMTCT, HIV prevention, and treatment. Since the start of RACHA’s safe motherhood program in 2003, over 54,390 babies have been successfully delivered.

RACHA has experienced great success in the dissemination of trained health care workers and the integration of these trainings with MoH services and facilities. The program is an excellent example of cross-sector partnerships and successfully building upon existing government health programs to reach rural women.

• Check out RACHA’s Online Health Resource Center

Flickr photo courtesy of United Nations Photo