Health-related MDGs in Democratic Republic of Congo (DRC) are very poor. Under-five mortality (2002-06) was 148 per 1,000 live births, the prevalence of chronic malnutrition among children under five is 45% and maternal mortality in 2001 was 1,289 per 100,000 live births. Administrative capacity is low. Not all health workers are salaried, salaries are often paid irregularly and health workers rely on user fees for a significant proportion of their remuneration. In many poor and rural areas, there are shortages of skilled workers. International support for the development of the health system, building on government experience with partnerships with church groups and other non-governmental organizations, is often channeled through contracts with NGOs. The health sector component (USD 60 million) of a multi-sectoral emergency project (2002-09) contracted NGOs to provide support to government and confessional health services in target areas. Similarly, the HSRSP (2005-11) contracts NGOs to provide technical assistance, training, and inputs in order to improve delivery of the government’s basic package of services which is designed to address the major causes of morbidity and mortality.