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Analytical summary - Child and adolescent health

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According to the Gambia Multiple Indicator Cluster Survey 2005–2006 (Round 3), the under-five mortality rate was 131 per 1000.[1] This figure represents a fall in mortality compared with the Gambia multiple indicator cluster survey 2000–2001 (Round 2), which reported a mortality rate of 141 per 1000.[2] Many factors related to the improvement in health services and social determinants of health have contributed to this success.

Malnutrition among children continues to be a major public health problem in the Gambia. Children aged under 5 years are vulnerable owing to poor feeding practices, inadequate care and increasing exposure to infection, with poor environmental sanitation being a major contributing factor. Although breastfeeding is a universal practice in the Gambia, exclusive breastfeeding practice stands at 41% and protein energy malnutrition is more prevalent among children aged under 5 years.[3]

The Gambia Expanded Programme on Immunization is a success story in Africa. The country was conducting campaigns as a means of disease prevention and control before the establishment of the Expanded Programme on Immunization in 1979. Overall, total vaccination coverage among Gambian children for all antigens is 55.3% and for single antigens ranges from 97.4% for Pentavalent 3 and 96.6% for Bacille Calmette-Guérin.[4]

In the Gambia, three fundamental strategies were established to curb the burden of communicable diseases in children. These are the:

The Ministry of Health and Social Welfare adopted the Integrated Management of Neonatal and Childhood Illness Strategy as a means of reducing child mortality through the holistic care of children aged under 5 years. With the introduction of newborn health as part of this Strategy, newborn health is given the attention needed. However, owing to resource constraints, both human and material, there remains much to be done. An initiative of the First Lady of the Gambia, dubbed "Operation Save a Baby", has been in the forefront of advocating and raising funds to care for newborns in the main teaching hospital and other hospitals.

In 2007, the President of the Gambia pronounced that pregnant women and all children aged under 5 years should be given free medical care. Despite the establishment of health facilities, disparities in the distribution of health care and the quality of health services between rural and urban areas remain evident.[5] The national policies system and clusters include:

  • health systems and services
  • determinants of health
  • healthy environment
  • food safety and nutrition
  • medical products and technology.

In 2001, policies and strategies aimed at addressing health system priorities were outlined and include the:

  • Malaria Policy
  • Adolescent and Youth Policy
  • Food and Nutrition Policy
  • Integrated Management of Neonatal and Childhood Illness Policy
  • National Policy on HIV/AIDS.

There is heavy reliance on external sources of funding.[6] The human resource for health situation analysis carried out between 2002 and 2003 highlighted a number of human resources for health issues that contribute in one way or another to poor performance of the health system and also affect child health.

To date, the country has enjoyed a polio, measles, neonatal tetanus and yellow fever free status since 2004, owing to high routine immunization coverage and a robust surveillance system.[7]


  1. Gambia Multiple Indicator Cluster Survey 2005–2006 (Round 3). Gambia Bureau of Statistics, Department of State for Finance and Economic Affairs
  2. Gambia Multiple Indicator Cluster Survey 2000–2001 (Round 2). Gambia Bureau of Statistics, Department of State for Finance and Economic Affairs
  3. National Nutrition Policy, 2000–2004. Banjul, Government of the Gambia
  4. Expanded Programme on Immunization routine data, 2010
  5. The Gambia Child Survival and Development Strategy, 2009. Banjul, Government of the Gambia, Ministry of Health and Social Welfare
  6. County progress report. The Gambia (pdf 443.16kb). National AIDS Secretariat, Office of the President, 2012
  7. World health statistics 2009 (pdf 5.77Mb). Geneva, World Health Organization, 2009