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Analytical summary - Social determinants

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The population growth rate in the Gambia is 2.74%, with a crude birth rate of 46 per 1000 population and a total fertility rate of 5.4 births per woman. The Gambia is one of the most densely populated countries in Africa.[1] The youthfulness of the population (63% below 24 years) puts a strain on health service delivery. Average life expectancy at birth is 64 years overall. Rapid population growth and high levels of fertility are a challenge for poverty alleviation efforts as well as for improving quality of life of the people.

The Government of the Gambia has introduced free primary education, hoping to empower women in the future to become more involved in their reproductive health. This will contribute to improving some of these indices and lead to improved quality of life for the population.

Poor living conditions, such as the quality of housing structure (building materials) and inadequate ventilation in combination with prolonged exposure to indoor air pollution in family homes leads to poor health, especially in children.

A total of 61% of the population is classified as poor. The pursuit of equity and the reduction of inequality in health by improving the health and survival chances of socioeconomically disadvantaged communities within the country has become the priority of the Government and international organizations over the years. The launching of the Programme for Accelerated Growth and Employment[2] by the President shows the level of the Government's commitment to reducing poverty through sustainable strategies such as job creation, especially among young people.

There are free services for pregnant women, who were previously disadvantaged because of their dependence on men to pay the service bill.

There has been an increase in net student enrolment in primary and secondary school from 46% in 1991–1992 to 94.9% in 2008–2009, and gender parity has been achieved.[3] This places the Gambia as one of the few countries that will meet the Millennium Development Goal targets in education by 2015. The establishment of a Ministry of Higher Education, Research, Science and Technology in 2007 shows that science and technology is recognized by the Government as a catalyst for rapid development.

The country relies heavily on external donor support; the Kuwait Fund for Arab Economic Development accounted for 10.4% of grant aid, the Islamic Development Bank accounted for 9.3% and Chinese Taipei accounted for 6.8%.

The Gambia is a peaceful country under a democratic system of government. It was ranked 91 out of 178 countries in Transparency International’s Corruption Perceptions Index for 2010.


  1. WHO Country Cooperation Strategy 2008–2013, Gambia (pdf 426.64kb). Brazzaville, World Health Organization Regional Office for Africa, 2009
  2. Programme for Accelerated Growth and Employment (PAGE) (2012– 2015) (pdf 745.29kb). Banjul, Government of the Gambia, Directorate of Development Planning, Ministry of Finance and Economic Affairs
  3. Cross-border trade and food security in West Africa. The Western Basin: Gambia, Guinea, Guinea-Bissau, Mali, Mauritania, Senegal (pdf 2.60Mb). World Food Programme, 2010