An estimated 61.2% of Gambians are classified as poor. This presents a very high level of disease vulnerability on the population with serious implications for our public health service delivery system.
In 2012, healthy life expectancy for both male and female was 8 years lower than overall life expectancy at birth. This loss represents 8 years of full health lost through morbidity and disability.
The leading causes of death in children are malaria and infectious diseases. Cardiovascular diseases (including hypertension), diabetes, cancers and trauma are the major cause of death among adults.
Inaccessible and inadequate maternal health care services are responsible for increased maternal morbidity and mortality. Although the maternal mortality ratio (MMR) has declined from 1 050 deaths per 100 000 live births to 730 per 100 000 live births, this is still unacceptably high.
Infant mortality rate (IMR) has increased from 84 to 93 per 1000 live births.
One of the major obstacles facing the health sector is the shortage of health personnel. The doctor population ratio is 1: 6132, the nurse population ratio is 1:1554, and the trained midwife population ratio is 1:3325. These are well below the standard ratios for developing countries (1:1000).
There is also a high attrition rate (between 30-50 %) and a snail-paced production and development of new health workers resulting in the shortage of personnel at all levels. As a consequence, there is a high reliance on foreign health professionals mainly from Cuba, Nigeria and Egypt.
Our objective is to strengthen primary health care; improve the referral system; develop and sustain adequate human resources for the health sector; and reinforce the regulatory framework with appropriate reforms in public health management. In this regard, we shall:
- Formulate and implement an appropriate and effective health care financing policy that would revamp and strengthen the cost recovery programme;
- Ensure equitable and rational staffing of all the health facilities in the country. Newly qualified doctors from the University would play a pivotal role in this effort;
- Decentralize and divest management and administrative responsibilities to the Regional Health Teams (RHTs) to facilitate efficient health care delivery in areas outside the Greater Banjul Area.
- Integrate traditional medicine into the mainstream health care delivery system, and to collaborate with research institutions like the Medical Research Council (MRC) in that regard;
- Improve maternal health care and reduce neonatal and childhood morbidity and mortality;
- Guarantee six months maternity leave with pay for working mothers;
- Improve the preventative and control aspects of public health including environmental sanitation;
- Provide better staff accommodation with standard amenities, in rural health centres to improve staff retention.
Health care should not be a privilege. It is a basic human right.