The Gambia’s ranking on the UNDP's Human Development Index (HDI) value two years ago for 2014 was 0.441— which put the country in the low human development category—positioning it at 175 out of 188 countries and territories. Between 1990 and 2014, Gambia’s HDI value increased from 0.330 to 0.441, an increase of 33.5 percent or an average annual increase of about 1.21 percent. Yet despite this positive development trend, a National Household Survey (NHS) estimated that 61.2% of the population is classified as "poor". This high poverty rate implies a high level of disease vulnerability on the population and has serious implications for public health services delivery.
Life expectancy at birth for both men and women increased by 5 years over a twelve-year period of 2000-2012; the WHO region average increased by 7 years in the same period. In 2012, healthy life expectancy in both sexes was 8 years lower than overall life expectancy at birth. This lost healthy life expectancy represents 8 equivalent years of full health lost through years lived with 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 common diseases/conditions are major killers among adults. Inaccessible and inadequate maternal health care services are responsible for increased maternal morbidity and mortality. The maternal mortality ratio (MMR) in the Gambia has declined from 1 050 deaths per 100 000 live births to 730 per 100 000 live births but this is still unacceptably high.
Infant mortality rate (IMR) has increased from 84 to 93 per 1000 live births.
The Gambia is faced with a high disease burden with emerging and re-emerging diseases such as HIV/AIDS, cholera, and other communicable diseases such as malaria, tuberculosis and meningitis
One of the major obstacles facing the health sector is the shortage of health personnel at all levels of the health care delivery system. The doctor population ratio of 1: 6132, the nurse population ratio of 1:1554 and the trained midwife population ratio of 1:3325 are below the 1:1000 standard ratios for developing countries. There is a high attrition rate (between 30-50 %) and slow production of new health workers resulting in the shortage of health personnel at all levels of health delivery. As a consequence, there is a high reliance on foreign health professionals. Out of the 99 medical doctors (clinicians) in the public health sector, almost 80% are expatriates, mainly from Cuba, Nigeria and Egypt.
The Gambia faces daunting challenges in disease control. The gaps in the health system that demand the most attention are to do with service delivery at the district level, through the strengthening of primary health care; improving the referral system; sustaining adequate Human Resources for Health (HRH) and reinforcing the regulatory framework with appropriate reforms in public health.
Under a UDP leadership, the key issues area to be addressed would be:
· To implement an appropriate and effective health financing policy by revamping and strengthening the cost recovery programme – A Drug Revolving Fund for the rationalized procurement of drugs and other medical supplies;
· To improve the health care delivery system in the country by the rational staffing of the Health Centres. Newly qualified doctors from the University would play a pivotal role in this effort;
· To decentralize the health management responsibilities, especially the administrative functions to the Regional Health Teams (RHTs) will be fully implemented to facilitate health delivery in areas outside the Greater Banjul Area.
· To integrate traditional medicine into the mainstream health care delivery systemas a priority in collaboration with research institutions like the Medical Research Council (MRC);
· To reduce morbidity and mortality due to communicable and non-communicable diseases and conditions, and strengthen health-promotion capacity at all levels; this would entail strengthening primary health care from village level to referral hospitals;
· To improve maternal health and reduce neonatal and childhood morbidity and mortality;
· To guarantee a six -months maternity leave with pay for working mothers;
· To improve the general standards of health of the population and address health consequences of emergencies by improving the preventative aspects of public healthincluding environmental sanitation.
· To effectively improve skilled staff retention and circulation by providing incentives particularly for staff serving in the rural areas, including better housing and amenities.
· To increase the size as well as improve the quality of our health service delivery team/personnel through continuous recruitment and training.
Health should not be a privilege; it is a basic Human Right. A UDP government will make sure that under its watch no Gambian dies because they could not afford the money for health. The UDP's commitment is caring for our country's most precious resource: The Gambian People.