Water, sanitation and hygiene
Children in The Gambia today are more likely to have a healthy start to life than they did two decades ago. Between 2005 and 2010, the under-five mortality rate has declined from 131 to 109 per 1,000 live births and the infant mortality rate from 93 to 81per 1,000 live births. The 2013 Levels and Trends in Child Mortality Report shows a much lower trend in 2012 for both infant (49.2/1000 live births) and under-five (72.9/1000 live births) mortality rates, respectively. Despite this decline, The Gambia still has one of the highest child mortality rates in the world and the reduction in under-five mortality varies among wealth quintiles and geographical areas. In 2010, under-five mortality rates in the rural areas were 36 per cent higher than those in urban areas.
Access to improved source of drinking water is a challenge, with disparities among the regions. The Gambia’s 2010 Multiple Indicator Cluster Survey (MICS) report shows that only 32 per cent of households have improved drinking water source on their premises. The use of unprotected wells for drinking water are more common in the predominantly rural areas (21.8%) and are highest in the Janjanbureh Local Government Area (LGA), situated in the Central River Region, with about 30 per cent. In terms of sanitation, 40 per cent do not have access to sanitation and 4 per cent of the rural population practice open defecation (OD). The 2010 MICS shows that the majority of the OD population is living in the Kuntaur (13%) and the Janjanbureh (8%) LGAs. This situation leaves significant parts of the under-five population at continuous risk of illnesses and death. WaSH (Water, Sanitation and Hygiene) related diseases currently account for 20 per cent of under-five deaths in The Gambia.
The key to making progress towards attaining the MDG goals related to child health is to reach every child and mother in every district with low cost high impact interventions. These interventions include hand washing with soap and hygiene promotion, sanitation improvements, water safety/quality, and availability safe of water. Evidence shows that correct hand washing at critical times can reduce diarrhoea by 42 – 47 per cent and reduce ARI’s by 6 – 44 per cent. From 2012 – 2016, UNICEF will focus on the following key priority actions to address current gaps and missed opportunities:
Key bottlenecks will be identified and removed to ensure equitable access to WASH services for children while the capacity of partners will be enhanced to plan, implement and monitor WASH programme. An enabling environment will be created for the scale up of high impact WASH interventions and open defecation practice will be eliminated so that more children will be better protected from preventable WASH related diseases such as diarrhoea.
Overall, it is envisaged that the WASH programme will contribute to a 10 per cent reduction (baseline 13%) in the incidence of diarrhoea in children under five years and contribute to the achievement of improved learning environment in schools.