Child survival and development
UNICEF works with partners to ensure every child has access to quality services to survive and thrive.
The challenge
Despite efforts to promote equitable service delivery, The Gambia's health sector remains relatively weak, with deteriorating physical infrastructure, lack of adequate supplies and equipment, shortages of adequately trained health personnel, high attrition rates and an inadequate referral system.
Despite the shortcomings in the health sector, progress has been made in reducing mortality rates across several demographics and circumstances. For example, between 2010 and 2018, the under-five mortality rate has declined from 109 deaths out of every 1000 live births to 57 deaths per 1000 live births (MICS 2018); under 5 mortality in rural areas is at 64 deaths out of 1000 live births, compared to 53 deaths per 1000 live births in urban areas.
While under-five mortality rate has gone down significantly, neonatal mortality is on the increase. The neonatal mortality rate has risen from 22 deaths for every 1000 live births (Demographic Health Survey 2013) to 31 deaths for every 1000 live births (MICS 2018).
The prevalence of stunting in children 0-59 months has reduced from 23.4 per cent (MICS 2010) to 19.0 per cent (MICS 2018). Stunting is higher in rural areas with 22 per cent; urban areas (17 per cent). High stunting rates are found in the areas of Kuntaur, 26.6 per cent, Janjanbureh, 24.3 per cent and Kerewan, 20.8 per cent; the situation is better in Banjul – 16.6 per cent, and Kanifing Municipality 14.4 per cent.
Sanitation coverage is low, with only 47 per cent of the population using an improved sanitation facility that is not shared with other households. Diarrhoea, which is linked to poor sanitation and hygiene practices, accounts for 7 per cent of under-five mortality, and poor hygiene practices still contribute to high malnutrition and neonatal infection.
While there has been great progress in immunization, with a coverage of more than 90 per cent for all major antigens, coverage in the urban areas is on the decline. The country remains at risk to several infectious diseases with potential for epidemics, such as meningitis.
The solution
Our Child Survival and Development programme contributes to the strengthening of health, water, sanitation, and hygiene, and nutrition systems in The Gambia, through capacity-building and quality service delivery for children and women across the country.
It addresses both upstream policy advocacy and technical support, and downstream community-based systems and services, emphasizing on strengthened inter-sectoral collaboration and coordination at the community level.
The provision of access to improved equitable and quality health, nutrition and WASH interventions coupled with adequate community engagement and social mobilization, morbidity and mortality for women and children will significantly decrease.
In the area of health, the provision of immunization and other preventive services, the early treatment of maternal and childhood diseases with a special focus on the first 1,000 days period will contribute significantly to the reduction in mortality.
In nutrition, prevention of malnutrition with a special focus on the first 1,000 days of life and timely treatment of children with severe acute malnutrition will reduce mortality due to malnutrition.
In WASH, the provision of water, sanitation and hygiene facilities complemented with improved hygiene behaviours, childhood mortality and malnutrition rates due to diarrhoea and other WASH-related diseases will decrease.
Overall the objective is effective, low cost, integrated solutions that are equitable in providing services and support to all.
Despite the challenges, we have registered significant gains for children in The Gambia in the different thematic areas under our Child Survival and Development programme. We have been providing support to the Government of The Gambia and other partners to revitalize the primary health care system and high-impact health interventions at community levels.
We support the training of health workers to deliver effective services including immunization, emergency maternal, neonatal, infant and child health, nutrition and water and sanitation hygiene. We also support the strengthening of supply chain management systems, vitamin A supplementation, the procurement of essential drugs and medical equipment, and the elimination of mother-to-child transmission of HIV.
The Reproductive Maternal Newborn Adolescent and Child Health (RMNACH) policy and a strategic plan has also been developed and adopted for implementation from 2017 to 2022.
In 2019, we supported the Ministry of Health in reviewing and developing an integrated community case management strategy in coordination with Global Fund. integrated community case management (iCCM) is a key component of a functional primary health care system; it ensures a continuum of care from community to health facility and allows improved access and reduces treatment gap for malaria, pneumonia and malnutrition.
Join us in supporting children in The Gambia to have a healthy life!
Immunization
Vaccines work, and save lives. Our immunization programme supports the government to ensure that all children receive all basic vaccinations.
Health
Every child has the right to survive and live a full and healthy life. We work to ensure that children and women have access to, and utilise improved and equitable quality maternal and child health services.
Nutrition
Our nutrition programme supports capacity development, policy dialogue and advocacy for easy access to equitable and quality nutrition services.
Water, sanitation and hygiene
Clean water saves lives! We focus on policy dialogue and advocacy, evidence generation and capacity development, strengthening of WASH in institutions, and service delivery.