Geographical Locations - Gambia

• (Statistical) Number of Inhabitants per Doctor: 14,536
• CIA World Factbook : Gambia, The

Organisations and Networks

UN and Multinational

• WHO
  - WHO Country Profile - Gambia
  - WHO - Tobacco Control: Country Profile - Gambia
  - WHO - Environmental Burden of Disease: Country Profile – Gambia
  - WHO - Malaria Country Profile - Gambia
• WHO - Regional Office AFRO in Brazzaville, Congo
• UNHCR Gambia
• UNICEF Gambia

Government

• Republic of Gambia Statehouse Online
• Permanent Mission of the Gambia to the United Nations

Non-Government

• AHEAD Adventures in Health, Education and Agricultural Development - Our Programs: The Gambia
  AHEAD, Inc., an acronym for Adventures in Health, Education, and Agricultural Development, Incorporated, was founded in 1981 to provide hands-on, people-to-people assistance to underserved rural communities to combat malnutrition, disease, poverty, technological deprivation and other conditions that have an adverse impact on the health and welfare of people. This site outlines AHEAD activities in the Gambia.
• Centre for Innovation Against Malaria
  The Centre for Innovation Against Malaria (CIAM) is one of the four partners in Africa working with London School or Hygiene and Tropical Medicine (LSHTM) in an initiative called Gates Malaria Partnership (GMP). It operates a Medical Research Laboratory in the Gambia.
• Gambia Health Care Association
  The Gambia Health Care Association is a non-profit, non-governmental organisation formed in Switzerland to promote health in Gambia.
• Gambia HELP
  Gambia Health Education Liaison Project, also known as GambiaHELP is a non-profit, non-governmental organisation based in Seattle, USA that exists to enable communities in The Gambia to protect, conserve and improve their health and the health of their community while building a sustainable economy and environment.
• ReliefWeb Country Gambia
  ReliefWeb is the world’s leading on-line gateway to information (documents and maps) on humanitarian emergencies and disasters. An independent vehicle of information, designed specifically to assist the international humanitarian community in effective delivery of emergency assistance.

Academic Institutions

• Royal Victoria Teaching Hospital

National Policy and Related Documents

• Gambia Health Policy Framework
• Republic of Gambia, National AIDS Secretariat, Follow-up to the declaration of Commitment on HIV/AIDS (UNGASS) The Gambia Country Report Jan 2003- Dec 2005)

Reports, Guidelines, and Projects

• Bacterial Infection and Trachoma in The Gambia: A Case-Control Study
  Purpose: Trachoma is the leading infectious cause of blindness worldwide. Conjunctival scarring is initiated by recurrent Chlamydia trachomatis infection. However, disease progression to trichiasis occurs even in regions where chlamydial prevalence is currently low, which suggests that other factors, for example other bacterial infection, may also drive inflammation and scarring, particularly in the late stages of trachoma. This study was undertaken to investigate whether trachomatous trichiasis or conjunctival scarring are associated with increased prevalence of bacterial infection. Methods: Within a case-control study design, individuals with trichiasis or conjunctival scarring (without trichiasis) were compared with normal matched control subjects. Subjects were examined for signs of trachoma. Conjunctival swab samples were collected for bacteriologic culture and C. trachomatis PCR. Results: Recruited for the study were 121 trichiasis case-control pairs and 117 conjunctival scarring case-control pairs. Eyes with trichiasis were more frequently infected with bacteria (37%) than were normal control eyes (7%) (OR: 8.2; P < 0.001; 95% CI: 3.24–20.8). Bacterial infection was more common with increased trichiasis severity. In the conjunctival scarring case-control group, scarred eyes had slightly more bacterial infection (11%) than did normal control eyes (6%), although this was not significantly different (OR: 2.2; P = 0.144; 95% CI: 0.79–6.33). Conclusions: Trichiasis is associated with increased risk of bacterial infection, and there may be a similar trend in eyes with conjunctival scarring. Bacterial infection of the conjunctiva is associated with inflammation, which may result in progressive scarring. Prospective studies are needed to determine the contribution of bacterial infection to disease progression. Bacterial infection probably also contributes to the development of corneal opacification. [author abstract] [Investigative Ophthalmology & Visual Science, October 2007, Vol. 48, No. 10, pp.4440–4444]
• Changing Community Norms around Domestic Violence in The Gambia: A public health approach
  This Powerpoint/pdf presentation by Dr. Matthew Shaw MSc MRCGP makes the key points that "Change is possible; Ethnographic knowledge is essential for effective prevention eg Marital systems, Gendered identities, and Identification of an agenda which benefits both sexes; There are gendered relationships between domestic violence, reproductive health and gender inequality (education, status); and Quantitative evaluation problem: Interventions aimed at improving discussion of sensitive issues, may increase willingness to REPORT stigmatised behaviour, even if the true incidence is reduced."
• Maternal mortality in the rural Gambia, a qualitative study on access to emergency obstetric care
  Background: Maternal mortality is the vital indicator with the greatest disparity between developed and developing countries. The challenging nature of measuring maternal mortality has made it necessary to perform an action-oriented means of gathering information on where, how and why deaths are occurring; what kinds of action are needed and have been taken. A maternal death review is an in-depth investigation of the causes and circumstances surrounding maternal deaths. The objectives of the present study were to describe the socio-cultural and health service factors associated with maternal deaths in rural Gambia. Methods: We reviewed the cases of 42 maternal deaths of women who actually tried to reach or have reached health care services. A verbal autopsy technique was applied for 32 of the cases. Key people who had witnessed any stage during the process leading to death were interviewed. Health care staff who participated in the provision of care to the deceased was also interviewed. All interviews were tape recorded and analyzed by using a grounded theory approach. The standard WHO definition of maternal deaths was used. Results: The length of time in delay within each phase of the model was estimated from the moment the woman, her family or health care providers realized that there was a complication until the decision to seeking or implementing care was made. The following items evolved as important: underestimation of the severity of the complication, bad experience with the health care system, delay in reaching an appropriate medical facility, lack of transportation, prolonged transportation, seeking care at more than one medical facility and delay in receiving prompt and appropriate care after reaching the hospital. Conclusion: Women do seek access to care for obstetric emergencies, but because of a variety of problems encountered, appropriate care is often delayed. Disorganized health care with lack of prompt response to emergencies is a major factor contributing to a continued high mortality rate. [author abstract] [Reproductive Health 2005, 2:3 doi:10.1186/1742-4755-2-3]
• International Agency for Research on Cancer - Gambia Hepatitis Intervention Survey
  This programme supports an ongoing study assessing the effectiveness of vaccination against hepatitis B virus in preventing chronic HBV infection and hepatocellular carcinoma. During 1986-1991, some 60,000 Gambian children were vaccinated. Details of vaccinated and unvaccinated individuals were collected in a database.
• Maternal mortality in rural Gambia: levels, causes and contributing factors
  A demographic study carried out in a rural area of the Gambia between January 1993 and December 1998 recorded 74 deaths among women aged 15-49 years. Reported here is an estimation of maternal mortality among these 74 deaths based on a survey of reproductive age mortality, which identified 18 maternal deaths by verbal autopsy. Over the same period there were 4245 live births in the study area, giving a maternal mortality ratio of 424 per 100000 live births. This maternal mortality estimate is substantially lower than estimates made in the 1 980s, which ranged from 1005 to 2362 per 100 000 live births, in the same area. A total of 9 of the 18 deaths had a direct obstetric cause — haemorthage (6 deaths), early pregnancy (2), and obstructed labour (1). Indirect causes of obstetric deaths were anaemia (4 deaths), hepatitis (1), and undetermined (4). Low standards of health care for obstetric referrals, failure to recognize the severity of the problem at the community level, delays in starting the decision-making process to seek health care, lack of transport, and substandard primary health care were identified more than once as probable or possible contributing factors to these maternal deaths. [author abstract] [Bulletin of the World Health Organisation 2000, v. 78, n. 5, pp. 603-613]
• Refugee livelihoods A case study of the Gambia
  This 2004 document is part of a series of Refugee Livelihood Studies commissioned as a component of EPAU's Refugee Livelihoods Project, a follow-up project to the Global Review on Protracted Refugee Situations, examines refugee livelihoods strategies and the potential for UNHCR and other actors to promote sustainable livelihoods in those situations where refugees have been dependent on humanitarian assistance for longer periods.
• Republic of the Gambia, Injection Safety Plan of the Expanded Programme of Immunisation 2002-2006
  Published by the VaccineAlliance, an historic alliance between the Public and Private Sector committed to the mission of saving children's lives and protecting people's health through the widespread use of vaccines.
• School Based Peer Health Education: A Regional Approach to HIV/AIDS Prevention in West Africa
  This paper prepared by Burris Devanney was presented to the Senior Experts Conference on HIV/AIDS and Education in ECOWAS 'Towards a Regional Mobilisation', in Ghana March 2001. It outlines a plan to use a model of school based peer education in the Gambia to arrest the spread of HIV/AIDS throughout West Africa.
• Separate Lives, Different Interests: Male and Female Reproduction in the Gambia
  We report the initial findings of a research programme on the fertility and reproductive health of both men and women in rural Gambia. The reproductive experiences of men and women in the population studied were very different. During the period 1993—97, the total fertility rates were 12.0 for men and 6.8 for women, For men fertility began later, reached higher levels and continued into older ages than for women. Through serial and polygynous marriages, men were able to extend their reproduction beyond what would be possible with one woman. Of the married men interviewed, 40% were married polygynously. Men’s fertility preferences indicated that they recognized their reproductive potentials to be greater than those of their individual wives. On average, married men desired 15.2 children for themselves and 7.3 for each wife. In this polygynous population the available for attaining reproductive goals were different for the two sexes, depending on the separate lives and different interests of men and women.
• The Gambia Health Information System
  The assessment of the Gambia Health Management Information system was done using HMN assessment tool and frame work and its overall objective is to map out its weaknesses and strengths in other to pave a way forward for developing a system that is sensitive and captures all that is required to integrate all data methods and sources… The Gambia HIS Needs Assessment was conducted using the HMN framework and tool looking at all the six components: 1. Context & resources, 2. Indicators, 3. Data sources, 4. Data Management, 5. Information product, and 6. Dissemination and use. There were a few assessment items added to the tool to capture information on transport services and supplies which were placed under the third component "Data sources". [August/September 2006]
• The Gambia Hepatitis Intervention Study (GHIS)
  "The Gambia Hepatitis Intervention Study (GHIS) is a collaborative undertaking by the International Agency for Research on Cancer, The Government of the Republic of The Gambia and the Medical Research Council of the United Kingdom. This programme was launched in 1986 with the objective of evaluating the efficacy of Hepatitis B (HB) vaccination in childhood in the prevention of HB infection, chronic liver disease and primary liver cancer in a population at high risk." [Suplemento Iatreia, vol 20, no.1 (Junio 2007), S21–S22]
• The Gambia: Progress and Challenges towards SUFI
  Roll Back Malaria (RBM) undertakes Survey-Based Progress Tracking to keep track of SUFI (Scaling Up For Impact) in various countries, including The Gambia. RBM's vision is of a world free from the burden of malaria. "The RBM Partnership is the global framework to implement coordinated action against malaria. It mobilizes for action and resources and forges consensus among partners. The Partnership is comprised of more than 500 partners, including malaria endemic countries, their bilateral and multilateral development partners, the private sector, nongovernmental and community-based organizations, foundations, and research and academic institutions. RBM’s strength lies in its ability to form effective partnerships both globally and nationally. Partners work together to scale up malaria-control efforts at country level, coordinating their activities to avoid duplication and fragmentation, and to ensure optimal use of resources."
• U.S. Department of State Country Reports on Human Rights Practices The Gambia 2003
• WHO Country Cooperation Strategy - Republic of Gambia

Educational Resources

• CDC Traveler's Health West Africa
• The Gambia Resource Page
  The Gambia Resource Page is intended to be an online depository of information related to The Gambia. The target audience for this web site includes: students and teachers wishing to learn more about The Gambia, past and future tourists to The Gambia, Gambians living abroad and researchers, linguists, and others wishing to study different aspects about The Gambia.
• SCIRUS Search Gambia and Health
  Scirus is a comprehensive science-specific internet search engine.This search provides hundreds of references and links where available to journal articles about the health situation in Gambia.