Healthcare Scenario in Gambia

Are you considering building, restructuring, or venturing into healthcare ventures in Gambia? Seeking insights into the major healthcare players, in the country? Perhaps you’re interested in discovering the optimal locations within the city to establish your venture or understanding the existing healthcare facilities and planning requirements for a new setup. In this article, Hospaccx Healthcare Consultancy delves into the healthcare landscape of Gambia, mapping out the major players in medical facilities and the overall healthcare scenario in the country.

Introduction

Nestled along the western coast of Africa, The Gambia with Banjul as its capital is bordered by Senegal to the north, south, and east, with the Atlantic Ocean to the west. Its heart is the Gambia River, which has shaped its geography and history since the 10th century when Muslim merchants established it as a trans-Saharan trade hub. European colonial powers, notably the United Kingdom, engaged in trade, leading to a British colony in 1664. Over 300 years, The Gambia endured the trans-Atlantic slave trade, with an estimated 3 million individuals forcibly exported. This compact nation’s narrative is a testament to global commerce and colonialism.

Demographics

Economy

Economic Overview of The Gambia

• Economic growth surged to 5.3% in 2023, driven by agriculture and industry.
• Agriculture flourished due to favorable rainfall and increased fertilizer subsidies.
• Services sector slowed despite tourism growth, with several subsectors contracting.
• Private and public investments, along with remittance inflows, fueled growth.

Key Economic Indicators

• Inflation averaged 16.9% in 2023, driven by imported food inflation and currency depreciation.
• Poverty increased to 16.9% in 2023, mainly due to rising food prices.
• GDP growth forecasted to average 5.6% in 2024-26, with growth expected across all sectors.
• Fiscal deficit halved to 2.6% of GDP in 2023, supported by increased tax revenues and grants.
• Public debt declined to 75.8% of GDP in 2023, but the Gambia remains at high risk of debt distress.
• Current account deficit estimated at 4.5% of GDP in 2023, driven by tourism recovery and infrastructure-related imports.
• Monetary policy tightened, with the policy rate increasing to 17% in August 2023.

Connectivity

By Air:

• Banjul International Airport (Yundum International) is Gambia’s only airport.
• Direct flights to Gambia are scarce, typically involving a layover in Dakar or Casamance, Senegal.

By Land:

• Land entry available through border crossings in Senegal, with ferry access to Banjul.
• Border crossings include Karang in the north and Seleti in the western area of Gambia.

Main Co-operates 

Growth Plan 

The Recovery-Focused National Development Plan (RF-NDP) 2023-2027, also known as the “YIRIWAA” (which means “Development” in Mandinka) plan, represents The Gambia’s strategic blueprint for the next four years. Its key objectives include,

Strengthen Democratic Governance: The plan prioritizes the enhancement of democratic institutions and processes within the country. This entails promoting transparency, accountability, and citizen participation in governance.

Foster a Green Economy: YIRIWAA is dedicated to promoting sustainable practices and environmental conservation while facilitating green growth initiatives. This involves investing in renewable energy, sustainable agriculture, and eco-friendly infrastructure.

Social Transformation: The plan aims to overhaul social services, education, and healthcare to ensure equitable access and quality delivery for all citizens. This includes initiatives to improve education outcomes, enhance healthcare services, and address social disparities.

Enhance Resilience: YIRIWAA focuses on building resilience within The Gambia to effectively cope with and recover from various shocks and crises. This encompasses measures to strengthen disaster preparedness, mitigate climate change impacts, and bolster socio-economic resilience at both individual and community levels.

Medical Tourism

Although the Gambian healthcare system has made strides, issues remain regarding access to specialized care and advanced technology. This presents an attractive market for international healthcare providers offering top-notch services, shorter wait times, advanced tech, and skilled professionals. The rising middle-class population’s demand for better healthcare services adds to the potential for medical tourism market in Gambia.

Strategies for Entering the Gambian Market:

Targeted Marketing: Tailor marketing to showcase specialized services online and through social media.

Local Partnerships: Collaborate with Gambian healthcare providers to build trust and referral networks.

Patient Education: Provide comprehensive treatment information for informed decisions.

Cultural Training: Train staff to understand Gambian customs for effective communication.

Support Services: Offer personalized assistance for smooth patient journeys.

Collaboration: Partner with local tourism services for integrated medical travel packages.

Important Heath statistics

Major Infectious Diseases

Food Or Waterborne Diseases: Bacterial and Protozoal Diarrhea, Hepatitis A, And Typhoid Fever

Vector borne Diseases: Malaria, Dengue Fever, and Sexually Transmitted Diseases: Hepatitis B 

Water Contact Diseases: Schistosomiasis

Animal Contact Diseases: Rabies

Respiratory Diseases: Meningococcal Meningitis

Top Causes of Mortality 

1. Influenza and Pneumonia – 10.42%
2. HIV/AIDS – 8.75%
3. Coronary Heart Disease – 7.83%
4. Stroke – 6.24%
5. Birth Trauma – 5.86%

6.Road Traffic Accidents – 5.40%

7.Malaria- 5.24%

8.Low Birth Weight – 5.15%

9.Diarrhoeal diseases – 4.87%

10.Tuberculosis – 3.46%

Healthcare Scenario in Gambia

The Gambia is currently undergoing an epidemiological transition, marked by a rising prevalence of Non-Communicable Diseases (NCDs), which presents significant challenges to its healthcare system. Access to medical services often entails high out-of-pocket expenditures, potentially restricting healthcare access for many Gambians. Maternal and women’s health remain areas of concern, necessitating efforts to ensure safe pregnancies and childbirth.

Compounding these issues is a shortage of skilled health personnel, impacting the overall effectiveness of the healthcare system. Moreover, poverty and income inequality, particularly prevalent in rural areas with a poverty rate of 70%, further impede healthcare access for vulnerable populations.

The Ministry of Health and Social Welfare oversees the public healthcare system in The Gambia, providing free services to citizens. However, while open to foreigners such as expatriates and digital nomads, utilization of the public healthcare system by these groups is limited.

Healthcare Infrastructure (Rural V/S Urban) 

• 64.4% population is urban
• There is an urban bias in the distribution of health workers. Approximately 66% of healthcare personnel are located in the main urban region (West Coast Region).
• However, the distribution of health workers is hindered by poor infrastructure and insufficient availability of health technology in the less well-developed rural regions.

The healthcare system in Gambia operates across three levels: Primary, Secondary, and Tertiary. There are four government-operated referral hospitals, eight main health centers, and 16 smaller centers, along with over 200 mobile clinic units and the Medical Research Council funded by the UK Government. Additionally, there are privately run clinics and health-focused NGOs.

Primary Health Care: Focuses on villages with populations of over 400, where Village Health Workers and Traditional Midwives are trained and assigned to deliver primary healthcare. They provide outpatient care, community health education, ensure essential medicines availability, and conduct home visitations. Midwives assist with home births and refer high-risk cases to local health centers.

Secondary Health Care: Provided by large and small health centers, including approximately seven main government/private centers and 12 smaller ones. These facilities offer both inpatient and outpatient treatment, staffed by resident nurses, doctors, and support staff.

Tertiary Health Care: Delivered by four main referral hospitals, the Medical Research Council (MRC), private clinics, and NGO-operated clinics. The primary referral hospital is located at RVTH in the capital, with others situated at Bansang, Farafenni, and Bwiam.

Healthcare related Human Resources (2015)

Major Medical Institutions 

American International University West Africa

Established in August 2010, AIU Health Science Center in The Gambia comprises five colleges offering accredited medical and health programs. These include Medicine (M.D.), Dentistry (D.M.D.), Pharmacy (Pharm D.), Nursing (BSN), and Health Professionals (AAS). The institution is recognized by professional councils for accreditation and listed in The World Directory of Medical Schools.

The University of the Gambia, The School of Medicine and Allied Health Sciences.

Established in 1999, the School of Medicine and Allied Health Sciences plays a vital role in meeting the health sector demands of the country, focusing on prevention and curative medicine. Situated within the Edward Francis Small Teaching Hospital in Banjul, it conducts research on tropical diseases and medicine. The school consists of three departments: Medicine, Nursing, and Public Health and Environment.

Major Hospitals

Royal Victoria Teaching Hospital (RVH): 650 Beds

Built in 1853 in Banjul, the 650-bedded tertiary hospital houses various medical departments, including pediatrics, general surgery, obstetrics, and A&E.

Farafenni APRC General Hospital: 250 Beds

 Established in 1999, the hospital in Farafenni provides healthcare for 300,000 Gambians in the North Bank region with 250 patient beds.

Bansang Hospital: 

Built by the colonial government in 1938, Bansang Hospital serves communities 200 miles up-river from Banjul.

Bundung Maternal & Child Health Hospital: 

Established on May 25th, 2001, this charity hospital in Bundung, a joint project between the president and the Department of State for Health, has treated over 1,000,000 patients.

Medical Research Council: 

Financed by the UK Government, this research facility in Fajara is the UK’s largest medical research investment in a developing country.

Sulayman Junkung General Hospital:

 Established in 2003 and operated by the Gambian Government Ministry of Health, this hospital in Bwiam town treats approximately 16,000 patients annually.

Private Hospitals/ Clinics

• Westfield Clinic – 16 Beds

Founded in May 1969, this clinic provides primary and secondary healthcare services as a charitable organization. Eight general practitioners manage routine appointments, while specialist consultations are available in cardiology, general medicine, general surgery, obstetrics and gynecology, ophthalmology, orthopedics, pediatrics, pediatric surgery, and psychiatry.

• AfricMed International Hospital.

Africmed is a leading Gambian private provider, offers 24/7 clinical care, lab tests, and essential supplies. They manage emergencies with a 24-hour ambulance and facilitate medical evacuations for complex cases. It is located at Banjul.

• Bijilo Medical Center

The Bijilo Medical Center (BMC), founded in 2002 by Dr. Musa Touray, is a non-profit hospital in The Gambia. Committed to providing affordable, high-quality healthcare to everyone, this facility is run by a dedicated Gambian doctor with international training.

• Kololi Clinic

It is privately run clinic headed by Dr. Sheriff A. Ceesay who is a Fellow of the West African College of Surgeons. The medical facility is situated about 250m from the Palma Rima Hotel Junction.

• Lamtoro Medical Center

Lamtoro is a private Gambian clinic located in Kololi with a testing lab for its patients. There are private patients’ rooms, x-ray lab as well as a maternity unit.

• Swedent Clinic (Dentists)

A Swedish dentist program in Gambia identified a need for dental care.  Seeing this need, one of the dentists (Lars-Göran Wärn) decided to open a private clinic after his volunteer work there.

Diagnostic Centres

• MediLab Diagnostic Centre
• Jobot Labs
• MiniLAB

Conclusion

Gambia’s healthcare system, lays the groundwork for comprehensive care. With opportunities for infrastructure upgrades, enhanced training, and improved access to essential medicines, Gambia could see significant advancements in healthcare delivery. Moreover, there’s potential for medical tourism, where Indian healthcare providers could benefit from treating Gambian patients, further fostering international healthcare collaborations.

If you need any support in planning and designing of a new hospital you can contact us: Hospaccx healthcare business consulting Pvt.Ltd on :hospaccx.india@gmail.com. Or you can visit our website http://www.hospaccxconsulting.com/

References

• The Gender Ratio of Gambia (2020 – 2028, males per 100 females) – Global Data, https://www.globaldata.com/data-insights/macroeconomic/the-gender-ratio-of-gambia-325385/
• World Fact Book – Gambia, CIA.gov https://www.cia.gov/the-world-factbook/countries/gambia-the/
• The Gambia Overview,The world Bank in Gambia

https://www.worldbank.org/en/country/gambia/overview

• The Gambia Economy – Index Mundi

https://www.indexmundi.com/the_gambia/economy_overview.html

• A Comprehensive Guide on Moving to Gambia, 

https://www.internations.org/gambia-expats/guide/moving-to-short

• List of companies based in the Gambia – Wikipedia

https://en.wikipedia.org/wiki/List_of_companies_based_in_the_Gambia

• https://op.gov.gm/sites/default/files/2024-02/02092024%20H.E%20Barrow%20statement%20at%20the%20launch%20of%20the%20RF-NDP%202023-2024%20YIRIWA%20Programme%20SH%20%281%29.pdf
• Gambia Unveils National Development Plan 2023-2027 With Focus On Recovery

https://www.kerrfatou.com/gambia-unveils-national-development-plan-2023-2027-with-focus-on-recovery/

• Gambian Medical Tourism: Key Techniques for Attracting Patients by Medical https://www.magazine.medicaltourism.com/article/gambian-medical-tourism-key-techniques-for-attracting-patientsTourism Magazine.
• Medical Visa From The Gambia to India: Unlocking Healthcare Opportunities

https://wellnessdestinationindia.com/

• Health Profile: Gambia, World health rankings.

https://www.worldlifeexpectancy.com/country-health-profile/gambia

• ActionAid International: “Assessment of the Health System in The Gambia” (November 2019). 
• Thanzi la Onse: “The Gambia Health Expenditure and Performance Review” (Final Report).
• Expat Exchange: “Understanding the Health System in Gambia.” 
• The Borgen Project: “Healthcare in The Gambia.” 
• https://public.knoema.com/erdvvie/population-estimates-and-projections?tsId=1379390
• WHO country cooperation strategy – Gambia.
•  https://knoema.com/atlas/Gambia/topics/Health
• https://accessgambia.com/tag/med-schools.html#:~:text=…The%20medical%20school%20in%20Gambia%20is%20made%20up,of%20Health%20Professionals%20and%20the%20College%20of%20Pharmacy.
• https://www.accessgambia.com/extra/general-hospitals.html
• https://www.accessgambia.com/information/health-care.html

Related Team Members