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Unicef says Gambia’s health system lacks mechanisms to identify high-risk pregnancies

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By Omar Bah

UNICEF reports that The Gambia’s health system lacks comprehensive mechanisms to identify high-risk pregnancies, contributing to elevated maternal mortality rates. The key challenges facing the country’s health sector include limited access to prenatal care, with only 10% of women receiving adequate antenatal visits, and a significant unmet need for family planning at 24% among married women. Furthermore, the health system struggles with resource allocation and financing, hindering effective maternal health services. These deficiencies exacerbate risks for mothers and newborns, particularly in rural areas where healthcare access is more limited.

Nafisa Binte Shafique, the country representative of UNICEF, said: “I have met a number of mothers, particularly young mothers, who do not even know what are the five symptoms of emergency obstetric cases, or five danger signs. Where they need to seek the services immediately and urgently Many of the wives, or women are left behind alone with many other kids in their care because their husbands or partners travelled to another country or another city for livelihood. So, they are all by themselves and when I ask, why didn’t you go to the services? She said, I have too many works to complete and I have too many children to take care of. So, I don’t have time for myself. These are the voices that I’m bringing on the table today from the rural areas that I have travelled in last one year.”

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She added that emergency care remains insufficient. “In many hospitals, particularly in rural areas and the follow-up care system, requires reinforcement to enable early identification and intervention in complications. I recently visited Kuntaur North Hospital and there is no emuos there. Mothers are coming and delivering in a very dire situation with no medical services made available for them. Very, very little or very limited medical equipment available there to handle a very complicated case,” she stated.

Modou Lamin Touray, a private medical practitioner, told The Standard lacking comprehensive mechanisms to identify high-risk pregnancies can lead to severe consequences, including increased maternal and neonatal mortality.

“High-risk pregnancies, which can arise from various factors like chronic health conditions or multiple gestations, require specialised care to mitigate risks,” Touray added.

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He said inadequate detection often results in delayed referrals and insufficient prenatal care, exacerbating health issues for both mother and child. “Improved screening protocols and access to trained healthcare providers are crucial in rural and low-resource settings to ensure timely interventions and reduce preventable deaths,” he advised.

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