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Celebrating Fifteen Years of Development (1994-2009) |
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THE GAMBIA GOVERNMENT DEPARTMENT OF STATE FOR HEALTH DEVELOPMENTS 1994-2004 The Government of the Gambia under the leadership of His Excellency the President identified the sector as one of the priority areas of its intervention since July 1994. The ten year period (1994-2004) could be termed successful years of the management, protection and provision of health care to Gambians. Over the past years, Government and health development partners investment in the sector was on a steady rise and this resulted in many major developments, notable among them are the construction of new hospitals, developments in Royal Victoria Hospital to a teaching hospital status to support the training of medical doctors, and the upgrading and construction of several health centres to improve access to basic health services to the population. The high level of coverage achieved with the National Immunization Days for Poliomyelitis eradication, and Vitamin A coverage for the under - five children. In the area of infrastructural development, Service delivery the following can be mentioned: NORTH BANK DIVISION
Whilst one would not want you to demonstrate that we are not North Bank Division biased, I would like to report that the health services delivery system in that division saw the biggest development. All the health centres in the division were rehabilitated and upgraded through the support of the CISP Italian Project, which was personally, negotiated by His Excellency the President himself. The centres were: * The African Development Bank Project supported the construction of a new ward and medical store for drugs and vaccines in Essau. The above will help ease the load on the AFPRC General Hospital in Farafeni. Thus the division has been adequately catered for. UPPER RIVER DIVISION With funding from the African Development Bank, Basse major health centre is being upgraded to the level of a divisional hospital and Fatoto and Yorobawol are also being upgraded and rehabilitated. LOWER RIVER DIVISION Soma Major health centre has already been upgraded to a divisional hospital, and the upgrading of the Kiang Karantaba health centre is on course and almost nearly completion. CENTRAL RIVER DIVISION In this division the Bansang hospital has undergone some rehabilitation and the Kuntaur Health Centre is being rehabilitated and expanded with the inclusion of a reproductive health (RH) clinic. WESTERN REGION
Egypt - 7 United States of America through the Peace Corps - 30 These additional medical officers and other health personnel which include Urologists, Physicians, Pharmacologists, Surgeons, Nurses, Medical Equipment Engineers, General Practitioners, administrators, lecturers are distributed to hospitals, the medical school, Divisional health teams, health centres, dispensaries and village health posts all over the country. Specifically they are in: Royal Victoria Hospital Sulayman Junkung Hospital Bansang Hospital Jammeh Foundation for Peace Hospital AFPRC Hospital in Farafeni Upper River Division, Central River Division, Lower River Division, North Bank Division, Western Region, HEALTH SERVICES DELIVERY, EXPANDED PROGRAM OF IMMUNISATION 84.3 percent of the population were vaccinated against meningitis. The Gambia`s National Immunisation Days achievement were amongst the highest attainable, that is 98.8 % in the first round and 102 % in the second round. DPT/HIP 3 coverage was 86.5 % in 2001 and initial reports indicate that the coverage in 2002 will be higher. The government of the Gambia started the procurement of vaccines and consumables after the phasing out of the Vaccine Independent Initiative (VII) beginning 1998. In a bid to maintain and sustain the EPI programme, a Financial Sustainability Plan (FSP) has recently been developed. The cold chain system has been rehabilitated recently for the entire health system. VACCINATION COVERAGE Both the Global Alliance for Vaccine Initiative, UNICEF and the World Health Organisation rated the vaccination coverage of the Gambia as one of the best attainable in sub-Saharan Africa. MALARIA The Malaria control programme is responsible for reducing morbidity and mortality due to malaria. A national control work plan that included the Roll Back malaria plan has been developed and is being implemented .In addition The Gambia is co-ordinating the Roll Back malaria Component of the Health for Pease Initiative. Also the first and last Saturday of every month is set aside as a ‘OPERATION CLEAN THE NATION’ day countrywide To protect the pregnant women and children and other vulnerable groups in the major mosquito breeding areas, Government with the support of the development partners distributed free of charge well over 20,000 nets. Accelerated Child Survival and Development Project & IPT interventions supported by UNICEF and DOSH contributed to reductions in infant and maternal deaths in CRD and LRD. A large quantity of insecticide was also provided and a total of 2000 litres of biolarvicide was used, with Cuban technical assistance, in rice fields in Niamina and some areas in the Greater Banjul. EYE CARE REPRODUCTIVE AND CHILD HEALTH Maternal and child health services are now provided throughout the country and as close to the homes as possible. HIV/AIDS The prevalence of HIV I is at 1.2 percent and HIV II at 0.9 percent. The HIV/AIDS Rapid Response Project has picked up in terms of implementation in some of these areas: TB AND LEPROSY CONTROL PROGRAMME Major successes have been achieved in the area of TB and leprosy control. Hardly do we come across with any new case of leprosy these days .TB still poses a challenge since it is an opportunistic infection for people living with HIV/AIDS ESSENTIAL DRUGS AND OTHER MEDICAL SUPPLIES Given the priority Government accords to the provision of drugs and medical items, training was provided in 2002 to dispensing assistants and storekeepers as well as security personnel. For the first time drugs were purchased in the bulk to avoid stock outs. To enhance efficient and effective utilisation and management of drugs and other medical supplies, a Medical Stores Inventory Control and Management System has now been put in place, operational in all the regional medical stores and hospitals. REFERRAL SYSTEM The management of the health transport fleet has been contracted to Riders for Health; this has resulted in the improvement in the following areas: MEETING THE MILLENNIUM DEVELOPMENT GOALS The World Bank in its Country Assistance Strategy reported that the country is on way to meeting the millennium development goals for health as well as the PRSP. · Strengthening planning and health management information generation at all the levels of health service delivery PERFORMANCE OF WORLD BANK FUNDED PROJECTS IN HEALTH The Vice President of the World Bank, the Sector, the Country Director and the Task Team Leader have all expressed satisfaction with the performance of the Participatory Health and Population Project and this will contribute to the revision of The Gambia's funding portfolio with the Bank. The PHPNP will thus be extended for twelve months and a follow-up project prepared. RESULTANT IMPROVEMENT IN THE HEALTH PROFILE OF THE COUNTRY It may not be easy to report on all the achievements of the health sector in 2002 in the available time, but we need to appreciate the fact that all these were possible as a result of the special attention that His Excellency The President accords to the health sector. We are most grateful for this. Despite some of these achievements, the challenges ahead are immense and the following are the priority activities for 2004. INFRASTRUCTURE DEVELOPMENT 4 new health centres now under construction, and 19 of the existing health centres are in the process of being upgraded. These new facilities under construction includes: Kafuta Albreda Foday Kunda and Sara Kunda The nineteen health centres to be upgraded and rehabilitated are: Basse Major Health Centre, Fatoto Minor Health Centre, Kiang Karantaba Minor Health Centre, Brufut Minor Health Centre, Yorobawol Major Health Centre, Kuntaur Major Health Centre. Sukuta Minor Health Centre, Banjulunding Minor Health Centre, Gunjur Minor Health Centre, Medina Bafuloto Minor Health Centre, Kuntair Minor Health Centre, Ngeyen Sanjal Minor Health Centre, Kwinella Minor Health Centre, Brikamaba Minor , ealth Centre, Dankunku Minor Health Centre, Sami Karantaba Minor Health Centre Chamen Minor Health Centre, Gambisara Minor Health Centre and Diabugu, Minor Health Centre A Modern Central Medical Stores will be built in Kotu, to take care of the medicines supply of the country. A modern Standards laboratory will be built for quality control of foods, and medicines and to support export of Gambian products. STRENGTHENING OF THE DIRECTORATE OF POLICY, PLANNING, BUDGETING AND INFORMATION
Medical doctors are being provided in all the health centres and even in villages throughout the country. From 1997 to 2001, the number of medical doctors in the public health sector increased by 70 per cent. This puts the Gambia at 0.2 physicians per 1,000 populations a ratio higher than the Sub-Saharan regional average of 0.1 physicians per 1,000 populations. Provision of different types of consultants in all the hospitals A focal person has been identified Human Resource situational analysis finalized A Human Resource Policy for Health developed in 2003 A long-term plan of action is being currently developed OTHER AREAS Improve on the Health Management Information system for timely information generation on the status of the health of the population Improve the financing of health services Increase community involvement in the management of their health ROYAL VICTORIA HOSPITAL The Royal Victoria Teaching Hospital has been upgraded to a full-fledged Teaching hospital and has been accredited. To Transform the Accident and Emergency and Paediatric Departments to a modern one achievements at the RVH include: Construction of a new dental building in the polyclinic Provision of a seminar room, lecture theatre and teaching laboratory Extensive refurbishment of the wards Oxygen piping for the entire hospital to increase availability at the critical care points. COMPLEMENTING GOVERNMENT IN IMPROVING QUALITY OF AND ACCESS TO HEALTH SERVICES The Jammeh Foundation for Peace President Jammeh believes that genuine peace is only attainable where there is social justice, and therefore, investment in the social sectors of Education, Health and Food Security are direct contributors to maintaining national peace and stability. The Jammeh Foundation for Peace Hospital was started to complement Government effort in providing quality health care for the population. OPERATION SAVE THE BABY INITIATED BY THE FIRST LADY In her own way, the First Lady, Madam Jammeh initiated Operation Save the Baby. This Initiative has since made major contributions to neonatal health care countrywide. Five (5) incubators were provided for the Premature Unit of Royal Victoria Hospital A mobile incubator was provided for Bansang Hospital for the Eastern part of the country 2 autoclaves for sterilisation of the items were also supported And recently 2 additional incubators have been provided these will strengthen neonatal services in other parts of the country. PARTNERSHIP WITHIN THE SUB-REGION The Health for Peace framework provides opportunities for a sub-regional approach to managing major health challenges. The Gambia was identified to have superior capacity to co-ordinate Malaria Control and sub-regional Eye Care Program. The Cuban Malaria Expert Team has the potential to support the sub-regional malaria project. For Eye Care, plans are at advanced stages for the establishment of a Regional Eye Training Centre in the country. PARTICIPATORY HEALTH POPULATION AND NUTRITION PROJECT The Participatory Health Population and Nutrition Project has funded and continues to fund major programs in health, nutrition and population. In addition to programs, the following major developments are supported: Construction of 4 minor health centres to increase access to basic health services Rehabilitation and upgrading of 13 heath centres Purchase of additional equipment for health centres to improve on quality of service delivered. Support to human resource development. In addition, this Project supports the initial funding of the following major interventions: Riders for Health for the transport services Social Marketing Project The Social Marketing Project is intended to increase access to and uptake
of the following health commodities: Contraceptives for population management Oral rehydration salts for diarrhoea management Condoms for HIV/AIDS control and prevention
The Project is supporting the following activities: Construction of new ware house for Central Medical Stores Rehabilitation, upgrading and equipping of six health centres to improve on access and quality of services. Support to human resource development Provision of Technical Assistants to support various sectors of Health. Construction of new laboratory compound to house the following standard/ Research laboratories The National Health Laboratory for setting standards for laboratory practice in the Gambia, for setting and testing food standards and to support analysis of local foods to promote their export. The National Drugs Laboratory for medicines quality control and testing of drugs. CISP -ITALIAN PROJECT This Project has supported the strengthening of Primary Health Care in the North Bank Division through the following activities: Construction of a new minor health centre at Illiasa to increase access to basic health services to that community Upgrading and rehabilitation of 5 minor health centres Construction of 10 new community health posts in new Primary Health Care Villages, to support expansion to and improvement in quality of village health services delivery in those communities Support to training of health centre staff to improve on quality. BILATERAL AND MULTI -LATERAL HEALTH DEVELOPMENT PARTNERS: WORLD HEALTH ORGANIZATION WHO continues with its traditional role of providing technical support and fellowships to the sector, however, in recent years, WHO has made significant financial support to a number of health programs, notably Malaria, Essential drugs, Environmental Health, Mental Health and the Expanded Program of Immunization. In addition, WHO still remains the second major financier of the training of medical doctors. Its Country Corporation Strategy 2002-2005 is a response to priority interventions in health. UNITED NATIONS CHILDREN `S FUND (UNICEF) UNICEF continues to invest in those activities areas considered very essential for the Early Development and Growth of the Child. As its response to PRSP, UNICEF has identified 3 divisions as their priority intervention areas: Lower, Central and Upper River Divisions. A 5-year UNICEF-Gambia Government Corporation Program was developed and is being implemented. UNITED NATIONS POPULATION FUND (UNFPA) UNFPA continues to invest in Reproductive and Child Health, in particular those areas specifically targeting population management. UNITED NATIONS DEVELOPMENT PROGRAM (UNDP) In addition to supporting other activities in Health and Social Welfare, UNDP provided significant funding for HIV/AIDS prevention and control program REPUBLIC OF CHINA ON TAIWAN The Republic of China on Taiwan continues to finance in health the provision of additional medical officers to support health services delivery. REPUBLIC OF CUBA Cuba continues to provide health officials to support health services delivery and research in particular malaria control. NIGERIA Nigeria continues to provide health workers to support health services delivery. Gambia Government input to the Nigerian health personnel is in transport allowances and accommodation. EGYPT Egypt also provides a number of clinicians (mostly consultants) to support health services delivery. Gambia Government input in maintenance of these clinicians is in their allowances and accommodation. KINGDOM OF NETHERLANDS - KNCV PROJECT This project continues to support Tuberculosis and Leprosy Control in the Gambia. OTHERS The European Union supported Vaccines Initiative International and Global Alliance for Vaccines Initiative (GAVI) is major support to ensure availability of essential vaccines. |
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