The Gambia

Maternal mortality in my country has declined from 760 woman in 2001 to 330 in 2012, but that is not enough… We will not stop until we can stand here and tell you that we have zero deaths per 100,000 births.

— Honorable Bala Garba Jahumpa,
Minister of Health & Social Welfare, The Gambia

Access to health services is a key challenge for many vulnerable populations and geographically-remote communities. In the Gambia this challenge of access has amplified the country’s high maternal mortality rate and low contraceptive prevalence. In seeking innovative solutions, the Gambia has made strides in expanding the reach of its health care system, promoting greater equality in the scope of its services.

The Resolve Award

The Resolve Award celebrates country-level, public sector leadership in driving innovations in reproductive health policy development, service delivery, and financing mechanisms. The Global Leaders Council for Reproductive Health (GLC) recognizes national governments for their leadership and for serving as the hub around which civil society, the private sector, donors, and so many others engage.

The GLC celebrated the Gambia with the 2013 Resolve Award for an innovative approach to service delivery, recognizing the Gambia’s work to improve health transport. In 2009, The Gambia became the first African country with enough health-care delivery vehicles to service its entire population, thanks to an innovative partnership between the Gambian government and Riders for Health. Previously, many Gambians lacked access to needed health services because of unpaved roads, an aging fleet of health transport vehicles and an unreliable fuel supply. With support from the Clinton Global Initiative and the Skoll Foundation, Riders for Health secured bank funding to purchase a new fleet of health transport vehicles—ambulances, SUVs, and motorcycles. Riders for Health is responsible for training mechanics and providing parts to maintain the fleet, which it leases to the Gambia’s Ministry of Health for a not-for-profit, fixed fee.

The results have been dramatic—both for reproductive health and public health more generally:

Health outreach workers now have motorcycles that enable them to visit three times as many villages each week, and spend twice as long in each community

Health workers see 6,000 more people every week than they did previously

Three times more patients are referred from health centers to hospitals

Outreach clinics provide maternal and child care on a scheduled basis, ensuring access to family planning, immunizations, and prevention of maternal-to-child transmission of HIV