Abstract:

Maternal health is a major public health concern in The Gambia. The aim of this study was to determine the current status of maternal health services in The Gambia. This study applied well-structured questionnaire to obtain information from 217 participants from seven (7) administrative regions in The Gambia. Descriptive statistics was used to analyze the data. The respondent profile was majorly males, aged 25-34 and highly educated. Findings show that 73.8% reported the presence of community awareness programs, and 83.8% affirmed their personal role in maternal health efforts. Also, the most frequently offered services during community-based maternal health outreach included health education (77.5%), family planning (59.9%), antenatal care (58.2%), and immunization (56.6%). The results also showed that family planning and birth spacing initiatives (65.5%) had the highest implementation rates regarding awareness. Resource and system constraints (55.5%), data availability and quality issues (50.9%), limited technical and human capacity (46.2%), and coordination/communication gaps (32.9%) were frequently reported. Based on the findings of this study, ANC and PNC attendance (67.5%), skilled birth attendance (55.6%), and place of delivery (52.7%) were the most monitored key indicators. The significant representation of nurses/midwives and public health officers is very important, as these professionals are at the forefront of implementing community-based maternal health initiatives. Findings show a strong emphasis on community awareness and engagement in maternal health. Meeting national and international health goals and providing equitable, high-quality maternal health services depend on addressing these issues through focused policy changes and capacity building.

References:

[1].   World Health Organization. Reproductive Health, 2003, Pregnancy, childbirth, postpartum, and newborn care: a guide for essential practice. World Health Organization.

[2].   World Health Organization, 2022, WHO recommendations on maternal and newborn care for a positive postnatal experience. World Health Organization.

[3].   Al Amin, S. U., 2023, Impact of Limited-Service Availability and Preparedness on Facility-Based Delivery in Bangladesh. [Online], Available at: https://era.library.ualberta.ca/items/438e754d-6434-4eba-b8bb-c218e737382c

[4].   Ukwu, S., 2019, Association of Health Facility Delivery and Risk of Infant Mortality in Nigeria. Walden University.

[5].   Olea-Ramirez, L. M., Leon-Larios, F., & Corrales-Gutierrez, I., 2024, Intervention Strategies to Reduce Maternal Mortality in the Context of the Sustainable Development Goals: A Scoping Review. Women, 4(4), 387-405.

[6].   Lowe, M., Chen, D. R., & Huang, S. L., 2016, Social and cultural factors affecting maternal health in rural Gambia: an exploratory qualitative study. PloS one, 11(9), e0163653.

[7].   Hossain, I., Hill, P., Bottomley, C., Jasseh, M., Bojang, K., Kaira, M., & Mackenzie, G., 2021, Healthcare seeking and access to care for pneumonia, sepsis, meningitis, and malaria in rural Gambia. The American Journal of Tropical Medicine and Hygiene, 106(2), 446.

[8].   Lassi, Z. S., Musavi, N. B., Maliqi, B., Mansoor, N., de Francisco, A., Toure, K., & Bhutta, Z. A., 2016, Systematic review on human resources for health interventions to improve maternal health outcomes: evidence from low-and middle-income countries. Human Resources for Health, 14(1), 10.

[9].   Shepard, D. S., & Zeng, W., 2011, Design of Health Insurance in The Gambia.

[10].  CIA World Factbook, 2019, Maternal mortality rate-country comparison, https://www.indexmundi.com/g/r.aspx?c=ga&v=2223.

[11].  Stanislas, P., & Chongan, E., 2022, Communal Complexity Conflict and Security in Gambia. In Understanding and Preventing Community Violence: Global Criminological and Sociological Perspectives (pp. 205-217). Cham: Springer International Publishing.

[12].  Johm, P. T., 2023, Understanding factors influencing maternal vaccination acceptance in The Gambia (Doctoral dissertation, London School of Hygiene & Tropical Medicine).

[13].  Ansong, J., Asampong, E., & Adongo, P. B., 2022, Socio-cultural beliefs and practices during pregnancy, child birth, and postnatal period: A qualitative study in Southern Ghana. Cogent Public Health, 9(1), 2046908.

[14].  Allendorf, K., 2007, Couples' reports of women's autonomy and health‐care use in Nepal. Studies in family planning, 38(1), 35-46.

[15].  Andualem, F., Nakie, G., Rtbey, G., Melkam, M., Tinsae, T., Kibralew, G., & Fentahun, S., 2025, Magnitude and determinants of intimate partner controlling behavior among women in sub-Saharan African countries from the recent demographic and health survey data: a multilevel analysis. BMC Public Health, 25(1), 1787.

[16].  Lowe, M., 2017, Social and cultural barriers to husbands' involvement in maternal health in rural Gambia. The Pan African Medical Journal, 27, 255.

[17].  Vieira, C., Portela, A., Miller, T., Coast, E., Leone, T., & Marston, C., 2012, Increasing the use of skilled health personnel where traditional birth attendants were providers of childbirth care: a systematic review. PLoS One, 7(10), e47946.

[18].  Lembani, M., De Pinho, H., Delobelle, P., Zarowsky, C., Mathole, T., & Ager, A., 2018, Understanding key drivers of performance in the provision of maternal health services in eastern cape, South Africa: a systems analysis using group model building. BMC Health Services Research, 18(1), 912.

[19].  Hosseini, A., Shakiba, R., Ramezanghorbani, N., & Asadi, F., 2023, Identifying and Determining Effective Key Performance Indicators in the Development of Maternity Dashboard. Shiraz E-Medical Journal, 24(11).

[20].  Moller, A. B., Patten, J. H., Hanson, C., Morgan, A., Say, L., Diaz, T., & Moran, A. C., 2019, Monitoring maternal and newborn health outcomes globally: a brief history of key events and initiatives. Tropical Medicine & International Health, 24(12), 1342-1368.

[21].  Coombs, N. C., Campbell, D. G., & Caringi, J., 2022, A qualitative study of rural healthcare providers' views of social, cultural, and programmatic barriers to healthcare access. BMC Health Services Research, 22(1), 438. https://doi.org/10.1186/s12913-022-07829-2

[22].  WHO, 2019, Making every baby count: Audit and review of stillbirths and neonatal deaths. Geneva, Switzerland.

[23].  UNICEF, 2020, Neonatal mortality. In UNICEF DATA. World Health Organization, Geneva, Switzerland. Available at: https://data.unicef.org/topic/child-survival/neonatal-mortality/

[24].  Koblinsky, M., Anwar, I., Mridha, M. K., Chowdhury, M. E., & Botlero, R., 2008, Reducing maternal mortality and improving maternal health: Bangladesh and MDG 5. Journal of Health Population and Nutrition, 26, 280–94. doi: 10.3329/jhpn.v26i3.1896.

[25].  Pacagnella, R. C., Cecatti, J. G., Osis, M. J., & Souza, J. P., 2012, The role of delays in severe maternal morbidity and mortality: expanding the conceptual framework. Reprod Health Matters, 20(39), 155-63. doi: 10.1016/S0968-8080(12)39601-8.

[26].  WHO, UNICEF, UNFPA, World Bank Group and the United Nations Population Division, 2015, Trends in maternal mortality: 1990 to 2015. Estimates by the UN-IAGME. WHO, Geneva, Switzerland.

[27].  Victora, C. G., Barros, A. J., Axelson, H., Bhutta, Z. A., Chopra, M., & França, G. V., 2012, How changes in coverage affect equity in maternal and child health interventions in 35 Countdown to 2015 countries: an analysis of national surveys. The Lancet, 380(9848), 1149–56.