Policy Recommendations from The Gambia on Improving the Maternal Health System in Sub-Saharan Africa
Abstract:
The Gambia is
ranked as one of the countries with the highest maternal death rate and the
country has made great strides in improving maternal health through
community-based interventions during the last ten years. The aim of this study
is to assess policy recommendations from The Gambia on improving the maternal
health system in sub-Saharan Africa. The specific objectives of this study were
to; (i) determine the socio-demographic information of the respondents in
the study area; (ii) determine policy and government interventions on maternal
health; (iii) assess donor programs and interventions targeting on maternal health;
(iv) determine external donor programs and interventions on maternal health;
(v) determine representative of the community on maternal health. A
retrospective quasi-experimental design with a well-structured questionnaire
was used to obtain information from 217 participants across the major administrative
regions of The Gambia, and the data were analysed using descriptive statistics.
The results showed that the majority (64.8%)
of respondents confirmed the existence of government policies to improve
maternal health service quality, 52.9% were aware of interventions for maternal
health in the study area, and UNICEF was the highest external donor (58.8%). Representatives of the community
showed that 41.7% of the group of community representatives were community
mobilizers/facilitators, the majority utilised services at hospitals (79.5%),
and hospital-based service utilisation was primarily guided by the availability
of good services and supplies (61.0%). Given that high maternal mortality rates persist in
Sub-Saharan Africa, The Gambia's approach highlights the significance of
inclusive, creative, and context-specific solutions.
References:
[1].
Merdad, L., & Ali, M. M., 2018,
Timing of maternal death: levels, trends, and ecological correlates using
sibling data from 34 sub-Saharan African countries. PloS one, 13(1),
e0189416.
[2].
Konje, E., 2020, The Context of
Maternal and Child Health Services in Northwest Tanzania: Missed Opportunities
for Preventing Maternal and Perinatal Mortality in Rural Communities.
[3].
Lincetto, O., & Banerjee, A.,
2020, World Prematurity Day: improving survival and quality of life for
millions of babies born preterm around the world. American Journal of
Physiology-Lung Cellular and Molecular Physiology, 319(5), L871-L874.
[4].
Lawn, J. E., Blencowe, H., Oza, S.,
You, D., Lee, A. C., Waiswa, P., & Cousens, S. N., 2014, Every Newborn:
progress, priorities, and potential beyond survival. The lancet,
384(9938), 189-205.
[5].
Onwuagbu, O. U., 2020, The
Epidemiology of Stillbirths According to the Perinatal Problems Identification
Program (PPIPP), at Rahima Moosa Mother and Child Hospital, from August 2016 to
July 2017 (Master's thesis, University of the Witwatersrand, Johannesburg
(South Africa)).
[6].
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.
[7].
Cole-Ceesay, R., Cherian, M., Sonko,
A., Shivute, N., Cham, M., Davis, M., ... & Southall, D., 2010,
Strengthening the emergency healthcare system for mothers and children in The
Gambia. Reproductive Health, 7(1), 21.
[8].
Johm, P. T., 2023, Understanding
factors influencing maternal vaccination acceptance in The Gambia (Doctoral
dissertation, London School of Hygiene & Tropical Medicine).
[9].
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.
[10].
Sundby, J., Ingstad, B., &
Walraven, G., 2003, Maternal Mortality in the Gambia: Contributing factors and
what can be done to reduce them (Doctoral dissertation, Department of General
Practice and Community Medicine Faculty of Medicine, University of Oslo).
[11].
Kanteh, O., & Palamuleni, M. E.,
2019, Women status and fertility in The Gambia. Gender and Behaviour,
17(3), 13627-13644.
[12].
Afferri, A., Dierickx, S., Bittaye,
M., Marena, M., Pacey, A. A., & Balen, J., 2024, Policy action points and
approaches to promote fertility care in The Gambia: Findings from a
mixed-methods study. Plos one, 19(5), e0301700.
[13].
Kinteh, B., Barrow, A., Nget, M.,
Touray, E., Touray, J., Kinteh, S. L., ... & Jatta, S. P., 2022, Research
Article Maternal and Child Health Services in Rural Settings of The Gambia:
Contextual Determinants of Postnatal Care from Mothers' Perspectives—A
Community-Based Analytical Cross-Sectional Study.
[14].
Babajide, O. O., 2021, Model-based
sub-population estimates of maternal mortality rates and ratio from siblings'
survivorship histories in Nigeria (2008-2018) (doctoral dissertation).
[15].
Sundby, J., 2014, A rollercoaster of
policy shifts: global trends and reproductive health policy in The Gambia. Global
public health, 9(8), 894-909.
[16].
Say, L., & Raine, R., 2007, A
systematic review of inequalities in the use of maternal health care in
developing countries: examining the scale of the problem and the importance of
context. Bulletin of the World Health Organization, 85(10), 812-819.
[17].
Gautam, S., Suso, A., & Wood, E.,
2024, Effect of antenatal care on birth outcomes in The Gambia: a propensity
score matching analysis.
[18].
Kothari, M. T., Coile, A., Huestis,
A., Pullum, T., Garrett, D., & Engmann, C., 2019, Exploring associations
between water, sanitation, and anemia through 47 nationally representative
demographic and health surveys. Annals of the New York Academy of Sciences,
1450(1), 249-267.
[19].
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.
[20].
Aglobitse, D. M., 2012, Intra-Family
Communication and Reproductive Health Decision Making in the Volta Region of
Ghana (Doctoral dissertation, University of Ghana).
[21].
Gagnon, M. P., Desmartis, M.,
Labrecque, M., et al., 2012, Systematic Review of Factors Influencing the
Adoption of Information and Communication Technologies by Healthcare
Professionals. J Med Syst, 36, 241–277.
[22].
World Health Organization, 2022, WHO
recommendations on maternal and newborn care for a positive postnatal
experience. World Health Organization.
[23].
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.
[24].
Morrison, B., 2015, The problem with
workarounds is that they work: The persistence of resource shortages. Journal
of Operations Management, 39, 79-91.
[25].
Veress, T. A., 2024, Community-Based
Organizations and the Challenges of the Anthropocene (Doctoral dissertation,
Budapesti Corvinus Egyetem).
