A joint mission led by WHO, UNICEF, and UNFPA in The Gambia’s Central River Region focused on strengthening national health systems by engaging directly with frontline health workers. Conducted from 8–10 April as part of preparations for a UN joint programme on maternal and child health, the mission aimed to better understand real-world service delivery conditions, identify gaps, and co-develop solutions that reflect local realities. It also emphasized ensuring that national health priorities are informed by experiences at the facility and community levels.
The team visited several health facilities, including those in Bansang, Brikamaba, Janjanbureh, Njau, Karantaba Tenda, Kudan, Kuntaur, and Kaur, as well as the Regional Health Directorate. Discussions with frontline staff covered key service areas such as maternal and newborn health, immunization, nutrition, reproductive health, and adolescent services. Health workers also provided insights into broader health system components, including governance, workforce capacity, financing, supply chains, health information systems, and community participation.
Overall, service delivery was found to be generally aligned with demand, with adequate staffing levels and sufficient availability of essential medicines, equipment, and supplies across facilities. However, the mission also highlighted areas requiring improvement, particularly in the effective use of available health products, which would benefit from further training, orientation, and stronger community engagement to enhance uptake and impact.
A major concern identified during the mission was the failure of critical infrastructure, particularly the oxygen plant at Bansang Government Hospital, which has been non-functional for over three months. As a result, the hospital has been forced to rely on costly private suppliers, highlighting the urgent need for repair to ensure uninterrupted access to life-saving care services.
The mission reinforced the importance of collaboration between international partners and the Ministry of Health in using frontline evidence to guide decision-making and strengthen service delivery. It also emphasized the need for improved coordination among stakeholders, integrated planning, and continued investment in supportive supervision, workforce capacity building, and community engagement to enhance health system performance.
Moving forward, the findings will inform coordinated action with national and regional health authorities to address identified challenges and strengthen service delivery in the Central River Region. WHO, UNICEF, and UNFPA reaffirmed their commitment to working closely with the government and health workers to build a more resilient, responsive, and equitable health system in The Gambia, ensuring improved access to quality care for all populations.
