1. 7TH – 12TH MARCH 2011 LAUSANNE , SWITZERLAND
4th International Seminar on Epidemiology and Public health Aspects of Non communicable Diseases
7TH – 12TH MARCH 2011 LAUSANNE , SWITZERLAND
The Gambia NCD Situation By Mr OMAR BADJIE
NATIONAL NCD FOCAL POINT, MOH&SW

2. COUNTRY PROFILE Projected Population: 1, 500,000 (2003 census)
Population Density: 128 person/Sq. KM
Annual Growth Rate: 2.74%
Crude Birth Rate: 46%
Total Fertility Rate: 5.4
Adult literacy rate is 62.2 (GBoS, 2003)
61% of population live below poverty line (2003 census)
< 15 years constitute about 44%
Women population: 51%
Rural Population: 60%

3. HEALTH SYSTEM Three-tier system Five Directorates
Primary Level (492 PHC Villages, )
Secondary Level (32 Minor H/C, 6 Major H/C)
Tertiary Level ( 4 General Hospitals, 1 Teaching Hospital)
Five Directorates
Health Services
Planning & Information
Social Welfare
Food Hygiene and Safety
National Public Health Laboratory
Six Health Regions (RHTs)

4. HEALTH INDICATORS Maternal Mortality Rate: 730/100,000 LBs
Neonatal Mortality: 28/1000
Infant Mortality: 75/1000 LBs
Under Five Mortality: 99/1000
Child Mortality: 135/1000
Immunisation Coverage: 89.2% (MICS 2006)
Life Expectancy: 65yrs (female), 63yrs (male)
HIV Prevalence Rate: 2.8% (2007)

5. NCD SITUATION DIABETES MELLITUS adult urban population - 8.6%
adult rural population - 1.4%
CANCERS
cervical cancer(9.4/100,000
liver cancer in men 19.2/100,000
liver cancer in women 5.9/100,000
HYPERTENSION
24.2% of the adult population
Mental health disorders- prevalence 20 %
Road traffic injuries- average 1000/yr

6. NCD RISK FACTOR SITUATION (WHO STEP SURVEY 2010)
About 2% of the adult population, aged 25 – 64 years, drink alcohol
Low consumption of fruits and vegetables, with the average mean number of days for fruits and vegetable consumption among adult males and females estimated at 3.3 and 5.0 respectively

7. NCD RISK FACTOR SITUATION CONT’D
About 22% of the adult population (males and females) have a low level of physical activity, whilst nearly 59% of adults do not engage in rigorous physical activity.
on average, Gambian adults spend 231 minutes per day on sedentary activities
On average, 41.4% of adult Gambians never had their blood pressure tested.

8. NCD RISK FACTOR SITUATION CONT
about 24.4% of the adult population have raised blood pressure (25.5% for men and 23.4% for women)
About 90.5% of adults (92.1% of men and 89% of women) never had their blood sugar tested
About 39.5% of the adult population (33.7% for men and 45.3%) are considered overweight with mean BMI >25kgM2

9. CURRENT ACTIVITIES
Finalizing Integrated National NCD Policy & Action Plan
Finalizing WHO Step Survey Report for 2010
Routine Sensitization Campaigns on (radio, TV etc)
Mobilizing & Strengthening inter-sectoral action for NCD prevention
Advocacy for NCD prevention and control
Training of Drama groups , TCs & peer Health Educators.
School Health programmes
Community outreach programmes

10. CONSTRAINTS
Building human capacity for the prevention and control of NCDs in The Gambia.
Establishing National Programme for NCD prevention and control
Limited trained staff on NCDs in the Public & Private Sectors
No NCD Policy and Action Plan
No National Budget for NCD Prevention and Control
Limited Logistics for monitoring and implementation of NCD activities

11. challenges
Addressing the limited human resource capacity for NCD prevention and control.
Prioritizing NCD prevention and control like other diseases e.g Malaria, TB, HIV/AIDS etc
Securing high level political commitment for NCD prevention and control.
Bridging the treatment gaps

12. Challenges cont
Support for the finalization of policy and strategic plan for NCDs.
 Support for transport to facilitate Monitoring and evaluation.
Resource mobilization for NCD prevention and control
Fostering and sustaining public and private sector collaboration.

13. Challenges Con’t
Enhancing political commitment for NCD prevention and control
Effective monitoring of NCD activities in The Gambia
Decentralization of NCD treatment
Finalization of national NCD policy and Action plan

14. Priority Areas for Action
Establishment of NCD unit within MOH&SW
Strengthening advocacy & Social Mobilisation
Fostering intersectoral collaboration
Human resource development
Community participation & empowerment
Strengthening research and knowledge management on NCDs

15. cont Finalisation of both the NCD Policy & Step Survey report.
Strengthening the Primary prevention of NCD

16. THANK YOU