Project information

Reducing maternal & child mortality in The Gambia

Our Strengthening Emergency Care programme (SEC) is a sustainable whole system programme for the emergency care of pregnant women, newborn infants and children in countries where there is extreme

3 years

Charity information

Maternal & Childhealth Advocacy International

Maternal & Childhealth Advocacy International logo
  • Need


    The risk of maternal death in The Gambia is 1 in 32. Many women, babies and children die because of inadequate health care.

    More than 80 per cent of maternal deaths worldwide are due to five direct causes: haemorrhage, sepsis, unsafe abortion, obstructed labour and hypertensive disease of pregnancy


    Whilst we acknowledge the importance of maternal and child health care improvements through primary prevention, inevitably emergency situations arise which are poorly managed, especially in the early hours of their presentation, leading to avoidable maternal and child deaths. In The Gambia for example over two-thirds of the deaths take place during labour or shortly after delivery.

  • Aims

    Aim 1

    To reduce unacceptably high levels of maternal and child mortality and morbidity rates.


    » Through a sustainable training programme for health care professionals and community workers in emergency care for mothers, neonates and children
    » Improving the availability of essential drugs, medical and surgical supplies and equipment, renovating existing hospital premises
    » Improving the “emergency chain of care” functional by developing communication and transportation for the critically ill or injured.
    » Refurbishing/building better accommodation for staff.

    Success will be demonstrated through improved health worker skills; system change and a reduction in mortality.

  • Impact


    In the long term we want to strengthen emergency care and work with the government to do this. We believe that by training not only doctors and nurses but also community health workers, long term improvement in emergency care for pregnant women, babies and children will occur.

    Although maternal mortality rates are hard to monitor accurately we do monitor the improved skills that health workers are using both qualitatively and quantitatively.


    An independent audit has already been carried our on the pilot of this programme in The Gambia and we have learnt from that. Risks include:

    1) Health care workers having low morale and therefore not practicing new skills
    2) Health care workers being moved around the country by the government. This risk means that we have had to ensure accurate monitoring to prevent duplication of training.


    We already have internal monitoring systems that feed into reporting for donors. So for exampel we can say how many people have been much money has been spent to renovate an operating theatre etc

  • Budget

    Budget - Project Cost: £235,081

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      Amount Heading Description
      £124,617 Upper River Region To complete training and renovation work at Basse Major Health Centre
      £110,464 Western River Region To train 100 health care workers & 24 instructors
  • Background


    Our project is based in The Gambia which is ranked 160 out of 179 in the UN Human Development Index. The Gambia is the smallest African country and yet healthcare facilities are sparse, basic medicines unavailable and emergency care very poor. The risk of maternal death in The Gambia is 1 in 32 and for every death another 20 women are left disabled, often ostracized by their families.


    All pregnant women, babies and children in the areas served by the two health centres.

    Basse Major Health Centre serves 38,245 children under 5 years of age, 81,078 children aged 5-14 years of age, and 45,704 women between 15 and 49 years of age.

    Brikama serves a population of 200,000 people

    The system change that we support is beneficial to all patients and is not only about saving life but also about preventing disability such as Obstetric Fistula.

  • Why Us?

    Why Us?

    Maternal & Childhealth Advocacy International (MCAI), an NGO with fourteen year’s experience of delivering healthcare programmes in countries where there is extreme poverty

    Read more about the Charity running this project.


    Meggie Szszesny

    Meggie is the Programmes Director at MCAI and her project management skills are instrumental in pushing this project forward in many ways.