Health in Gambia

The Ministry of Health coordinates health services under the National Health Sector Policy 2021–2030. Primary health care, or PHC, is the first level of care intended to serve most people through community and local facilities. Village Health Workers, Community Birth Companions and Community Health Nurses support local access, alongside Community Clinics, Health Posts, Minor Health Centres and Major Health Centres. District Hospitals and General Hospitals manage more complex care, while Edward Francis Small Teaching Hospital, known as EFSTH, is the country’s teaching hospital and main referral hospital. Care before illness or complications includes health education, routine immunization, antenatal care, maternal and newborn services, child health, family planning, malaria prevention and testing, HIV testing, nutrition screening and community outreach. WASH-related prevention addresses risks connected with water, sanitation and hygiene. During care, facilities may provide clinical assessment, laboratory or radiology services where available, treatment, maternal and newborn emergency care, malaria, tuberculosis and HIV services, non-communicable disease care and mental-health support. The available service depends on the facility, staff, equipment and supplies. The health system includes public facilities, private clinics, NGO clinics and service clinics. Traditional medicine remains a trusted entry point for many people and is increasingly subject to regulation and integration efforts. Its use does not remove the need for qualified assessment when symptoms are severe, persistent or worsening. Mental-health care has historically been concentrated in urban areas, but mhGAP training is expanding the role of primary-care and community providers. The Mental Health Bill was still at stakeholder stage in January 2026, so its enactment was not verified. The Lunatics Detention Act 1917 continued to be cited in the 2025 official assessment. Referral care should move upward when a local facility cannot safely manage the condition. Delays can result from distance, roads, transport, fuel, ambulance availability, incomplete referral feedback and gaps in referral protocols. For a health emergency, call the Ministry of Health emergency line on 1025 and contact the nearest health facility. Health facilities are expected to screen and stabilize emergencies within the policy framework, but a specific ambulance response time was not identified. Do not delay urgent assessment while trying to arrange a distant referral yourself. The Directorate of National Pharmaceutical Services coordinates medicines under the National Medicines Policy. Central Medical Stores procure, store and distribute medicines, consumables and equipment, using the National Essential Medicines List and Standard Treatment Guidelines. Stock, quality and availability can still vary by facility and region. HIV care is integrated into 77 health facilities. Differentiated HIV services include multi-month dispensing, integrated visits and flexible hours, and more than 1,000 treatment initiations were reported between October 2025 and March 2026. Follow-up can include treatment adherence, viral-load monitoring, chronic-disease reviews, rehabilitation, palliative care and referral checks, depending on the condition and facility. The Ministry of Health policy framework includes patient rights to understandable information, provider choice where possible, emergency screening and stabilization, participation in treatment decisions, respectful and non-discriminatory care, confidentiality, access to and correction of medical records, and complaints or appeals. The current statutory force of every listed right was not separately verified. General patient responsibilities include giving relevant health information, following agreed treatment or referral instructions and respecting facility rules. Nationally uniform tariffs, medicine prices and appointment or referral deadlines were not identified; costs and timing can therefore differ between providers and regions.