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Analytical summary - Non-communicable diseases and conditions

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As in some developing countries, noncommunicable diseases such as diabetes and cardiovascular disease are on the rise in the Gambia.[1] Unhealthy diet, lack of exercise and obesity are the risk factors that predispose to noncommunicable diseases in the Gambia. These account for most of the health care resources used and present a significant economic burden in the country.

The Government of the Gambia's 2009 Health management and information system report[2] showed that noncommunicable diseases such as hypertension account for 35.56% and 43.64% of diseases in males and females, respectively. Diabetes affected 1.78% and 1.87% of males and females, respectively.

Inadequate investment in prevention is a major contributing factor to the steady, continuous and sustained increase in noncommunicable diseases in the Gambia. This is further substantiated by the findings of the 2010 WHO STEPwise approach to surveillance (STEPS) survey to assess risk factors for noncommunicable diseases, conducted by the Ministry of Health and Social Welfare, which shows an increase in the prevalence of noncommunicable diseases.

One of the major achievements of the immunization programme in the Gambia is hepatitis vaccination aimed at preventing liver cancer, the commonest cancer in adult male Gambians. There have also been preliminary discussions with collaborators to introduce human papillomavirus vaccine in the bid to prevent cervical cancer in females. There is a need for follow-up on cancer screening and prevention programmes.

The Ministry of Health and Social Welfare continues to give out health messages intended to reduce chronic diseases such as diabetes mellitus, and heart and lung diseases. The Government's ban on smoking in public places is a positive step that needs concerted effort to implement.

The Gambia needs to do more regarding oral health. There is no policy on oral health and no representation at the directorate level to advocate for improvement in oral health. The awareness level on dental health is low, even among health professionals. Noma, which affects mainly malnourished children, is not uncommon in the Gambia although documentation is a challenge. Late diagnosis of oral health problems contributes to the development of noma in the Gambia. It is recommended that the Ministry of Health and Social Welfare begins to raise awareness and makes dental health a priority, especially in schools.

The prevalence of mental health disorders is about 20%. Mental health services are integrated into primary health care and provide affordable and accessible care to the general population and protect the mentally ill against stigma, discrimination and social exclusion. One good practice is that the community mental health team visits traditional healers who offer services to the mentally ill. This support is important as it helps to protect the dignity and rights of the patients by discouraging harmful practises such as violent restraint of patients.

Road traffic injuries have become an important public health problem, with a yearly average of about 1000 road traffic accidents. With the improvement of roads, it is envisaged that more accidents will occur. The strict surveillance of speed limits by law enforcement agents is therefore crucial.

Recent data suggest that the Gambia is on course for elimination of blinding trachoma as a public health problem.[3] This is commendable and is due to Government collaboration with partners, both national and international.

Routine data are collected using the Integrated Disease Surveillance and Response framework, which is reviewed on a monthly basis.

References

  1. WHO Country Cooperation Strategy 2008–2013, Gambia (pdf 426.64kb). Brazzaville, World Health Organization Regional Office for Africa, 2009
  2. Health management and information system report. Banjul, Government of the Gambia, Ministry of Health and Social Welfare, 2009
  3. Report of the Fourteenth Meeting of the WHO Alliance for the Global Elimination of Blinding Trachoma, 19–21 April 2010 (pdf 284.98kb). Geneva, World Health Organization, 2010