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Analytical summary - Partnerships for health development

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Local and international partners make a significant contribution to the health sector in the Gambia, providing an estimated 66% of funding. However, the priorities of the different actors often differ and this results in vertical health programmes, inefficient utilization of health services and lack of coordination at the implementation level. In order to maximize effectiveness of partners, there needs to be a policy on partner/donor coordination.

There are positive moves at the intersectoral level, especially within the education sector, through health programmes and the recently established multisectoral Health and Nutrition Committee by the Ministry of Education. Achievements of this collaboration include, but are not limited to:

  • implementation of deworming of schoolchildren
  • hand washing
  • immunization campaigns in schools
  • the WHO Health Academy Project jointly implemented by the Ministry of Health and Social Welfare and the Ministry of Education.

The health sector also works closely with water resources and community development sectors to provide safe water and sanitation.

The private sector, faith-based organizations, civil society organizations, nongovernmental organizations and government agencies work with the Ministry of Health and Social Welfare in health care delivery at all levels. At community level, primary health care structures, such as the village development committees and the multidisciplinary facilitation team, serve as the main coordination mechanism for health care delivery. Technical advisory committees also serve as useful structures for coordination at regional level. Through these committees, global initiatives are translated into activities at the implementation level.

Currently, funding from international donors (e.g. bilateral and multilateral agencies, the Global Fund to Fight AIDS, Tuberculosis and Malaria, GAVI Alliance) is channelled directly to the intervention programmes through the Ministry of Health and Social Welfare. This has led to better outcomes since continuation of such funding is based on achievement of mutually agreed targets.

The Gambia has benefited from the International Health Partnership (September 2007) and other similar global initiatives aimed at promoting a more coordinated approach to developing and implementing national health plans and strategies, and addressing health system constraints.[1]

Despite an increasing commitment of the global community to health goals, the Gambia still experiences shortfalls in funding to strengthen its health systems, particularly human resource development. The health sector has been advocating for the establishment of a sector-wide approach that will contribute significantly to service delivery through effective utilization of donor funds.[2]

Public–private sector partnership also involves implementation of key national events such as polio national immunization days and commemoration of international health days. Banks, local musicians, artists and petroleum companies are some of the major contributors to the health sector. There is, as yet, no explicit policy on private sector involvement per se but the Directorate of Health Services has the oversight function of ensuring that this contribution is properly managed.

There are formal agreements between the Gambia and China, Cuba, Egypt, Nigeria, Spain, Taiwan and Venezuela in the delivery of health care in training, provision of expertise and, most outstandingly, in the setting up of the first and only medical school. Another training programme for community doctors is being implemented in four regions of the country. This is a novel venture for the Gambia and it is hoped that populations that were previously underserved will be provided with locally trained doctors who understand the environment they will work in.

References

  1. Harmonization for health in Africa (HHA). An action framework (pdf 71.22kb)
  2. Joint Assistant Strategy 2008─2011. The Gambia, African Development Bank–World Bank, Regional Department West 2, February 2008