The country has a three-tier health care system comprising the Primary, Secondary and the Tertiary levels. The primary level consists of the Village Health Services and Community Clinics; the Secondary comprises the Minor and Major Health Centres. The Tertiary level composes the General Hospitals and a Teaching Hospital. The Ministry of Health and Social Welfare (MoH & SW) is the main government agency responsible for health care delivery in The Gambia.
The health sector is managed at two levels, the central and regional levels. The Gambia has three main referral hospitals. In the capital Banjul there is the Royal Victoria Hospital which is a tertiary hospital with 650 beds. There are also referral hospitals in Farafenni and Bansang.
There are also a number of private clinics in Banjul, however these are inaccessible to vast majority of Gambians. The hospital bed density in 2009 was reported as 1.13 beds per 1,000 population; this is in stark contrast to Ireland which has 5.17 beds per 1,000 population. Adding to this dire situation of low levels of hospital beds is the low level of physician density: 0.038 physicians per 1,000 population in The Gambia while Ireland has 3.187 physicians per 1,000 population. In other words, there is only one doctor for every 26,000 Gambians compared to one doctor for every 300 people in Ireland. Consequently, Gambian doctors can only see the most severely ill patients resulting in many people never seeing a doctor whatsoever during their lifetime. The World Health Organization estimates that fewer than 2.3 health workers (physicians, nurses, and midwives only) per 1,000 would be insufficient to achieve coverage of primary healthcare needs.
The Gambia is rated as “very high” for risk of major infectious diseases. The main food or waterborne diseases seen there include bacterial and protozoal diarrhoea, hepatitis A, and typhoid fever. The most prevalent vector borne diseases is malaria. Water contact diseases include schistosomiasis while respiratory diseases include meningococcal meningitis. Rabies is the most prevent zoonotic disease.
The HIV and AIDS statistics are some of the lowest for any Sub-Saharan African country. The HIV/AIDS – adult prevalence rate is 2% (2009 est.); people living with HIV/AIDS 18,000 (2009 est.); deaths from HIV/AIDS is fewer than 1,000 (2009 est.). Nevertheless, these figures are still very high compared to the vast majority of the developed world nations.