Gambia

The National Health Sector Strategic Plan 2021-2025 of The Gambia aligns with the National Health Policy 2021-2030 and the Sustainable Development Goals (SDGs) to achieve Universal Health Coverage (UHC). It aims to strengthen health governance, enhance service delivery, and improve health financing to ensure equitable access to quality healthcare for all citizens​. The strategic plan builds on a three-tier healthcare system—primary, secondary, and tertiary levels—ensuring comprehensive health service delivery. Primary healthcare is decentralized, focusing on community clinics and health posts. Secondary care, including emergency obstetrics and surgeries, is provided at district hospitals and major health centers, while tertiary care comprises specialized hospitals and a national referral system. The governance framework supports transparency and accountability through policy development, decentralization, and multi-sectoral coordination​. Despite these strengths, the healthcare system faces several challenges, including fragmented programs, unstable leadership, and financial constraints. The reliance on external funding highlights the need for sustainable domestic financing. Additionally, there are gaps in data collection, monitoring, and evaluation, which hinder effective decision-making and policy implementation. Strengthening the Health Information System and research governance are crucial to overcoming these obstacles​. The plan promotes public-private partnerships and community engagement to enhance service delivery. Success will depend on sustained political commitment, effective intersectoral collaboration, and the implementation of robust monitoring mechanisms. Addressing governance weaknesses, strengthening financial risk protection, and improving human resource capacity will be essential in achieving the plan’s vision of an efficient, equitable, and resilient health system.