Introduction - UNDP The Gambia

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the enrolment ratio by gender, thus reversing
the gain made to negative indicators. Girls are
still discriminated against and cultural
practices such as early marriages, male
preference and female genital mutilation still
affect them. These factors have contributed to
the perpetuation of the gender gap. The role
of parents and social mobilisation with
citizen participation in the communities are
necessary to achieve the stated target.
5.2.3 Reduction of Child Mortality
and Improvement of Maternal Health
Challenges
within the health facilities poses many
problems for women of reproductive age.
5.2.4 Combating HIV/AIDS:
Challenges
Meeting the target of combating HIV/AIDS is
very remote, given the fact that Gambian
women have no control over their sexuality.
Most of what happens to them is determined
by cultural dictates influenced by religious
conservatism. Many women ,particularly
those from the rural communities, are married
off at a very early age .
The Gambia is on track in its efforts to reduce
maternal mortality. However, access to good
antenatal care and specialised health facilities
and referral systems have been challenges for
many women of reproductive age. Poor
infrastructure and communication facilities
mean that most deliveries are done at home.
Therefore, safe and healthy delivery
procedures are needed to prevent women
from infection and other related
complications. Where skilled health
personnel are available, the urban areas are
always at an advantage.
The challenges to meeting this target in the
rural areas will always be at a disadvantage
due to poverty. People in the rural areas lack
the opportunity to access the services of
skilled health personnel. TBAs are available
to these communities.
Most TBAs have been trained to improve
their delivery practices by both the NGOs and
the Department of State for Health and Social
Welfare. They provide 25 per cent of births
(MIC, 2000), and 42 per cent in some rural
areas, compared to only 4 per cent in the
urban areas (MDG Report, 2003:20). The
biggest challenge is to improve the role of
these traditional structures in contributing
effectively to the achievement of the stated
target.
Similarly, timely evacuation systems to
prevent maternal and infant deaths in cases of
complications are a threat to achieving the set
targets. Lack of adequate facilities and drugs
As a result, they assume their reproductive
roles as early as fifteen years old. They can
hardly negotiate ‘safe sex’ nor make
decisions about their sexual life. Crossgenerational
marriages also put young girls in
a vulnerable situation of contracting
HIV/AIDS.
Being sexually active at a very early age
without protective sex and other risky
behaviour of young people could also be a
challenge to meeting the target. The use of
hard drugs among drug users may contribute
to the risk of increasing the disease.
According to NAS, the prevalence of HIV-1
and HIV-2 is estimated at 2.1 per cent and 0.8
per cent respectively. In statistical terms it
means approximately 97 per cent of the
population are free from the disease.
However, knowledge of transmission and
prevention of the disease is very limited. At
the same time, stigma and discrimination are
factors which could facilitate the increase of
HIV/AIDS in The Gambia.
Other influencing factors are the people’s
social and cultural practices such as crossgenerational/early
marriages, wife
inheritance, polygamy and female genital
mutilation. The culture of silence and refusal
to recognise the gender dimensions of
HIV/AIDS pose a formidable challenge.
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Building Capacity for the Attainment of the Millennium Development Goals in The Gambia National Human Development Report 2005
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