The Gambia 2026 Women’s & Family Challenge

Reproductive Freedom & Health

‘Safeguarding and enhancing the health of women is fundamental to health and development, impacting not only the well-being of today’s population but also shaping the health of future generations.

Dr. Margaret Chan, Director-General, World Health Organization.

Women’s Health in the Gambia

– THE SITUATION –

African women have always stood as pillars of families and communities. They often endure extreme challenges. They carry the burden of disease and mortality yet persist as peacemakers, life-bringers, entrepreneurs, and caregivers for children.

Women’s health is vital for Africa’s social and economic development. As they make up over half of the region’s human resources, their health impacts overall progress. Improving women’s health and income benefits entire communities. Therefore, addressing this issue is a matter of human rights.

Here are some current facts about women’s health in Africa:

Maternal Deaths Are Still High Although women’s life expectancy at birth in more than 35 countries worldwide exceeds 80 years, it is only 54 years in the African region, according to recent WHO statistics. Sixty-six percent of maternal deaths occur in sub-Saharan Africa. One in 42 African women dies during childbirth, compared to one in 2,900 in Europe.

HIV Disproportionately Affects Young Women In 2015, young women aged 15 to 24 represented 20% of all new adult HIV infections, even though they made up just 11% of the global adult population, according to Avert.com. In East and Southern Africa, young women tend to contract HIV five to seven years earlier than their male counterparts. On average, approximately 4,500 new HIV cases were reported among young women each week—twice the number seen in young men. The disparity was also stark in West and Central Africa, where 64% of new HIV infections among youth occurred in young women.

U.N. Women Collaborates to Advance Women’s Empowerment in Africa In partnership with the International Rescue Committee, U.N. Women is working to strengthen women’s empowerment across Africa. The initiative supports progressive social protection policies and enhances access to financial resources through national banks and regional partnerships. While major reforms remain essential in the area of women’s health, numerous organisations are actively driving change toward meaningful improvements.

Reproductive Freedom & Family Planning

– THE FACTS –

Family Planning 214 million women of reproductive age in developing countries who want to avoid pregnancy are not employing modern contraceptive methods. Certain family planning methods, such as condoms, offer protection against HIV and other sexually transmitted infections. Contraceptives distributed by UNFPA annually are estimated to have: Reached 27 million people. Prevented 13.5 million unintended pregnancies. Averted 4.1 million unsafe abortions. Prevented 32,000 maternal deaths. Saved $819 million in health-care costs

Infertility Infertility affects approximately 16.4% of the population in Sub-Saharan Africa, the highest rate globally. The main cause of infertility in Africa is Infections (especially untreated STIs), complications from unsafe abortions, and postpartum infections. Male factor infertility is often underdiagnosed due to cultural biases. Exposure to toxins, poor nutrition, and stress can all contribute to a couple’s inability to conceive. In Africa Infertility is often attributed to supernatural causes, such as curses or divine punishment. Infertility is often overlooked in national reproductive health strategies. In African societies, women are disproportionately blamed and they face social exclusion, domestic violence, and psychological trauma. Women and men often spend significant resources on traditional or unregulated treatments, often with no success.

STDs More than a million individuals acquire an STI every day. Without diagnosis and treatment, certain STIs, such as HIV or syphilis, can be fatal. Moreover, STIs can cause pregnancy-related issues, including stillbirth, congenital infections, sepsis, and neonatal death. Infections like human papillomavirus (HPV) can lead to pelvic inflammatory disease, infertility, and cervical cancer, which is a significant health threat for women.

Cervical Cancer Sub-Saharan Africa, particularly West Africa, bears a significant cervical cancer burden. Of the top 20 countries with the highest rates, 19 are in Africa. Over 70% of cases result in death due to late diagnosis and limited treatment access. Women with HIV are up to six times more likely to develop cervical cancer, primarily caused by persistent HPV infection (types 16 and 18). Risk factors include early sexual activity, multiple pregnancies, and limited reproductive health services. Late-stage diagnoses are common due to poor screening access. HPV vaccination rates are low among girls aged 9–14. There’s also a shortage of trained personnel and equipment for screening and treatment. WHO recommends vaccinating girls aged 9–14 with two HPV vaccine doses and scaling up cost-effective screening methods like VIA and HPV testing, along with increasing education and awareness.

Child Marriage The practice of child marriage has seen a global decline over the past decade, with the proportion of young women married as children decreasing from 25% to approximately 21%. However, around 650 million girls and women today were married before turning 18. While this reduction is notable, no region is currently on track to meet the Sustainable Development Goal of eliminating this harmful practice by 2030. 1 in 5 girls worldwide are married before the age of 18. 650 million: More than 650 million women alive today were married as children.

FGM Female genital mutilation (FGM) has been a subject of growing concern. It was historically considered taboo and often associated with ancestral traditions or religious myths, complicating open discussions or challenges. Factors like illiteracy, poverty, and misinformation have exacerbated the issue. Fortunately, the last decade has seen a surge in efforts to end this practice. FGM is now widely recognized as a violation of the human rights and physical integrity of women and girls.

Personal Hygiene & Black Medicine In the Gambia vaginal douching is a commonly used method to wash out the vagina with water or a mixture of water and soap, Dettol or other solutions. Besides making them feel fresher, women say they douche to get rid of unpleasant odors, wash away menstrual blood after their period, avoid getting sexually transmitted diseases and prevent a pregnancy after intercourse. Vaginal tobacco ‘Tabo’, the practice of using tobacco or other dried leaves in the vagina, claims that it improves sensation during intimacy, increases fertility, and tightens the vagina.

Maternal and Child Mortality Between 1990 and 2015, maternal mortality nearly halved. The world has made significant strides in child survival, with many more children living beyond their fifth birthday compared to 1990. In 2017, the under-five mortality rate was 1 in 26, a marked improvement from 1 in 11 in 1990. Despite this progress, an estimated 5.4 million children under the age of 5 died in 2017, with roughly half of those deaths occurring in sub-Saharan Africa. Mortality rates among older children and adolescents also dropped by more than 50% since 1990, but nearly one million children in this age group died in 2017. These statistics underscore the urgency of further improving child survival worldwide. Gambia 63.6 per 1,000 live births.

The Challenge

– AT A GLANCE –

The inequity and inadequacy in reproductive health access and education, particularly in developing regions like Sub-Saharan Africa, is a significant challenge. This issue is multi-dimensional, involving:

• Limited Access to Modern Family Planning Millions of individuals lack access to safe, effective contraceptives, leading to unintended pregnancies, unsafe abortions, and preventable maternal deaths.

• High Infertility Rates and Stigma Infertility is common but insufficiently addressed. Cultural beliefs often place the blame on women, causing emotional and social harm. The lack of affordable, regulated treatment options exacerbates the problem.

• Prevalence and Impact of STIs Sexually transmitted infections are widespread and frequently untreated, resulting in severe health consequences such as infertility, cancer, and neonatal deaths. There is a lack of comprehensive testing, treatment, and education.

• Cervical Cancer Crisis Africa experiences a high burden of cervical cancer, with late diagnoses and limited treatment. Low HPV vaccination rates and inadequate screening infrastructure are major barriers.

• Harmful Traditional Practices Child marriage and FGM persist due to cultural norms, poverty, and misinformation. These practices affect girls’ health and education.

Our Strategy

– WHAT WE HOPE TO ACHIEVE –

To provide women and girls in the Gambia with access to information & help for all the SRRH services they need and ultimately empower them with the knowledge and tools to plan their lives and their families.

We seek funding to implement a nationwide SRHR campaign targeting all women and girls aged 10 and up in The Gambia. The project will provide cervical cancer screening, STD screening, menstrual health and hygiene education, infertility support, and family planning services.

This will involve:

1/ Training healthcare workers and procuring medical resources (3–6 months).

2/ Mobile Clinics and Community Outreach Programs (6–12 months)

3/ Monitoring the impact, sustainability planning, and scaling up services (12+ months)

Funding will be allocated to the following key area’s:

• Screening and Healthcare services
• Mobile Clinic operations
• Educational Material & Campaigns
• Training Healthcare Workers

Potential partners:

• Gambia Ministry of Health & the University of the Gambia
• MRC Unit The Gambia London School of Hygiene and Tropical Medicine
• Private- and NGO based Clinics in the Gambia
• Established local Women’s organizations and organizations like GAMCOTRAP, Safe Haven Foundation, Fabb Foundation, WILL, Gampads and others
• Family Planning, Baffrow and SOS Children’s village Gambia
• UNFPA and WHO
• Rotary International

Concrete Goals:

• A minivan/camper bus that we can equip as a gynaecology office setup: Bed, lighting, fridge, water, office space, storage for equipment etc
• Mobile ultrasound scanner
• Mobile X-ray
• Mobile colposcope
• Small lab facilities for basic microscopy, rapid tests etc
• Educational resources: Posters, Folders, Flyers etc on different SHRH topics
• Computer database/electronic file system and reliable Wifi system

Potential Funding:

• Rotary International Grants: Rotary provides funding for health and community development projects. You’ll need to collaborate with a local Rotary club to apply for grants.
• Amplify Change Grants: This fund supports SRHR advocacy and offers grants to organizations working in Africa.
• EU Development Assistance: The EU has historically funded SRHR initiatives, but recent budget cuts may affect availability.
• UN Agencies: UNFPA and WHO often support reproductive health programs in Africa.

The 2026 Women’s Chalenge

-IN SUMMARY-

Reproductive Freedom & Family Planning

The core challenge is the inequity and inadequacy in reproductive health access and education in developing regions like Sub-Saharan Africa.

Underlying Issues:

• Healthcare system weaknesses: Lack of trained personnel, equipment, and funding.
• Cultural and social barriers: Stigma, myths, and gender inequality.
• Policy gaps: Infertility and reproductive health often overlooked in national strategies.
• Education and awareness: Low levels of reproductive health literacy.

1. Limited Access to Modern Family Planning: Millions of women lack safe, effective contraceptives, leading to unintended pregnancies, unsafe abortions, and preventable maternal deaths.
2. Infertility: Affects 16.4% in Sub-Saharan Africa due to untreated STIs, unsafe abortions, infections, toxins, poor nutrition, and stress. Cultural stigma often blames women leading to emotional and social harm. Lack of affordable, regulated treatments worsens the issue.
3. Prevalence and Impact of STIs: Untreated sexually transmitted infections cause fatal outcomes, pregnancy complications, infertility, and cervical cancer. Common untreated STIs lead to severe health consequences like infertility, cancer, and neonatal deaths. There’s a lack of widespread testing, treatment, and education.
4. Cervical Cancer Crisis: Africa has the highest rates of cervical cancer with 70%+ resulting in death due to late diagnosis. Limited treatment and poor screening infrastructure are major barriers.
5. Harmful Traditional Practices: Child marriage and FGM persist due to cultural norms, poverty, and misinformation, violating human rights and hindering health and education.
6. Maternal and Child Mortality: Despite progress, high mortality rates remain, especially in Sub-Saharan Africa. Many deaths are preventable with better healthcare access and education.