How does healthcare work in Gambia, and what travel insurance, health insurance or expat insurance do you need?

How does the healthcare system work in Gambia?

Despite Gambia having one of the best health coverage systems in Africa (more than 80% of the population has access to care), the Gambian healthcare system faces many challenges, such as shortages of staff, infrastructure, and medicines. Fortunately, the government is working to expand both the public and private healthcare systems in the coming years.
The Gambian healthcare system consists of three levels:
Primary care: Health centers in villages and smaller communities.
Secondary care: Regional hospitals providing specialized care.
Tertiary care: Large hospitals and specialized institutions such as the Royal Victoria Teaching Hospital and the Medical Research Council (MRC) in Fajara.
The government (Ministry of Health) is responsible for policy, planning, and primary care networks; international partners donate significant resources and personnel, including through NGOs.
Quality and capacity vary widely. Urban areas such as Banjul and Kombo are better equipped than rural areas. Staff shortages and medicine shortages are not uncommon in rural areas. Pharmacies are available throughout the country, but medication availability isn't always guaranteed.
For medical emergencies, dial 116 or 1515. There are also several 24-hour doctors and medical facilities. Some institutions also have their own ambulance services.

The Ministry of Health and Social Welfare is responsible for coordinating healthcare in the country.
Health centers and community clinics are located throughout the country. They offer preventive, prenatal, and primary care.
The main public hospitals are the Edward Francis Small Teaching Hospital (EFSTH, formerly RVTH) and Kanifing General Hospital (KGH). Specialist care is available at these.
The public system is far from ideal. Capacity is limited, there are often long wait times, and shortages of equipment and medications. Therefore, most people who can afford it choose private options.

The private sector is growing in Gambia and is an important complement to the public system for both locals and foreigners.
There are private clinics, laboratories, specialist practices, and private hospitals/clinics in Banjul and tourist areas.
Private healthcare offers faster access, more modern equipment, and sometimes internationally trained staff.
It is more expensive, however, and usually requires out-of-pocket expenses or through good private (travel) insurance.
The National Health Insurance Authority (NHIA) regulates private insurance.

The first point of contact for care is found in health centers and clinics and often consists of clinical officers, nurses, and a growing number of general practitioners (GPs) in urban centers.
In rural areas, you will usually be treated by nurses who refer you to district hospitals; in Banjul, you will find more private doctors and walk-in clinics.
For routine consultations, vaccinations, and simple treatments, you can go to local clinics; for more complex problems, go to EFSTH or Kanifing/KGH.

Basic dental care is offered in some public hospitals/clinics, but much of it is private.
In rural areas, access to dental care is limited.
Tourists and (temporary) residents often use private clinics in Banjul/Kombo.
Reviews of dental clinics can often be found on (expat) forums.

Maternity care in Gambia is limited, and maternal mortality rates are high. The country faces many challenges, such as strong population growth, low incomes, and high government debt. Fortunately, there are programs and projects to increase safe deliveries, but maternal mortality and access in rural areas remain a concern.
Prenatal and postpartum care in the public sector is primarily available in the maternity wards of large hospitals such as the KGH. However, many challenges remain.
Private care might be better, but for complications, referral to larger hospitals is necessary, but in some complex cases, referral abroad is necessary.

Many areas in Gambia are relatively safe for tourists, but crime (including pickpocketing and theft) and road safety are important considerations.
Keep valuables safe and don't leave items unattended in cars; be careful in crowded markets and when driving at night.
It is important to follow local advice and monitor health situations.

Tap water is not safe to drink and can significantly disrupt your vacation. Drink filtered water and be sure to bring some ORS.
Yellow fever and malaria are common, as is HIV/AIDS.
Because healthcare is limited, medical evacuation may be necessary.

Traffic drives on the left, roads can be poorly lit or even unlit, and the roads are not always safe.
Outside the cities, four-wheel-drive vehicles are required during the rainy season.

Is the trip to Gambia and your return sufficiently covered? Are you sufficiently covered before, during and after your activities? Which insurance best suits your trip and your activity? Read more about insurances for abroad on JoHoinsurances.org.

When applying for your visa, you are usually required to be able to prove that you have valid health insurance.
If you have private insurance, you can choose your own doctor in Gambia.
Read more about insurances for abroad on Expatinsurances.org.

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