The Gambia

Country Overview

Malaria overview

Malaria is endemic across all of The Gambia, with 275,910 cases and 262 deaths reported in 2013. The Gambia’s overall malaria trend is downward, with cases in 2013 representing a 38% reduction on 2008. This has been achieved through the pilot and rapid scale up of a number of interventions such as community-based malaria diagnosis and treatment, bednets, and SMC. Malaria in The Gambia is very heavily concentrated within the short rainy season which affects the whole country from September to December.

Which areas of The Gambia are eligible for SMC?

With a short rainy season and high malaria burden, all of The Gambia is eligible for SMC. Areas in the far east of the country are prioritized as this is where malaria incidence is higher. 

What is The Gambia’s experience with SMC?

The Gambia has experience of rolling out SMC prior to the ACCESS-SMC project. SMC has been implemented in two of The Gambia’s seven regions (Central River Region and Upper River Region), led by the National Malaria Control Program (NMCP) and supported by UNICEF. Expansion to cover Western 2 Region is planned for 2015.

ACCESS-SMC in The Gambia

Where is SMC being delivered?

In 2015, ACCESS-SMC is supporting The Gambia’s NMCP to administer SMC to 91,676 children in Central River Region and Upper River Region. 

When is SMC delivered?

In The Gambia, SMC is administered to children from August, with monthly distributions continuing until November.

How is SMC managed in The Gambia?

ACCESS-SMC is providing technical, financial and logistical support to the NMCP and regional health teams for them to lead roll out of SMC. This support covers topics such as planning, health worker training and supervision, managing the supply chain and communicating key SMC information to communities. By combining financial and technical support, we aim to strengthen existing approaches to ensure the NMCP can continue delivering in years after ACCESS-SMC finishes.

How is SMC administered?

In The Gambia, SMC is delivered by 272 teams working for five days per month (a ‘cycle’). Each team consists of 1 Village Health Worker (VHW) and 1 community volunteer.

‘Door-to-door’ methodology is used for SMC delivery, with teams visiting each household with eligible children to administer SMC drugs. Within the team, the VHW is responsible for administering the drugs to the child, with record keeping and stock management being the responsibility of the community volunteer. 

How do SMC drugs reach the ‘last mile’?

ACCESS-SMC is working with The Gambia’s National Pharmaceutical Services (NPS) and Regional Health Directorates to ensure that SMC products are ready to be distributed to VHW teams in time for delivery. Once received at the country port, NPS stores the drugs in the central medical stores until two weeks before the first SMC cycle. Drugs are then moved to the regional medical stores, and dispatched monthly to health centers. VHWs collect the SMC drugs from health centers each day during the SMC cycle, returning unused stock at the end of each day. ACCESS-SMC and the NMCP are monitoring the flow and consumption of the SMC drugs using a logistics management information system (LMIS) which has been specially designed for the project.