Healthcare Resource Guide: The Gambia

 

The Gambia Statistics



Summary

Market Entry

Current Market Trends

Main Competitors

Current Demand

Registration Process

Reimbursement

Barriers

Procurement and Tenders

Trade Events

Local Associations

FAQs

Government Links

Best Prospects

Statistics Snapshot

CS Contacts

 

Capital: Banjul

Population: 1.9 million

GDP: $1.45 billion

Currency: Dalasi (GMD)

Language: English (Official); Wolof and Mandinka (Local)

Summary

The Gambia is a low-income country with limited access to health services. The prevalence of communicable diseases like tuberculosis (TB) and malaria have lessened in recent years, as The Gambia nears nationwide malaria elimination. HIV/AIDS affects less than 2% of the Gambian population. The prevalence of maternal and child mortality cases are on the decline, while diabetes and high blood pressure are on the rise. The Government of The Gambia (GOTG) is also contending with increasing fertility rates, which has added more pressure on the already meager health resources. The health sector is experiencing a shortage of healthcare professionals and facilities throughout the country, and particularly in rural areas.

The Ministry of Health and Social Welfare (MOHSW) is responsible for overall policy formulation, planning, organization, and coordination of the health sector at the national, regional, district, and community levels. It seeks to improve the healthcare services sector under the framework of the National Health Policy (2012-2020), the National Health Strategic Plan (2014-2020), and the National Development Plan (NDP) (2018-2021). In 2016, GOTG spending on healthcare rose to 10.56% of its annual budget, which is still below the 15% Abuja Declaration target. The GOTG is also promoting Public Private Partnerships, including in the health service sector.

The NDP activities and programs to improve access to quality basic health services are:

  • Strengthen quality health service delivery for the reduction of maternal, new-born, infant, child and adolescent morbidity and mortality and improvement of adolescent and youth health
  • Reduce burden of communicable and non-communicable diseases and enhanced capacity to respond to public health emergencies
  • Improve equitable access to safe and affordable water and sanitation, good hygiene practices, and environmental protection for all
  • Improve nutritional well-being of all Gambians, particularly mothers and children
  • Benefit the poor and most vulnerable with social safety nets as part of social and child protection systems
  • Enhance inclusiveness and participation of persons with disabilities

According to the Health Minister, healthcare constitutes 40% of projects under the NDP. The GOTG seeks more investment in the healthcare sector, on a scale that the Minister of Health describes as a “Marshall Plan” for the health sector. The GOTG’s goal is achieve a complete overhaul of the entire healthcare system by equipping all health facilities with adequate manpower and resources.

Market Entry

The health sector is open to foreign investors and is a subsector among the priority sectors identified in the 2015 Gambia Investment and Export Promotion Agency (GIEPA) Act. Healthcare investors are therefore eligible for Special Investment Certificates which offer investors access to tax holidays. The GIEPA is the government agency responsible for the promotion and facilitation of private sector investments in The Gambia. GIEPA services include helping market entrants identify joint venture partners. Prospective investors should also consult with the Gambia Public Procurement Agency, the Gambia Consumer Competition and Protection Commission, and the Gambia Standards Bureau. These agencies are mandated by government acts to regulate health service providers. The 2015 GIEPA Act places no restrictions on the entry of health-related FDI.

Current Market Trends

The Gambia’s public health service delivery system has three tiers: Tertiary Health Care (Hospitals); Basic Health Services; and Village Health Services (VHS). The Gambia has three hospitals, 36 health facilities at the secondary level, and 492 health posts at the primary level, of which approximately 23 are private clinics. The share of GDP spent on healthcare facilities has been steadily increasing over the years. In June 2017, a private sector-led effort to construct a $27 million tertiary care health facility in Kololi was launched by President Barrow. The project has already received $16.4 million in financing from the African Development Bank (AfDB) and the Islamic Development Bank (IDB) and is sourcing the balance in financing from private investors and philanthropic contributions. Baylor College of Medical Horizons in the United States is also a partner to this project, which is being built in a designed Tourism Development Area and will seek to promote the country as a medical tourism destination.

The GOTG is open to Public Private Partnerships to revamp the healthcare sector; however, the National Development Plan also seeks to engage development partners and agencies in project financing for the NDP. The NDP and main healthcare sector goals are focused on improving the quality of pharmaceuticals, providing training to medical professionals and technical staff, and importing medical supplies and equipment.

Main Competitors

A major percentage of healthcare equipment and supplies are imported from the United States and Asia – particularly China and India. More advanced medical treatment and access to more specialists is available to Gambian patients through neighboring Senegal.

Current Demand

There is a healthy demand for healthcare services in The Gambia. The Health Minister has indicated 40% of the activities proposed in the NDP is dedicated to healthcare. Sector needs include the acquisition of medical equipment and supplies; however, financing remains a major challenge. According to the National Health Strategic Plan, the standard bed capacity for major health centers ranges from 110-150 beds per 150,000 - 200,000 population; and between 20–40 beds per 15,000 population at minor health facilities.

Registration Process

A U.S. firm wishing to establish a branch office in The Gambia must register to do business in-country under the Single Window Business Registration Office where prospective firms can pay their incorporation fees and:

  • register a unique company name
  • obtain a tax identification number (TIN)
  • register employees with the Social Security and Housing Finance Corporation
  • register with the Commercial Registry
  • obtain an operational license
  • design a company seal

Reimbursement

There are good market prospects for prospective health sector investors considering the large market gaps that exist. The GOTG is interested in providing nationwide access to medical equipment, supplies, and personnel in its ambition to make The Gambia a regional center of excellence in healthcare. The tax holidays accessible to healthcare investors through the 2015 GIEPA Act, are active for a period of eight years and cover exemptions for the importation of heavy machines and medical equipment. There are no restrictions on foreign investors converting or repatriating funds out of The Gambia.

 

Barriers

A weak regulatory environment and poor access to credit are the main barriers to market entry in the Gambian healthcare sector. Additional factors are periodic exchange rate fluctuations; lack of access to a skilled workforce, expertise, and specialists; poor infrastructure in areas, such as electricity, communication networks, and roads; bureaucratic procedures; high transportation and transactional costs and lack of transparency in the public procurement system.

 

Procurement & Tenders

Most of the tenders and procurements are advertised in local newspapers and online. The main newspapers are:

  • The Point
  • Foroyaa

Ministry of Health and Social Welfare [www.moh.gov.gm

The Gambia Public Procurement Agency [www.gppa.gm]

Trade Events

  • The Gambia Chamber of Commerce and Industry (GCCI) Annual Trade Show – please contact the U.S. Commercial Service for more information.

FAQs

  • How can I enter to The Gambian market?

U.S. firms interested in entering the Gambian market are advised to visit the Gambia Import and Export Promotion Agency and the Ministry of Health and Social Welfare.

  • What are the requirements for U.S. firms seeking to penetrate the Gambia healthcare and pharmaceuticals sector?

U.S. firms seeking to engage in healthcare related activities in The Gambia are advised to visit The Gambia Chamber of Commerce and Industry (http://www.gcci.gm) and Ministry of Health and Social Welfare (www.moh.gov.gm) for requirements with regard to healthcare investments.

 

U.S. Commercial Service Contact Information

 

Name: Kebba Omar Jagne

Position: Economic/Commercial Specialist

Email: jagneko@state.gov

Phone: +220 438 1325

Best Prospects

  • Pharmaceuticals: The Gambia has a small medical services industry with only a few clinics. Patients requiring advanced medical care or treatment usually go abroad, most frequently to Senegal. Over the past five years, a few private clinics have opened. These include the Afrimed, Sharab, and Medicare clinics. Specialist care and advanced medical equipment are in very short supply. Most public medical establishments are equipped with lower quality equipment and facilities, as compared to privately-owned ones.

Market Size

Healthcare spending (including investment)

11.2% (2012 percentage of total government expenditure)

... as percent of GDP

7.3% (2014)

Hospitals, Procedures, Healthcare Professionals UN:

Number of hospitals

3

... available beds per capita

11 (per 10,000)

Physicians

0.11 physicians/1,000 population (2015)

Dentists

12 (2008)

Demographics

Population

2,051,363 (July 2017 est.)

Life expectancy men/women

Total: 65.1 years (2017 est.)

male: 62.8 years

female: 67.5 years

Infant mortality

60.2 deaths/1,000 live births (2017 est.)

Percent of population older than 60

3.72%

Annual deaths

7 deaths/1,000 population (2017 est.)

...caused by Lower Respiratory Infections

9.55% of total deaths (2016)

...caused by Ischemic Heart Disease

7.5% of total deaths (2016)

Sources: UN Data; World Health Organization; CIA Factbook


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