95% survival rate thanks to our Strengthening Emergency Care Programme (SEC)
Improving the health system for mothers and children in The Gambia: an interim evaluation

The evaluation is an assessment of our SEC programme, with particular reference to Brikama Major Health Centre in the Western River Region of The Gambia, where since 2006 we have renovated and equipped the hospital; provided essential emergency medical and drug supplies more efficiently; established an emergency ambulance service linking the community with the hospital through a mobile telephone system. Local health professionals at all levels have been trained in medical emergency procedures and management.

Making a difference

• 109 women were transferred from the community to the hospital by our emergency ambulance – that’s nearly one patient a week. Most importantly of these transfers 39 were for life-threatening obstetric complications (eg post partum haemorrhage) and all 39 women survived.
• There have been 297 resuscitations/life saving interventions carried out of mums and babies in the hospital – that’s over two a week. The survival rate of the mothers resuscitated was 95%.

System improvements essential to improving health care:

• The hospital now has constant water and electricity
• There is nowa functioning operating theatre and emergency room
• the maternity unit and children’s wards have better emergency equipment and there is a more reliable supply of oxygen, emergency drugs and a blood transfusion service.
• 217 doctors, nurses, and midwives have undergone training courses in the provision of emergency maternal, child and newborn care, including major trauma. 83 traditional birth attendants and 48 Village Health Workers have been trained in the recognition and initial management of emergencies, including resuscitation of the newborn.

Many of these women and babies would have lost their lives if it was not for the SEC programme. The success of the programme is team work from the community to the hospital and the collaboration between MCAI, hospital staff, ALSG (Advanced Life Support Group), the Ministry of Health and the World Health Organisation.