Introduction

In the Gambia, the demographic and health survey (DHS) has been conducted every five years

with the collaboration of the Gambia Bureau of Statistics and the ministry of health (MOH) to

assess health status, accessibility, and health service utilization in a given period. The primary

objective of the GDHS is to provide up-to-date estimates of basic demographic and health

indicators. Demographic and Health Surveys (DHS) are nationally-representative household

surveys that provide data for a wide range of monitoring and impact evaluation indicators in the

areas of population, public health, and nutrition.

Objectives of the 2019-20 Gambian DHS: 

GDHS aimed that, to collect data on fertility levels and preferences such as contraceptive use;

maternal and child health; infant, and child. To determine the mortality levels such as maternal

mortality, infant and child mortality. And also gender, nutrition, awareness about HIV/AIDS,

self-reported sexually transmitted infections (STIs), and other health issues that are relevant to

the achievement of the Sustainable Development Goals (SDGs) are surveyed. 

The Malaria Control Programme information on the availability of access and use of mosquito

nets as part of the National are obtained. Malaria testing of children aged 6-59 months The

information collected through the 2019-20 GDHS is intended to assist policymakers and program

managers in evaluating and designing programs and strategies for improving the health of the

country’s population The information on other health issues such as injections, tobacco use,

hypertension, diabetes, and health insurance also gathered. In addition, obtained data on child
feeding practices, including breastfeeding, and conducted anthropometric measurements to

assess the nutritional status of children under age 5 and women aged 15-49. 

Methodology 

The sampling frame used for the 2019-20 GDHS was based on an updated version of the 2013

Gambia Population and Housing Census (2013 GPHC) conducted by GBoS. Five questionnaires

were used for the 2019-20 GDHS: the Household Questionnaire, the Woman’s Questionnaire,

Man’s Questionnaire, the Biomarker Questionnaire, and the Fieldworker Questionnaire. These

questionnaires, based on The DHS Program’s standard questionnaires, were adapted to reflect

the population and health issues relevant to the Gambia (GBoS and ICF., 2021).

Anthropometry tests, malaria testing, and anemia testing are obtained to check observant status.

The results of which were recorded in the Biomarker Questionnaire. For anemia and malaria

testing, In households selected for biomarker collection, height and weight measurements were

recorded for children aged 0-59 months and women aged 15-49. Weight measurements were

obtained using lightweight, and child functions. Height measurements were carried out with

measuring boards made by Weigh and Measure

Key Findings ▪ 

In GDHS various socio-demographic data are described in detail. For example, safe and clean

water accessibility, hygiene and sanitation status, infrastructures like electricity and housing,

literacy status, employment status, and others are described in detail. 

According to the GDHS report, the total fertility rate (TFR) in The Gambia is 4.4 children per

woman. Urban areas have a lower TFR (3.9) than rural areas (5.9). The median birth interval in
the Gambia is 35.3 months. Overall, 14% of adolescents have begun childbearing. The

percentage of teenagers who have begun childbearing is higher in rural areas (20%) than in urban

areas (11%) (GBoS and ICF., 2021).

About 19% of currently married women use a method of contraception. The most commonly

used methods are Injectable and implants, and 6% respectively. In the 5 years preceding the

survey, 42% of episodes of contraceptive use were discontinued within 12 months. The most

common reason for discontinuation wanted to become pregnant (37%). The total demand for

family planning among currently married women increased from 34% in 2013 to 43% in 2019-

20; 40% of the total demand is satisfied by modern methods (GBoS and ICF., 2021). 

The neonatal, infant and under-5 mortality rates were 29, 42, and 56 deaths per 1,000 live births,

respectively. From 2013 to 2019-20, under-5 mortality increased from 54 to 56 deaths per 1,000

live births, infant mortality increased from 34 to 42 deaths per 1,000 live births, and neonatal

mortality rose from 22 to 29 deaths per 1,000 live births. The perinatal mortality rate for the 5

years before the survey was 41 deaths per 1,000 pregnancies of 7 or more months’ duration.

Error or bias of Gambian demographic and health survey (GDHS) 2019-20.

The surveys were useful in providing a wide variety of health indicators and health service

status. The major limitation of demographic and health surveys is recall bias and sampling errors

(Boerma, & Sommerfect, 1993). Just like a cross-sectional study, during the survey both

exposure and outcome are measured simultaneously. Often it uses retrospective data. In most

cases, healthy people may difficult to recall their history. Another error/limitation of Gambian’s

demographic and health survey is, that the authors used the quota sampling method to determine
the sample, but they did not use the group variability adjustment analysis method. The variability

between and within the group might affect the precision of the result. 

References 

Boerma J. T., and Sommerfect A. E., (1993). Demographic and health surveys (DHS):

contribution and limitations. World health stat. 46(4). 222-6. PMID: 8017881. Retrieved

from: - https://pubmed.ncbi.nlm.nih.gov/8017081/

Gambia Bureau of Statistics (GBoS) and ICF. (2021). The Gambia Demographic and Health

Survey 2019- 20. Banjul, The Gambia, and Rockville, Maryland, USA: GBoS and ICF.