Gambiaj.com – (BANJUL, The Gambia) – A new Afrobarometer survey has revealed that access to affordable and quality health care remains a major challenge for most Gambians, even as strong public support grows for universal health coverage (UHC) and increased government intervention in the sector.
According to Afrobarometer Dispatch No. 1106, released on January 8, 2026, three out of four Gambians say they or a family member went without needed medical treatment at least once in the past year. The findings are based on a nationally representative survey of 1,200 adults conducted between April and May 2024.
The survey shows that health is now the most important issue Gambians want their government to address, ranking ahead of the rising cost of living and crime. More than half of respondents cited health among the country’s top three problems.
Despite this urgency, medical aid coverage remains extremely limited. Only 11% of Gambians report having any form of health insurance, with coverage particularly low among women, rural residents, the poor, and those with little or no formal education.
Among those without insurance, more than half say they are unaware of any available health insurance schemes, while others cite affordability and lack of information on how to enrol.
The absence of financial protection has left households vulnerable. An overwhelming 85% of respondents say they worry about being unable to obtain or afford medical care when needed, including nearly half who say they worry “a lot.” This concern is most pronounced among the poorest households.
In response to these challenges, a clear majority of Gambians are calling for decisive government action. About 69% of respondents say the government should ensure universal access to health care, even if it requires higher taxes. Support for UHC is strongest among urban residents, the well educated, and economically better-off citizens, but remains significant across all demographic groups.
Experiences within the public health system further underscore the depth of the crisis. While three-quarters of respondents had contact with a public clinic or hospital in the year preceding the survey, only 28% said it was easy to obtain the care they needed.
Vast majorities reported encountering serious problems, including shortages of medicines and medical supplies, long waiting times, poor facility conditions, unaffordable treatment costs, and absent health workers.
Corruption also emerged as a concern, with nearly one in four patients reporting that they had to pay a bribe, give a gift, or do a favor to receive care at a public health facility.
Public confidence in the health authorities remains low. Four in five Gambians say the government is doing a poor job of improving basic health services, and only about one-third express trust in the Ministry of Health.
The survey findings come against a backdrop of long-standing structural weaknesses in the health sector. Recent national and international assessments have pointed to declining per capita health spending, rising out-of-pocket costs, shortages of skilled health workers, and persistent gaps in primary health care delivery, particularly in rural areas.
Afrobarometer concludes that the data reflect a strong public demand for meaningful reforms. With most citizens struggling to access care and facing financial hardship when illness strikes, the report stresses the need for urgent policy action to strengthen service delivery, expand health insurance coverage, and move the country closer to universal health coverage by 2030.
