THE REPUBLIC OF THE GAMBIA’S COMBINED REPORT ON THE AFRICAN CHARTER ON HUMAN & PEOPLES’ RIGHTS & INITIAL REPORT ON THE PROTOCOL TO THE AFRICAN CHARTER ON THE RIGHTS OF WOMEN IN AFRICA According to the 2013 DHS, adult mortality is slightly higher among men than women at 2.4 male deaths and 2.3 female deaths per 1,000 population. Between ages 15 and 50, approximately 99 women per 1,000 and 102 men per 1,000 are likely to die. The report also revealed that maternal deaths account for 36 per cent of all deaths among women age 15-49. The maternal mortality rate for the seven-year period preceding the survey was 0.77 maternal deaths per 1,000 women. The maternal mortality ratio was 433 maternal deaths per 100,000 live births for the seven-year period preceding the survey. The Gambia subscribed to the 75% reduction of MMR by 2015. However, the reduction of MMR in the country has been very slow and remains among the top priority of the country for the post-2015 SDG agendas. Majority of maternal deaths in the country are as a result of avoidable direct obstetric complications, including haemorrhage (37%), hypertensive disorder of pregnancy (11%) and sepsis (11%) (WHO, et al, 2015). The main contributing factors include, inadequate access to CEmONC and BEmONC services, lack of trained human resources, transportation and low socio-economic status of the people. Addressing these challenges and improving availability and quality of CEmONC can contribute to at least 60% maternal mortality reduction in the country.17 The Government continues to provide free maternal and antenatal health care in all Government health centres. Primary and secondary health care has also significantly expanded, and increased immunization has reduced mortality rates. The mortality and causes of death data and the denominator for 2015 mid-year population estimates is illustrated below. 17 National Reproductive, maternal, Neonatal, Child and Adolescent Health (RMNCAH) POLICY (2017 -2026) 145