Malnutrition remains a significant public health challenge in The Gambia, despite notable progress in recent years. As a small West African nation with a population heavily reliant on subsistence agriculture, The Gambia faces persistent undernutrition alongside emerging issues of overnutrition, reflecting a complex nutrition transition.
According to recent data, approximately 17.5% of children under five are stunted (low height-for-age), 5.1% are wasted (low weight-for-height), and the country reports around 16.8% undernourishment in the broader population. While stunting has declined from higher levels in previous decades, it still affects cognitive development and future productivity. Wasting rates indicate acute malnutrition episodes, often linked to seasonal food shortages and disease. Exclusive breastfeeding stands at 53.6%, showing improvement, but anaemia affects nearly half of women of reproductive age (49.5%).The economic cost is substantial. Child undernutrition drains roughly 5.1% of GDP annually through higher healthcare expenses, poorer educational outcomes, and lost workforce productivity. In 2025, UNICEF-supported programs treated thousands of children for severe acute malnutrition (SAM) with encouraging cure rates, yet systemic vulnerabilities persist.
Several interconnected factors drive malnutrition in The Gambia:
- Food Insecurity and Agriculture: Dependence on rain-fed farming makes the country vulnerable to climate variability, droughts, and floods. Inadequate domestic production, post-harvest losses, and limited diversification beyond groundnuts exacerbate seasonal hunger.
- Poverty and Economic Constraints: High poverty levels limit household access to diverse, nutritious foods. Many families rely on staple-heavy diets low in micronutrients, fruits, and vegetables.
- Health and Sanitation: High burden of infectious diseases (malaria, diarrhoea, respiratory infections) impairs nutrient absorption. Poor WASH (water, sanitation, and hygiene) practices contribute to recurrent illnesses.
- Social and Cultural Factors: Gender disparities affect feeding practices, with adolescent girls particularly vulnerable. Traditional beliefs, early marriages, and limited maternal education influence child feeding and care practices.
- Climate Change: Increasing environmental shocks disrupt food systems and livelihoods, compounding existing vulnerabilities.
Urban-rural divides are evident, with rural areas often facing higher rates due to limited infrastructure and services. The double burdeni.eundernutrition coexisting with rising overweight and obesity, signals dietary shifts toward processed foods high in sugar and oils.
Interventions and Progress
The government, with support from UNICEF, WFP, and other partners, has implemented community-based management of acute malnutrition (CMAM), nutrition-sensitive agriculture programs, and school feeding initiatives. Advocacy for domestic funding of therapeutic foods and stronger national nutrition policies is gaining traction. Exclusive breastfeeding campaigns and micronutrient supplementation show positive results.
The Way Forward
Addressing malnutrition in The Gambia requires a multi-sectoral approach. Strengthening climate-resilient agriculture, improving market access, enhancing social protection, and investing in education, particularly for girls and mothers, are critical. Integrating nutrition into health systems, scaling digital tools for monitoring, and addressing the double burden through balanced dietary guidelines will be essential.
While The Gambia is “on course” for some global nutrition targets, sustained commitment is needed to break the intergenerational cycle of malnutrition. With targeted investments and community empowerment built through frameworks on the social and commercial determinants of health and the End Malnutrition Initiative pioneered by the Edward & Cynthia Institute of Public Health, the country can build a healthier, more productive population and reduce the heavy economic toll of this preventable condition.