Located on the West African coast, the Republic of The Gambia stretches 350km inland, occupying 10,690sqkm with a population of 2.8 million. It borders Senegal to the north, east and south, and is the smallest mainland nation in Africa.

Major constraints to healthcare in The Gambia include shortage of qualified personnel, limited health facilities and limited referral hospitals. Currently, patients requiring specialist care either do not receive it or travel abroad at significant cost.

According to the UN's Sustainable Development Goals Global Database 2023, Gambia has the 18th highest maternal mortality ratio (MMR) in the world. This database states that in 2020, the MMR in The Gambia was 458 deaths per 100,000 live births.

The UNICEF Data Warehouse says that the neonatal mortality ratio (NMR) in 2021 was 25.2 deaths per 1,000 live births. That means Gambia has the 26th highest NMR globally. Currently, the UN predicts that The Gambia will only reach the Sustainable Development Goal of 12 or fewer deaths per 1,000 live births by 2047.

Every one of these deaths is one too many. Horizons is determined to save the lives of our mothers and babies.

Maternal Health

The Millennium goal of reducing maternal deaths by half is a complex problem. One strategy considered to be most effective is investing in building the capacity of personnel with midwifery skills. Another is reducing incidences of infection: in The Gambia, it’s been reported that 11% of maternal deaths are caused by sepsis and other infections, and up to 30% of neonatal deaths. The true figure is thought to be higher.

The 48 hours immediately following birth is the most crucial period for newborn survival. Children in sub-Saharan Africa are 15 times more likely to die before the age of five than children in Europe.

Infant Health

A child's risk of dying is highest in the neonatal period, the first 28 days of life. Safe childbirth and effective neonatal care are essential to prevent these deaths. 44% of child deaths under the age of five take place during this neonatal period.

Within the first month, up to one half of all deaths occur within the first 24 hours of life, and 75% in the first week.


These are preventable deaths.

Pregnancy and childbirth should be happy events. We can achieve this through our work at Horizons Trust.

Our projects.

The Horizons Clinic will be the first international standard hospital in The Gambia and offer a range of secondary & tertiary specialist services that are not available at present. Currently, patients needing specialist care either do not receive it or travel abroad at significant cost.

The Horizons Clinic therefore will be complementary to the current healthcare provision in The Gambia.

Horizons Outreach works to improve the capacity and standard of healthcare through the provision of education and training.

Our two flagship programmes – Infection, Prevention & Control and Safer Delivery, provide essential training for maternity health workers and world-class infrastructure in The Gambia. We work in partnership with national and global stakeholders to reduce maternal and neonatal mortality rates in the country.

The impact we've made.

Our community deserves better and that is what we are now able to give them.

Alieu, Midwife

I’m excited about this project. My real fulfilment is in seeing both women and babies go home happily – that’s my real joy.

Dr Jose TK Green Harris, Obstetrician Gynaecologist

I can now protect myself and our mothers and babies from infections. It makes me proud.

Amy, Cleaner

Facts and figures.


Mums and babies impacted through the Infection, Prevention & Control Programme


Pieces of cleaning supplies provided


Health workers trained on how to stop mums and babies dying from sepsis


Health workers trained on emergency obstetric & neonatal care


Healthcare facilities targeted, covering 40% of Gambia’s population

How you can help.

Please support us to stop mums and babies dying in The Gambia. Every single life lost is one too many.

Please donate at

For more information including how to volunteer with Horizons Trust please email: contact@horizons-trust.com

Latest news.

Get in touch.

Horizons Trust Gambia
C/O Fajara Chambers, Standard Chartered House,
Kairaba Avenue, Fajara, The Gambia

Horizons Trust UK
University of Aberdeen
2nd Floor, Health Sciences Building
Foresterhill, Aberdeen AB25 2ZD