The Gambia has hospitals in Banjul (Royal Victoria) and Bansang and a health clinic in Konbo, St. Mary. The country provided 62% of its people with safe water and 37% with adequate sanitation in 2000. Health conditions are poor: in 2000, average life expectancy was estimated at only 53 years for women and men. Nearly half of all children die by age five, primarily because of malaria and diarrheal diseases. Malaria, tuberculosis, trypanosomiasis, and schistosomiasis are widespread. In 1999, there were approximately 260 reported cases of tuberculosis per 100,000 people.
The fertility rate was 5 births per woman in 2000 and the infant mortality was 73 deaths per 1,000 live births. The Gambia has a higher than average maternal mortality rate, with an estimated 1,100 maternal deaths during childbirth or pregnancy per 100,000 live births, as of 1998. Contraceptives were used by 12% of married women (ages 15–49) between 1989–95. As of 1999, there were fewer than 0.05 physicians per 1,000 people, and 0.6 hospital beds. As of 1999, total health care expenditure was estimated at 3.7% of GDP.
Female genital mutilation is performed on nearly every woman in The Gambia. Nearly 500,000 women were affected in 1994. The government has published a policy opposing female genital mutilation, but no specific laws currently prohibit it.
The most recent immunization rates available (1990–94) for children under one year old were as follows: tuberculosis, 98%; diphtheria, pertussis, and tetanus, 90%; polio, 29%; and measles, 87%.
At the end of 2001 the number of people living with HIV/AIDS was estimated at 8,400 (including 1.6% of the adult population) and deaths from AIDS that year were estimated at 4,000. HIV prevalence in 1999 was 1.95 per 100 adults.