Although Gambians aged 60 and above make up just 3% of the population, they face a disproportionately high risk of poverty, food insecurity and poor health outcomes — and the systems meant to support them are shrinking. Elderly poverty in The Gambia is a significant challenge, which makes up about 3.0% of the total population according to the Gambia Bureau of Statistics. HelpAge International reports that traditional family care systems in West Africa are weakening due to urban migration and economic hardship. This shift leaves many elderly Gambians vulnerable to poverty, food insecurity and limited access to basic services.

Health Care Access Challenges

One of the most critical problems for the elderly in The Gambia is limited access to health care. The country has about 0.1 physicians per 1,000 people according to World Bank health statistics. This is among the lowest rates globally, reflecting a severe shortage of medical professionals. Elders with chronic health conditions—such as hypertension and diabetes—often go without proper diagnosis or treatment, especially those living in rural areas far from medical centers.

Many elderly people in The Gambia live in the aforementioned rural areas where access to health care facilities is limited. Geographic barriers and lack of affordable transportation make it difficult for seniors to reach medical centers. These challenges often result in delayed treatment or no treatment at all. Financial constraints further worsen health care access. Many elderly Gambians lack health insurance or steady income and rely on out-of-pocket payments to cover medical expenses which can be prohibitively expensive.

Social Protection Initiatives

The Gambian government, with support from international partners, continues to strengthen social protection systems to support vulnerable populations, including the elderly. The World Bank’s Integrated Social and Economic Resilience Project (GISERP, Project ID: P1672600) and the Social Safety Net Project focus on improving social safety nets through targeted cash transfer programs that provide financial assistance to those living in poverty, including older adults. One key component of these efforts is the NAFA Program, which delivers unconditional cash transfers to vulnerable households, including many elderly and disabled beneficiaries. These programs aim to reduce elderly poverty in The Gambia and improve the quality of life by offering reliable income support. 

The Gambia partnered with the World Bank in 2019 to launch these efforts, which provide cash transfers and food assistance to more than 90,000 vulnerable households, many including elderly members. Official World Bank documents describe the project as a major step toward reducing poverty and food insecurity among vulnerable populations. Although comprehensive impact evaluations are pending, early reports suggest the program improves financial stability and nutrition for recipients. The initiative also strengthens data systems and targets support more effectively to those most vulnerable.

Challenges

While praising the NAFA Program as a “transformative initiative,” elderly beneficiary Loli Joum urged the World Bank to increase the amount of support provided. “We definitely appreciate what is being given to us, and I do not devalue the amount,” Joum told The Point. “But due to my age and health condition—as you can see, I am physically challenged and cannot do anything physically.” 

UNICEF’s work in The Gambia complements these efforts by focusing on enhancing social protection mechanisms that cover health care, education and income support for vulnerable groups. While much of UNICEF’s programming targets children and women, the agency also recognizes the growing need to address the challenges faced by the elderly population, especially as traditional care structures decline and the number of older adults rises. UNICEF has noted the importance of incorporating aging populations into broader protection frameworks to ensure that no one is left behind.

Conclusion

Elderly poverty in The Gambia is a growing concern as traditional support systems weaken and formal care remains limited. Many seniors face critical challenges related to health care, income security and social isolation—especially in rural areas where access to services is scarce. While initiatives like the World Bank’s Integrated Social and Economic Resilience Project and the Social Safety Net Project are important steps forward, gaps still remain in fully meeting the needs of the aging population. Continued investment in health care infrastructure, targeted financial support and inclusive policy planning will be essential to ensure that elderly Gambians can live with dignity, health and security in the years to come.

– Mamie Hirsh

Mamie is based in Berkeley, CA, USA and focuses on Good News and Celebs for The Borgen Project.

Photo: Flickr