though the annual growth rate has slightly slowed down from 3.8% to 3.0%. There has been rapid and significant rural-urban migration; from 49% in 2000 to 57% in 2009. Fertility rate is high, though has reduced slightly in about a decade (5.6 to 5.0/woman). The Gambia has a low (45%) literacy level. Though still low, the GNI per capita has risen from $920 to $1,330 and there is high percentage of people living below the poverty level.
Table 2 shows increases in the three variables over a 4-year period, especially morbidity and mortality reported. Further analyses revealed that the percentage increase in total morbidity due to NCDs reported over a 4-year period is approximately 19.8% while increase in hospital admissions due to NCDs reported during the same period is approximately 9.9%. Mortality due to NCDs also rose by 23.4% between 2008 and 2011.
These measuring variables (morbidity, hospital admission and mortality) for the years 2008, 2009 and 2011 were subjected to statistical test (chi-square) which clearly shows that the observed differences (increases) in these defining variables between the years were indeed statistically significant (p<0.0001)
The data in Table 3 attest to a long-standing problem, as all the countries except Egypt has more than 10 physicians/10,000 population. Government expenditure on health is less than 2 digits in most African countries while external sources of health financing appears to be huge comparatively to the meagre government spending on health; 2-4 folds higher in 4 of the 6 countries cited. In terms of health infrastructures, radiotherapy unit is < 20/10,000 population in all except South Africa that has a figure of 28/10,000.
Table 4 below shows the gender differences in mortality, morbidity and hospital admission.
Globally, there is convincing evidence of gender difference in crude mortality over the years studied with males suffering higher mortality due to NCDs; p-value is 0.0003. However, in the year 2008, there is insufficient evidence of gender difference in mortality due to NCDs.
Hospital Admission
There is statistically significant evidence gender difference in hospitalisation due to NCDs, p-value is <0.0001. However, in the year 2010, the data suggest insufficient evidence of gender difference in hospitalisation due to NCDs, even though higher number of females were hospitalised due to NCDs.
Morbidity
There is a numerical difference in the number of people who suffer morbidity due to NCDs with consistently higher number of females than males. These observed gender differences were indeed statistically significant, either by yearly analysis or all the years put together; p-value <0.0001
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