Possible causes of increasing numbe

Possible causes of increasing numbers of NCDs in the Gambia
Epidemiological and Demographic Transition
The Gambia is in the early phase of nutritional and demographic transition [23] with the resultant effect on chronic NCDs epidemiology. The Gambia, like most developing countries has been experiencing increasing life expectancy [15,24]. One of the possible reasons for this increasing life expectancy in many African countries is the progress (or stagnation) being made in some areas of the Millennium Development Goals such as reduction in perinatal, infant and maternal mortalities [11,15]; poverty reduction as seen in the increments in GNI per capita witnessed in the last 2-3 decades; improvement in literacy level, particularly female education, and nutritional disorders, specifically under-nutrition [15]. This resultant longevity (advancing age) is an independent risk factor for most chronic non-communicable diseases [25], and also increases the duration of exposure to risk factors of NCDs. Though, the gains (increasing life expectancy) of the mid 20th century were threatened by HIV/AIDS and Tuberculosis, as many young and middle aged people died of this deadly combo.
There has also been increased investment on health by governments and from external sources, .i.e., international aids and donors [15], even though these funding are sub-optimal to effectively address the double burden of diseases being experienced in Africa. However, this has impacted in some ways (slight decline) particularly in the areas of infectious disease control.