The risk of maternal death in The Gambia is 1 in 32. Many women, babies and children die because of inadequate health care. More than 80 per cent of maternal deaths worldwide are due to five direct causes: haemorrhage, sepsis, unsafe abortion, obstructed labour and hypertensive disease of pregnancy

Whilst we acknowledge the importance of maternal and child health care improvements through primary prevention, inevitably emergency situations arise which are poorly managed, especially in the early hours of their presentation, leading to avoidable maternal and child deaths. In The Gambia for example over two-thirds of the deaths take place during labour or shortly after delivery.