Background: The care for patients with mental disorders have changed and this has led to higher demands on nurses. Research is conducted globally within the subject and studies have shown that nurses enquire more theoretical knowledge and practical training. In the Gambia, nursing education is conducted by five different schools and the country has one psychiatric hospital. Purpose: To explore nurses’ experiences and challenges while caring for patients with mental disorders in the Gambia. Method: The study was conducted using a quantitative cross-sectional design. Result: The result showed that the respondents enquire more education, that the work is challenging and that the majority of respondents have experience of working with patients with mental disorders. Conclusions:  There is a need for internal education for nurses on their workplaces and more research within the subject.

In recent years, Gambia is one of the few countries having experienced development in a more democratic direction. As part of democratic consolidation, the process of reviewing the constitution was started in 2017 with an aim to be participatory and inclusive. This thesis seeks to investigate how the Gambian civil society organization TANGO has tried to impact the constitutional review process, to further contribute to the understanding of civil society in democratic consolidation. This is achieved through an explorative and descriptive case study focusing on TANGO’s practice of advocacy and accountability. The method used is mainly semi-structured informant interviews with persons central to civil society in the constitutional review process together with secondary sources such as legal documents and news articles. The results show that TANGO has exercised advocacy mainly in terms of position papers to the Constitutional Review Commission, whereas accountability has primarily been exercised through press conferences and lobbying. However, statements on their efforts as lacking and too late have been persistent in the study, meaning that even if efforts were done, they could have been improved or have other focal points for leveraged impact in the constitutional review process.

Over 200 million women and girls alive today have been victims of Female Geni-tal Mutilation / Cutting, and another 3,6 million are at risk every year. This tradi-tional practice is widespread and has gained a lot of attention from Non-governmental organizations, scholars and medical professionals around the world, stating warnings about the harmful effects. Yet, the prevalence and continuance are still not regressing in a desirable rate. Many countries have enacted legislative actions against the practice, among these countries is the West African nation of The Gambia. The purpose of this qualitative study is to examine and analyse what experiences and perceptions NGOs in The Gambia have with using legislative ac-tion against FGM /C, how their work has changed due to the legislation as well as examine their perception on local community attitudes towards the law. This has been done using the theories of Cultural Relativism vs Universalism and through selected concepts within Hofstede's Theory of Cultural Dimensions. This study will theorise what happens when a law representing western norms and values gets implemented in a society where culture, traditions and the collective group is high-ly important. Our findings show that The Gambia, in particularly local communi-ties, holds a strong cultural relativistic mentality and is characterized by a collec-tivistic culture in which the power distance is high. This society puts emphasis on collective identity, solidarity and collective decisions as well as traditional heritage and cultural values. Implementing a law that promotes western values thus brings problems and a lack of efficiency.

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The aim of the study was to examine how advocacy workers from different governmental and non-governmental organisations work with female genital mutilation/cutting (FGM/C) and gender equality in The Gambia. We further examined their experienced difficulties and the provided support to women exposed to FGM/C. The study was based on field observations of events, meetings and educational events, as well as semi-structured and open-ended interviews with ten participants. Through a thematic analysis, findings show that counselling were the main form of support, and the most experienced difficulties was the male dominance, the cultural belief and the culture of silence. Education, traditional forums and advocacy where therefore used as informative tools regarding gender roles, power positions and the harmfulness of FGM/C. Thus, findings confirm the importance of the continuous work with the gender roles, the social exclusion of the unmutilated women and the gatekeeping roles hindering the abandonment of the harmful practice.

Malaria is caused by Plasmodium parasites, which are transmitted via the bite of infected female anopheles mosquitoes. There were 217 million cases of malaria worldwide, and about 435,000 malaria related deaths in 2017. WHO Africa region accounted for 92% and 93% of malaria cases and deaths worldwide. According to The Gambia National Malaria Strategic Plan 2013-2020, malaria is a leading cause of morbidity and mortality. The aim of this study was to identify factors influencing attitude towards the use of mosquito nets in households in The Gambia using Demographic and Health Survey (DHS) data. The current study is a secondary data analysis with a, cross-sectional study design. The source of the data for this study is the DHS, which was conducted by the United States Agency for International Development (USAID) together with the Gambia Bureau of Statistics (GBOS) in 2013. The study sample is representative of The Gambian population. The sample size for the study was 5276 subjects. Statistical Analysis System (SAS 9.3) was used for data analysis. Descriptive statistics were generated for the factors been tested. These included area of residence, presence of electricity, indoor residual spraying, highest level of education and wealth index. The outcome variable measured was household use of mosquito nets (Yes/No). Logistic regression analysis was done to determine whether area of residence, wealth index, education level, presence of electricity and indoor residual spraying influence attitude towards use of mosquito nets in households. Stepwise binary logistic regression was used to determine the final model with the most significant predictors. Odds ratios and corresponding confidence intervals were reported. Most of the study participants were poor (46%). Those with no education made up 45.5% of the study population and 58% of dwellings had no indoor residual spraying done in the past year. 76.6% and 59.1% of respondents lived in households that had at least one mosquito net and no electricity supply, respectively. 50.6% of the respondents resided in rural areas. Logistic regression analysis showed that wealth index, indoor residual spraying and area of residence were significant factors (p<0.05) influencing attitude towards use of mosquito nets in households. Indoor residual spraying (OR=2.00; 95% C.I. 1.71-2.36), primary school education (OR=1.1; 95% C.I. 0.94-1.32), middle class wealth index (OR=1.32; 95% C.I. 1.05-1.67) and rural residence (OR=1.29; 95% C.I. 1.01-1.64) are all independent factors that increased likelihood of mosquito net usage in households. Identifying factors that influence the usage of mosquito nets in households, can be useful in developing target interventions to further reduce malaria morbidity and mortality in The Gambia. Knowledge from this study can be used to further strengthen the national malaria strategic plan. To further establish causality and increase strength of association between factors and outcome, a case control or cohort study design will be needed, since that is one of the limitations of a cross sectional study.

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In The Gambia, financial sustainability and poverty alleviation have been largely based on the assumption that analysis of macro level growth will bridge the gap between the formal and informal sectors; alleviate poverty and exclusion, ignoring other important factors such as political, social, cultural and religious issues. The government, microfinance outlets and international development agencies have implemented many measures to bring the masses into the formal economy to no avail. This dissertation explores Reliance Financial Service and the role of the Osusus in poverty alleviation, and how the Osusus are the edifice of microfinance and economic sustainability in The Gambia. Firstly, Osusus are small microfinance groups where participants receive substantial amounts of money to meet planned heavy expenditure commitments. To put things into perspective, Osusu is one of the oldest community based microfinance institutions in The Gambia, it has mostly resisted formalization. It is a social and financial system, where members contribute a set sum of money each week or month that is then allocated to one member. This has given some women a degree of independence and solidarity. Secondly, despite women being the largest segment of the Gambian population, disparities in gender roles, illiteracy, high unemployment and the lack of mainstreaming the interest and needs of women in national policy and the system tends to leave many women economically disadvantaged. Hence, this dissertation found that the provision of microfinance services in the form of micro-credit, insurance and micro-savings could be a great sustainability tool to create equity, uplift the economic and social status of women in society. Also, women could use these services towards productive consumption such as feeding their families, sending their children to school, affording healthcare and engaging in productive economic activities to increase their income. Empirically, it examines the microfinance outlook in The Gambia, its impacts on socio-economics ramifications on the country. It also examines the role of microfinance, contextually Reliance Financial Services Kafoo scheme, as a viable alternative poverty-alleviation avenue. / Ph. D.