Gambia: evaluation of the mobile health care service in West Kiang district.

A project to improve the quality of maternal health services was carried out over a 3-year period in West Kiang district, Gambia. Coverage of maternal care was strengthened through upgrading of personnel, TBA training, improved treatment and referral schemes, and increased numbers of visits to rural outreach areas. A control district was used to compare the impact of the interventions. During the project period of 3 years a single maternal death was registered in the intervention district, and 5 in the control area. While improved staffing and service provision led to higher degrees of coverage of maternal care services, reductions in maternal morbidity could not be documented in the intervention area. Given concern over the quality of the data possibly influencing this result, further research is necessary to determine the relationship between improved mobile maternal care services and their impact on maternal morbidity and perinatal outcome.