In not less than 250 words. You are expected to critically evaluate and challenge the ideas of your classmates to help them develop better and more sustainable programming for the country in reference. References in APA.

Classmate answer:

Gambia, one of the smallest countries located at the tip of West Africa faces many public health concerns from poverty and hunger to combating climate change to intimate partner violence. Many developing countries, such as Gambia, across the globe struggle to meet Millennium Development Goals (MDG's) 4 and 5. In short, MDG 4 targets to reduce child mortality and MDG 5 targets to improve maternal health. Maternal and child health is a global health concern; however, it is one of the Gambia's greatest public health concerns. The top child health issues that the Gambia is combating is malnutrition and malaria. The top maternal health issues that the Gambia is facing is hemorrhage and infection.

Childhood malnutrition remains a problem in the Gambia, although there has been improvement in food security through the United Nations World Food Programme. The Gambia's childhood malnutrition at a glance is due to undernutrition, 28% of children under the age of 5 are stunted1, 16% are underweight1, 7% are wasted1, 20% of infants are born with a low birth weight1, and children who are undernourished between conception age and age two are at high risk for impaired cognitive development, which adversely affects the country's productivity and growth1. Childhood malnutrition has many such as poor feeding practices, burden of high diseases, and limited access to nutritious foods.

Children in the Gambia also experience malaria infections regularly. The child population under the age of 5 are the group that are hit the hardest, and it is not uncommon for the cases to turn severe resulting in death. Earlier studies in school children showed marked heterogeneity in malaria prevalence across the country and significant seasonal variation.2 The Gambia is one of the African countries that has had a decline in malaria transmission due to malaria control interventions, but the prevalence is still relatively high attributing to the cost of child mortality at 15%.

The majority (75%) of maternal deaths in Gambia are related to direct obstetric complications such as hemorrhage, postpartum infections, obstructed or prolong labour and hypertension disorders-all of which are treatable.3 Pregnancy and childbirth has many complications such as hemorrhaging and infections after delivery that are two of the top causes of maternal mortality. Pregnancy complications could be prevented if mothers or families would promptly seek health care.

The Integrated Management of Childhood Illness (IMCI) will be used to implement a plan for child malnutrition and malaria. This programme starts vertically-in other words it is planned, managed and financed by donors, governments and health authorities.4 But at the community level it becomes more comprehensive and horizontal as first-level workers are trained to provide a number of activities that increase child survival.4 The Safe Motherhood Programme will be used to address the maternal health issues in the Gambia to implement antenatal and delivery care services to Gambian women. Women are reminded that their child birthing pain will turn into joy, "A woman, when she is in labor, has sorrow because her hour has come; but as soon as she has given birth to the child she no longer remembers the anguish, for joy that a human being has been born into the world" (John 16: 21).