Death Exams and Certification
Building a system that counts every Gambian life
The Gambia does not know how its people die. Death certificates are only prepared at the Births and Deaths Registry Unit in Banjul, which means anyone who dies outside the capital has almost no realistic pathway to formal registration. Because the majority of Gambians die at home rather than in a hospital, the majority of Gambian deaths go completely unrecorded. There is only one facility in the entire country capable of conducting a post-mortem examination. Homicides go undetected. Epidemic outbreaks go unrecognised. Maternal deaths go uncounted. Families are left without legal proof of loss, unable to claim inheritance, transfer property, or access support programmes that require a death certificate. Without reliable death records, health policy is built on guesswork rather than evidence.
Imagine a Gambia where every life is counted and every death is documented, no matter where it happens. Where a family in Koina receives a death certificate within seven days, not a journey to Banjul and a bureaucratic maze. Where a widow can claim her inheritance, orphaned children can access government support, and justice can be pursued because the record exists. Where cause-of-death data from every district feeds into a national health system that can spot outbreaks, prevent maternal deaths, and deploy resources where they are needed most. The NBP will build this system from the ground up, and it will serve every Gambian with the dignity their life deserves.
The NBP will establish an independent National Civil Registration Authority to lead and govern the entire death registration system.
The NCRA will be a statutory body with a Director General appointed on merit and a Board of Directors drawn from the Ministries of Health, Justice, Interior, and Finance alongside the Gambia Bureau of Statistics. Regional Civil Registration Offices will be established in all seven administrative regions, each led by a Regional Registrar with full authority to issue death certificates and supervise district-level registration. The NCRA will publish an annual National Vital Statistics Report and report directly to the National Assembly on registration coverage and system performance.
The NBP will ensure that no Gambian is declared legally dead without medical verification by a qualified professional.
Every death in a hospital, clinic, or health center will be verified by the attending doctor or a trained nurse using a defined protocol. Every death at home will be verified by the nearest health worker within a defined timeframe, or by a Community Death Verification Officer where no health worker can arrive within 12 hours. No burial permit may be issued until a completed National Death Verification Form has been submitted. Emergency provisions accommodate rapid religious burial while still requiring verification to be completed within 72 hours.
The NBP will deploy a network of trained Community Death Registration Officers to every district in The Gambia.
One CDRO will serve every 1,500 to 2,000 households, recruited from the communities they serve and employed as formal civil servants of the NCRA on a competitive government salary. CDROs will be equipped with mobile devices loaded with the national registration application, enabling them to submit death notifications in real time from any location with mobile network coverage. They will work alongside community health workers, faith leaders, and local government to ensure no death in their area goes unreported.
The NBP will implement a structured Verbal Autopsy programme so that cause of death is documented even when no doctor was present.
CDROs will conduct a structured verbal autopsy interview with the primary caregiver or closest family member of every person who dies at home, using the WHO-validated questionnaire adapted for the Gambian context. Responses will be processed through a validated algorithm to assign a probable cause of death, which feeds directly into the national mortality database. Cases suggesting unnatural death, possible homicide, or a cause of public health significance will be immediately escalated to regional health authorities and, where appropriate, law enforcement.
The National Builders Party will ensure a Medical Certificate of Cause of Death is completed for every registered death in The Gambia.
The MCCD will follow the international standard format developed by the WHO, recording the immediate cause of death, any underlying cause, and contributing conditions. All MCCDs will use the ICD-11 coding system, bringing Gambian mortality data into alignment with the global health intelligence system for the first time. Cause-of-death data from every MCCD will feed directly into the national health database in real time, making The Gambia's mortality statistics current, searchable, and nationally comprehensive.
The NBP will make formal post-mortem examination mandatory for deaths involving suspected violence, unexplained circumstances, or deaths in custody.
A second post-mortem facility will be established at Brikama Trauma Hospital, beginning to address the country's critical shortage of forensic capacity. Mandatory autopsy categories cover suspected homicide, unexplained death, deaths in custody, and cases where a public health risk may exist. Findings will be submitted to both law enforcement and the national health database. This protects justice, supports epidemic detection, and ensures medical accountability for every death that demands closer scrutiny.
The NBP will replace the paper-based, Banjul-only registration system with a sovereign national digital platform accessible from every corner of the country.
The National Digital Death Registration System will be hosted on Gambian government servers under full government control. Electronic death certificates will carry a unique certificate number and digital verification code, eliminating the possibility of forgery or fraudulent alteration. Certificates will be issued to families within seven days of registration, available for collection at any regional NCRA office, downloadable through the national digital services portal, or collected in printed form from the district office. An offline-capable design ensures the system works in low-connectivity rural communities.
The NBP will build the death registration system with faith leaders and community authorities as formal partners, not obstacles.
Imams, pastors, priests, and community elders will be formally engaged as community registration partners, trained to guide families through the process at the moment of death within their own spiritual and cultural framework. A national public awareness campaign will be delivered in Wolof, Mandinka, Fula, Jola, and Serer through radio, community meetings, and mosque and church announcements. Testimonials from families who have benefited from having a death certificate will be the human face of the campaign, demonstrating in plain terms what registration makes possible.
For Grieving Families
A death certificate will no longer require a trip to Banjul. It will come to you, issued within seven days through a trained officer in your community. With that certificate, you can legally claim inheritance, transfer property, access government support programmes, and pursue justice if something went wrong. Your loss will be formally recognized by the state, and your rights will be protected from the moment it happens.
For Young Gambians
You are growing up in a country that is learning to count every life. The data collected through this system will shape how the government invests in the health challenges that affect your generation. When cause-of-death statistics are real and complete, health policy can target the diseases that are actually killing young Gambians rather than guessing at them. This system is built for the long term, and you will live in the country it helps to build.
For Every Family
When every death is documented, the entire health system becomes smarter. Epidemic outbreaks are caught earlier. Maternal death patterns are identified and addressed. Resources are sent to the regions that need them most rather than distributed on assumption. The benefits reach every Gambian family through a health system that knows where to focus and why, because it finally has the evidence to act on.
In The Gambia the National Builders Party builds, every death is recorded, every cause is documented, and every family receives a certificate within seven days regardless of where in the country they live. No death goes unverified by a qualified professional. No cause of death is left blank because the person died at home. Suspicious and unexplained deaths are examined by forensic professionals at facilities that exist in more than one city. The national health system draws on mortality data that is complete, current, and internationally comparable, enabling evidence-based policy that saves lives rather than estimates them. The National Builders Party is the government that treats every Gambian life as worth counting.
Every Gambian life deserves to be counted. Every death deserves a record. Every family deserves answers. The National Builders Party will build the system that delivers all three, in every district, in every region, starting on day one.
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