The Gambia is located in Western Africa, bordering the Atlantic Ocean on the west and with Senegal on the North, South and East. The river Gambia runs through the length of the country dividing it in to two parts. There is limited infrastructure like roads and electricity with decreased access to mass transportation like buses and river crossing vessels. In terms of health administration the country is divided in to six health divisions. Women comprise 51% of the population among which 23.3% are between 15-49 years. Crude birth and death rates are at 462 and 193 respectively. The dominant religion is Islam(95%) and therefore polygamy is widely practiced. Female Genital Mutilation, wife inheritance and early marriage are also components of the culture. Though the 2001 maternal mortality survey showed a decline in maternal mortality ratio, it has remained unacceptably high (730/100,000 live births), with 54.9 perinatal mortality.