Geographical Locations - Swaziland

• (Statistical) Number of Inhabitants per Doctor: 7,971
• CIA World Factbook : Swaziland

Organisations and Networks

UN and Multinational

• WHO
  - WHO Country Profile - Swaziland
  - WHO - Tobacco control: Country Profile: Swaziland
  - WHO - Environmental Burden of Disease: Country Profile – Swaziland
  - WHO – Malaria Country Profile – Swaziland
• WHO - Regional Office AFRO in Brazzaville, Congo

Government

• Swaziland Government Online Information Portal
• Ministry of Health and Social Welfare

Non-Government

• Humanitarian Coordination Swaziland
  This site was created by the The Unit for Coordination of the Emergency Response in Swaziland, which is administered by the UNDP. The Unit was established under the Office of the UN Resident Representative in May 2003. The purpose of the unit is to assist in coordination of information around the evolving food and health crisis in the country

Academic Institutions

National Policy and Related Documents

• National Health Policy
• Prevention of mother to child transmission of HIV: operation plan, 2007-2011

Reports, Guidelines, and Projects

• 8th HIV Sentinel Serosurveillance Report
  "The biennial HIV sentinel surveys among pregnant women aged 15-49 years attending antenatal care in various health facilities in the country have regularly been conducted in the last decade to monitor the magnitude and the progress of the epidemic. This leaflet highlights the findings of the 8th sentinel survey carried in the year 2002 and shows trends of the HIV epidemic in Swaziland since 1992 to 2002. The objectives of the sentinel surveillance were the following: to determine the prevalence of HIV, Syphilis and Hepatitis B infections among pregnant women attending antenatal care services; to monitor trends of HIV. Syphilis and Hepatitis B among pregnant women; to determine the distribution of HIV, Syphilis and Hepatitis B in different age groups, marital status and educational status among pregnant women; to determine the prevalence of HIV, Syphilis and Hepatitis B between the 4 regions and by urban/rural strata; and to collect HIV data that will enable HIV/AIDS projections in the future." [Ministry of Health & Social Welfare, Swaziland National AIDS/STDS Programme, Mbabane, Swaziland, December 2002]
• Battling bilharzia: Swaziland
  Bilharzia, or schistosomiasis, is a disease caused by parasitic blood flukes of the genus Schistosoma. Throughout the tropics and subtropics, up to 300 million people are infected, making bilharzia second only to malaria in terms of its socio-economic and public health importance in these areas. A collaborative project involving the Swaziland Institute for Research in Traditional Medicine, Medicinal and Indigenous Food Plants (SIREMIFOP), the Bilharzia Unit of the Ministry of Health and Social Welfare, the School of Environmental Sciences and Development of the University of Potchefstroom, South Africa and Legesse Wolde-Yohannes, an endod specialist from Ethiopia, together with rural development centres in Ntfonjeni Inkhundla and Manzini North Inkhundla has been initiated. It is a community outreach project involving the cultivation of endod (Phytolacca dodecandra) for the control of bilharzia in rural communities where the disease is endemic. The two rural communities participate in the cultivation of endod, prepare a powder from the harvest of berries, and apply given doses of the powder to ponds infested with bilharzia-transmitting snails. The outreach programme has also been extended to field workers, who are given the task of controlling parasitic diseases in the country and of providing technical know-how on the epidemiology of diseases. Throughout the project, research findings have been applied at the grassroots level using simple, unsophisticated technology for the benefit of local communities. [author summary] [Sharing Innovative Experiences, Vol. 10: Examples of the development of pharmaceutical products from medicinal plants, pp.135-144. (2004)]
• Costing Male Circumcision in Swaziland and Implications for the Cost-Effectiveness of Circumcision as an HIV Intervention
  "Clinical trials have now confirmed the efficacy of male circumcision (MC) in reducing female-to-male HIV transmission. Some cost data have been reported (ranging between US$25 and US$69) and these cost data also formed the basis of a cost-effectiveness analysis. It is unclear, however, what exactly is included in the costing studies and hence whether these costs are directly comparable. For example, often, indirect costs are not fully reflected; donations (especially clinicians’ time) are not costed; and variation by provider type and level of health facility is not considered. It is anticipated that this cost analysis will provide a more detailed examination of the costs of male circumcision and inform a sounder basis for an assessment of the cost-effectiveness of MC and planning for implementation of MC in Swaziland. This analysis is part of a larger study titled the 'Costing Male Circumcision in Lesotho, Swaziland, and Zambia: Implications for Cost-Effectiveness of Circumcision as an HIV Intervention.' The larger study has two major components: (1) costing MC and (2) modeling the impact of MC on the HIV epidemic. The purpose of the analysis in Swaziland was to (1) understand the social, cultural, and policy context of male circumcision; (2) assess the cost of providing adult MC in a resource-constrained setting; and (3) evaluate the implications of scaling up MC for the cost-effectiveness of MC and for the health system (e.g., resource mobilization and health system capacity)." [USAID Health Policy Initiative, September 2007]
• Helping Ourselves: Community Responses to AIDS in Swaziland
  "In March 2005, a Joint Mission of the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) and UNAIDS, led by Dr Peter Piot (Executive Director, UNAIDS) visited The Kingdom of Swaziland to see some of the community-based HIV programmes that have been developed there. In a country severely affected by the epidemic, these community programmes represent innovative and inspirational methods for supporting people infected with and affected by HIV, particularly orphaned and vulnerable children. The Joint Mission visited the community of Mambatfweni in Manzini region where community initiatives are based on several interconnected elements: building a community KaGogo social centre to coordinate efforts to respond to the epidemic and its impacts; establishing a system of Neighbourhood Care Points to feed orphaned and other vulnerable children, teach them basic life skills and give them care and support within the community; reintroducing traditional community Indlunkhulu fields to help grow food for the sick and vulnerable; establishing community support structures for people living with HIV; providing psychosocial support programmes; and strengthening community outreach services. Mambatfweni is not unique in developing these community efforts. Similar community-based initiatives are being rolled out and scaled up across the country and have become the foundation stones of the national response in Swaziland, now facing (in 2005) the highest recorded prevalence in the world." [UNAIDS Best Practice Collection, UNAIDS/06.22E (English original, June 2006)]
• HIV/AIDS in the Umbufto Swaziland Defence Force
  "Up to now no comprehensive study has been produced that analyses the HIV/AIDS situation in the Umbufto Swaziland Defence Force (USDF). This is in spite of the fact that the military is a high-risk sector both within itself and in its relationships with local, regional, continental and global communities. This chapter analyses the HIV/AIDS situation in the USDF, with particular emphasis on the manner in which the Swaziland military has reacted to the general advent of HIV/AIDS." [Chapter Three of The Enemy Within: Southern African Militaries' Quarter-Century Battle with HIV and AIDS, edited by Martin Rupiya, South Africa: Institute for Security Studies, October 2006, pp.65-90]
• Integrating quality postnatal care into PMTCT in Swaziland
  Swaziland's prevention of mother-to-child transmission (PMTCT) programme is linked to maternal and newborn health (MNH) services, but is mainly focussed on HIV/AIDS. Existing MNH services are inadequate, especially postnatal care (PNC) of mothers and babies, with delayed postnatal visits occurring at 4-6 weeks after delivery. Fifty-seven percent of staff in seven Swazi health facilities were trained in promoting and providing early PNC.Afinal evaluation showed a 20-fold increase in the number of visits coming for an early postnatal visit (within the first three days after birth). A direct observation of the client_provider interaction showed a significant increase in the competence of the health workers related to postnatal examinations, and care of mothers and babies (pB0.05_B0.01). The percentage of women breastfeeding within one hour of delivery increased by 41% in HIV-positive mothers and 52% in HIV-negative mothers. Cotrimoxazole prophylaxis for HIV-exposed infants increased by 24%. Although, health workers were observed providing counselling, maternal recall of messages was deficient, suggesting the need for additional strategies for promoting healthy behaviours. High-quality integrated PMTCT programmes and MNH postnatal services are feasible and acceptable, and can result in promoting early postnatal visits and improved care of both HIV-positive and HIV-negative mothers and their babies. [author abstract] [Global Public Health, 4:3, 253-270 (May, 2009)]
• Monitoring the Declaration of Commitment on HIV/AIDS (UNGASS) – Swaziland Country Report
  "Swaziland is among the countries hardest hit by the HIV/AIDS pandemic. Since the first AIDS cases were reported in the country in 1986, the disease has spread at an alarming rate. The general mode of HIV transmission remains heterosexual, with some new infections occurring as a result of mother-to-child transmission. The prevalence of HIV among pregnant women rose from 3.9% in 1992 to 42.9% in 2004 (Sentinel Surveillance Report 2004). However, the 10th sentinel surveillance in 2006 showed a slight drop to 39.2%. HIV prevalence in the 15-24 age group remained steady at 39.4% between 2002 and 2004 and showed a decline to 34.6% in 2006. A consistent decline in the 15-19 year age group (from 32.5% to 26%) was recorded between 2002 and 2006. 3 According to the 2006/7 SDHS, the overall HIV prevalence in the population aged 15-49 is 26% with women (31%) more likely to be HIV positive than men 20%). The estimated number of people living with HIV/AIDS (PLHIV) that are in need of combined ARV treatment has increased from approximately 43,157 in 2004 to 58,250 in 2007 (HIV Estimation and Projections for Swaziland, Draft Workshop Report, November 2007)."
• Prevention of mother to child transmission of HIV guidelines
  "Mother-to-Child Transmission (MTCT) is by far the largest source of HIV infection in children. According to UNAIDS estimates, more than 90 percent of children acquire HIV through MTCT during pregnancy, during labor and delivery or after delivery through breastfeeding. HIV exposed or infected infants have a high probability (50%) of dying in the first two years of life. Prevention of mother to child transmission (PMTCT) services provides an entry point to prevention of HIV transmission to infants and care and treatment for the entire family. The high HIV prevalence among pregnant women of 42.6% (MOH&SW Sentinel Surveillance 2004) indicates that if interventions to prevent MTCT are not scaled-up, paediatric HIV infections will continue to reverse the gains made in child survival through EPI and safe motherhood initiatives. In the light of the above, the Government of the Kingdom of Swaziland is committed to providing equitable access to cost effective and quality health care as close to the family as possible through the involvement of community-based health workers. It is within this context that the Ministry of Health and Social Welfare (MOH&SW) is working towards increasing access to PMTCT, Care and Treatment services for all pregnant women, mothers, infants and their families. This will be achieved through the expansion and integration of PMTCT services into routine maternal and child health (MCH) services. PMTCT has been identified as a viable intervention to reduce new HIV infections through a four prong approach: 1) primary prevention of HIV infection among women of child bearing age, 2) prevention of unintended pregnancies among HIV infected women; 3) prevention of HIV transmission from HIV infected mothers to the infants and 4) provision of continuous care and treatment for infected mothers, partners and their children. Therefore implementation of a PMTCT programme includes establishment of linkages to other support programmes within the framework of a continuum of care for people infected and affected by HIV. This 2nd Edition is an update of the PMTCT Guidelines developed in 2002 and has incorporated new WHO recommended public health approaches in HIV Prevention, Care and Treatment." [Ministry of Health and Social Welfare, Swaziland Government, 2007]
• Repositioning Postnatal Care in a High HIV Environment: Swaziland
  "Recognizing the need to improve the care and follow up of mothers and infants in the postnatal period, the Swaziland Ministry of Health and Social Welfare (MOHSW), with support from the Horizons Program of Population Council, the Elizabeth Glaser Pediatric AIDS Foundation (EGPAF), Basics Support for Institutionalising Child Survival (BASICS), and the Central Statistics Office (CSO), carried out an operations research project to reposition postnatal care (PNC) within the context of a high HIV environment. The objectives of the study were to determine if changes to the sexual and reproductive health guidelines on postnatal care would result in the timely and quality provision of key components of essential maternal and newborn care in the postnatal period, increase utilization of postnatal care services among all postpartum (PP) women, and improve the care and follow up of HIV-positive postpartum women and their infants." [Population Council, for the Ministry of Health and Social Welfare, Government of Kingdom of Swaziland, February 2008]
• Seven years of regional malaria control collaboration — Mozambique, South Africa, and Swaziland
  The Lubombo Spatial Development Initiative is a joint development program between the governments of Mozambique, Swaziland, and South Africa, which includes malaria control as a core component of the initiative. Vector control through indoor residual spraying (IRS) was incrementally introduced in southern Mozambique between November 2000 and February 2004. Surveillance to monitor its impact was conducted by annual cross-sectional surveys to assess the prevalence of Plasmodium falciparum infection, entomologic monitoring, and malaria case notification in neighboring South Africa and Swaziland. In southern Mozambique, there was a significant reduction in P. falciparum prevalence after the implementation of IRS, with an overall relative risk of 0.74 for each intervention year (P < 0.001), ranging from 0.66 after the first year to 0.93 after the fifth intervention year. Substantial reductions in notified malaria cases were reported in South Africa and Swaziland over the same period. The success of the program in reducing malaria transmission throughout the target area provides a strong argument for investment in regional malaria control. [author abstract] [American Journal of Tropical Medicine and Hygiene, 76(1), 2007, pp. 42–47]
• Traditional Medicine: Swaziland
  Plants are used extensively in Swazi traditional medicine. In the 1970s, the Department of Chemistry at the University of Swaziland decided to examine the scientific basis for this traditional medical system. In the process of researching drugs derived from medicinal plants, researchers began to understand the important cultural heritage that supported this system. The work has involved analyses of medicinal plants collected by rural people familiar with the traditional medical system. A key part of the studies are the ethnobotanical surveys of medicinal plants administered by traditional medical practitioners (TMP's) and the taxonomic identification of plant species by taxonomists with the Ministry of Agriculture and Cooperatives. Chemical screening and extraction of possible active constituents is also conducted with TMPs as an integral part of the laboratory team… Today, this work is housed in the Swaziland Center for Research in Medicinal and Indigenous Food Plants. As a result of the center's research on medicinal plants, the scientific bases of the use of traditional plants for therapeutic purposes has been established. [author abstract] [Sharing Innovative Experiences, Vol.7, 2001: Conservation and Wise Use of Indigenous and Medicinal Plants]

Educational Resources

• CDC - Travel Information : Southern Africa
• Report Card – HIV Prevention for Girls and Young Women: Swaziland
  "This report card aims to provide a summary of HIV prevention for girls and young women in Swaziland. This Report Card is one in a series produced by the International Planned Parenthood Federation (IPPF), under the umbrella of the Global Coalition on Women and AIDS, and with the support of the United Nations Population Fund (UNFPA) and Young Positives. The Report Card is an advocacy tool. It aims to increase and improve the programmatic, policy and funding actions taken on HIV prevention for girls and young women in Swaziland. Its key audiences are national, regional and international policy and decision-makers, and service providers. It builds on global policy commitments, particularly those outlined in the Political Declaration on HIV/AIDS from the 2 June 2006 High-Level Meeting, to follow up on the United Nations General Assembly Special Session on AIDS (UNGASS). The Report Card summarizes the current situation of HIV prevention strategies and services for girls and young women ages 15-24 years in Swaziland. It contains an analysis of five key components that influence HIV prevention, namely: 1. Legal provision; 2. Policy provision; 3. Availability of services; 4. Accessibility of services; [and] 5. Participation and rights. It also provides recommendations for key stakeholders to enhance action on HIV prevention strategies and services for girls and young women in Swaziland. The Report Card is the basis of extensive research carried out during 2007 by IPPF, involving both desk research on published data and reports, and in-country research in Swaziland to provide more qualitative information. This research is detailed in full within a 'Research Dossier on HIV Prevention for Girls and Young Women in Swaziland’(available on request from IPPF)." [c2007]
• UNAIDS/WHO Epidemiological Fact Sheets on HIV and AIDS, 2008 Update – Swaziland