Health in Eswatini

The Health Sector in Eswatini is deteriorating and four years into the United Nations sustainable development goals, Eswatini seems unlikely to achieve the goal on good health. As a result of 63% poverty prevalence, 27% HIV prevalence, and poor health systems, maternal mortality rate is at a high of 389/100,000 live births,{{cite web|url=https://www.indexmundi.com/swaziland/maternal_mortality_rate.html|title=Maternal Mortality Rate|access-date=18 October 2019|website=Index Mundi}} and under 5 mortality rate is at 70.4/1000 live births{{cite web|url=https://www.indexmundi.com/facts/swaziland/indicator/SH.DYN.MORT|website=Index Mundi|access-date=18 October 2019|title=Indicators in Eswanti}} resulting in a life expectancy that remains amongst the lowest in the world.{{cite web|url=http://worldpopulationreview.com/countries/life-expectancy-by-country/|title=Life Expectancy in Swaziland|website=World Population Review|access-date=15 September 2019}} Despite significant international aid, the government fails to adequately fund the health sector. Nurses are now and again engaged in demonstrations over poor working conditions, drug shortages, all of which impairs quality health delivery. Despite tuberculosis and AIDS being major causes of death, diabetes and other non-communicable diseases are on the rise.{{cite web|url=https://vizhub.healthdata.org/gbd-compare/|website=Vizhub|access-date=15 September 2019|title=Blobal Health Data Comparison}} Primary health care is relatively free in Eswatini save for its poor quality to meet the needs of the people. Road traffic accidents{{cite web|url=https://www.worldlifeexpectancy.com/swaziland-road-traffic-accidents|title=Swaziland Road Traffic Accidents|website=World Life Expectancy|access-date=15 September 2019}} have increased over the years and they form a significant share of deaths in the country.{{cite book|title=CIA Factbook, Eswatini|publisher=Central Intelligence Agency|url=https://www.cia.gov/the-world-factbook/countries/eswatini/#people-and-society}}

Furthermore, tuberculosis remains a significant problem. The shift has been towards multi-drug resistant strains. TB has an 18 percent mortality rate and 83 percent of cases are co-infected with HIV.{{cite web |url=http://www.doctorswithoutborders.org/news/article.cfm?id=4034&cat=field-news |title=Swaziland: An MSF Doctors Explains HIV-TB Co-Infection |date=28 October 2009 |publisher=Doctors Without Borders/Médecins Sans Frontières |access-date=31 October 2009 |location=USA |url-status=dead |archive-url=https://web.archive.org/web/20110725170922/http://www.doctorswithoutborders.org/news/article.cfm?id=4034&cat=field-news |archive-date=25 July 2011 }} There are roughly 14,000 new TB cases diagnosed each year.{{cite web |url=http://www.doctorswithoutborders.org/publications/article.cfm?id=4033&cat=special-report |title=HIV-TB in Swaziland: A Deadly Co-Infection Epidemic |date=28 October 2009 |publisher=Doctors Without Borders/Médecins Sans Frontières |access-date=31 October 2009 |location=USA |url-status=dead |archive-url=https://web.archive.org/web/20100621122506/http://www.doctorswithoutborders.org/publications/article.cfm?id=4033&cat=special-report |archive-date=21 June 2010 }}

The Human Rights Measurement Initiative{{Cite web |title=Human Rights Measurement Initiative – The first global initiative to track the human rights performance of countries |url=https://humanrightsmeasurement.org/ |access-date=2022-03-17 |website=humanrightsmeasurement.org}} finds that Eswatini is fulfilling 74.1% of what it should be fulfilling for the right to health based on its level of income.{{Cite web |title=Eswatini - HRMI Rights Tracker |url=https://rightstracker.org/ |access-date=2022-03-17 |website=rightstracker.org |language=en}} When looking at the right to health with respect to children, Eswatini achieves 85.5% of what is expected based on its current income. In regards to the right to health amongst the adult population, the country achieves only 52.8% of what is expected based on the nation's level of income. Eswatini falls into the "bad" category when evaluating the right to reproductive health because the nation is fulfilling only 84.2% of what the nation is expected to achieve based on the resources (income) it has available.

Mental health

The global shift towards more non-communicable diseases does not spare Eswatini. However, scanty research is on mental illness in the country yet increasing levels of poverty, sexual violence, HIV/AIDS, alcohol and cannabis abuse{{cite book|author=Mhlongo, Gladys Thembinkosi |title=Drug Abuse by Adolescents in Swaziland|publisher=MSc Thesis, University of South Africa|date=November 2005|citeseerx = 10.1.1.543.3720}} are highly associated with mental health issues. Lack of policy, poor facilities, and limited personnel{{cite web|url=https://www.who.int/mental_health/evidence/atlas/profiles-2014/swz.pdf|title=Profile of Swaziland|access-date=17 September 2019|website=WHO}} all contribute to poor awareness and is a concern that shall soon explode as a crisis in the population and burden it of disease in the country.

Eswatini does not have an expansive mental health infrastructure. Most healthcare is centralized in cities where only approximately 20% of the population lives. Though recently there may have been additions, in 2011 there was one psychiatrist in National Psychiatric Referral Hospital and in the country.{{cite web|url=https://www.who.int/mental_health/evidence/atlas/profiles/swz_mh_profile.pdf|title=Swaziland Mental Health Profile|access-date=20 September 2019}} Impractical as it may, they attended inpatients, prisoners, children, and outpatients.{{cite web|url=http://healingthroughart.webflow.io/|title=HealingthroughArt|website=healingthroughart.webflow.io|access-date=17 April 2016|archive-url=https://web.archive.org/web/20160425203830/http://healingthroughart.webflow.io/|archive-date=25 April 2016|url-status=dead}}

Given Eswatini's overall health situation, many health-oriented non-governmental organizations, university programs, and other organizations work in the country on research and service projects related to health. However, mental health remains the periphery. Despite all these negatives, there is but one organization working on awareness and promotion of mental health in the country.{{cite web|url=https://www.imerse.org/about-swaziland|title=About Swaziland|website=Imerse|access-date=17 September 2019}}

HIV/AIDS

File:Eswatinihf.png

Eswatini has made significant strides in fighting HIV/AIDS. From being highest in prevalence and incidence in late 2000s, it has shifted to be a model for HIV control in the world. Urgency, programmatic shifts and international aid make the frontline in the combat against the epidemic.

The first case of HIV in Eswatini was reported in 1986, approximately 26 years after the first known case in the world. Fast forward about two decades later, it was reported the biggest killer; at 64% of all deaths in the country. In 2003, the Eswatini government (then Swaziland) declared HIV/AIDS a national crisis, with 38.8% of tested pregnant women infected with HIV (see AIDS in Africa). Prime Minister Themba Dlamini declared a humanitarian crisis due to the combined effect of drought, land degradation, increased poverty, and HIV/AIDS.

NERCHA{{cite web|url=https://www.hivsharespace.net/organization/national-emergency-response-council-hiv-and-aids-nercha-swaziland|title=HIV and AIDS in Swaziland|website=HIV Sharespace|access-date=15 September 2019}} was formed in 2003 to coordinate action against the disease. HIV care guidelines were published in 2010, revised in 2015 and most recently in 2018 to improve models of care, and fit emerging developments in the fight against HIV/AIDS. A 2016 SHIMS 2{{cite web|url=https://phia.icap.columbia.edu/wp-content/uploads/2019/05/SHIMS2_Final-Report_05.03.2019_forWEB.pdf|title=Final Report|website=PHIA ICAP Columbia|access-date=13 September 2019}} found a significant decrease in prevalence of HIV compared to 2012 in SHIMS 1.{{cite web|url=http://files.icap.columbia.edu/shims/files/uploads/SHIMS_2nd_Report-Oct_2014.pdf|title=SHIMS 2nd Report|year=2014|access-date=13 September 2019}} Eswatini scores lowest incidence and related deaths today in the region.{{cite web|url=http://aho.afro.who.int/en/atlas/atlas-african-health-statistics-2019|archive-url=https://web.archive.org/web/20190802051122/http://www.aho.afro.who.int/en/atlas/atlas-african-health-statistics-2019|url-status=dead|archive-date=August 2, 2019|title=Atlas of African Health Statistics|year=2019|access-date=14 September 2019}} Universal ART coverage and extensive outreach targeted at hard to reach populations for HTC are responsible for the country's success towards the 90/90/90 2020 UNAIDS goal of ending HIV.

Public expenditure for HIV/AIDS was 4% of the GDP of the country, whereas private expenditure was 2.3%.{{cite web |url=http://hdrstats.undp.org/en/countries/data_sheets/cty_ds_SWZ.html |title=Human Development Report 2009 – Swaziland |publisher=Hdrstats.undp.org |access-date=27 June 2010 |url-status=dead |archive-url=https://web.archive.org/web/20100715092635/http://hdrstats.undp.org/en/countries/data_sheets/cty_ds_SWZ.html |archive-date=15 July 2010 }}{{specify|date=November 2010}} Infant mortality was 57.19 per 1,000 in 2014,{{cite web |url=https://www.cia.gov/library/publications/the-world-factbook/rankorder/2091rank.html |archive-url=https://web.archive.org/web/20070613003931/https://www.cia.gov/library/publications/the-world-factbook/rankorder/2091rank.html |url-status=dead |archive-date=June 13, 2007 |title=The World Factbook |publisher=Cia.gov |access-date=16 August 2014}}{{specify|date=February 2014}} 47% of all deaths under 5 were caused by HIV/AIDS.{{cite web |title=Swaziland, Mortality Country Fact Sheet 2006 |publisher=WHO |url=https://www.who.int/whosis/mort/profiles/mort_afro_swz_swaziland.pdf |archive-url=https://web.archive.org/web/20090805140020/http://www.who.int/whosis/mort/profiles/mort_afro_swz_swaziland.pdf |archive-date=5 August 2009}}

Healthcare

There were 16 physicians per 100,000 persons in the early 2000s.

In September 2018 as the government had not paid suppliers the health service ran out of food and medicine. Swazipharm could not buy drugs. In May 2017 US$18 million was said to be owed to drug companies. There were only 12 working public ambulances in the country in June 2018.{{cite news |title=Swaziland: No Food for Hospital Patients As Broke Swaziland Government Leaves Supplier Bills Unpaid |url=https://allafrica.com/stories/201809280147.html |access-date=25 November 2018 |publisher=All Africa |date=27 September 2018}}

=Hospitals=

File:Wz-map Eswatini 2.gif".gif

There were 135 medical facilities in Eswatini in 2019, including four hospitals run by the Ministry of Health and two hospitals run by NGO missions. The other medical facilities are clinics and health centers.{{cite web|url=https://www.who.int/malaria/areas/surveillance/public-sector-health-facilities-ss-africa/en/|archive-url=https://web.archive.org/web/20190422034044/https://www.who.int/malaria/areas/surveillance/public-sector-health-facilities-ss-africa/en/|url-status=dead|archive-date=April 22, 2019|title=A spatial database of health facilities managed by the public health sector in sub-Saharan Africa|website=World Health Organization|access-date=May 8, 2020|date=February 11, 2019}}

class="wikitable sortable plainrowheaders" summary="Medical facilities in Eswanti" \|+ Medical facilities in Eswatini !Name !Location !Type facility !Ref
Mbabane Government Hospital	Hhohho Region	Referral Hospital
Pigg's Peak Government Hospital	Hhohho Region	Regional Hospital
Good Shepherd Hospital	Lubombo Region	Mission Hospital
Mankayane Hospital	Manzini Region	Regional Hospital
Raleigh Fitkin Memorial (RFM) Hospital	Manzini Region	Mission Hospital
Hlatikhulu Hospital	Shiselweni Region	Regional Hospital

References

Category:Health in Eswatini