Swaziland
Swaziland, a country landlocked inside South Africa, has a population of approximately 956,000 people. An estimated 84 percent of its people live in rural areas. One of most impoverished countries in the world, Swaziland is unable to meet the basic food needs of two-thirds of its people. In addition, almost half its population lives in chronic poverty. Nearly 70 percent of the population lives on less than $1 US per day.
Health Care System
Swaziland's public health care system consists of six national hospitals and more than 135 health clinics. The country’s health care system suffers from chronic personnel shortages, particularly in remote and rural areas. There are only an estimated 50 doctors and 600 nurses providing health care services for the entire country. Poverty, poor nutrition, and a high disease burden combine to limit life expectancy to an average of 37 years of age.
HIV/AIDS in Swaziland
Swaziland has one of the highest adult HIV seroprevalence rates in the world at 26 percent. HIV has also orphaned an estimated 70,000 children in the country. Since 1986, the government of Swaziland has been actively engaged in responding to HIV/AIDS, issuing two strategic plans to respond to the pandemic in 2001 and 2006. Barriers, however, persist to HIV prevention, treatment, care, and support, including limited prevention education, HIV/AIDS stigmatization, lack of access to services, inadequate laboratory services, and lack of trained staff.
ICAP in Swaziland
Since January 2006, the International Center for AIDS Care and Treatment Programs (ICAP) at Columbia University’s Mailman School of Public Health has been supporting activities in Swaziland to provide care and treatment for pregnant women, children, and their families, including services to prevent mother-to-child transmission (PMTCT) of HIV and reduce HIV-related morbidity and mortality. In addition, ICAP provides technical and clinical assistance to the Ministry of Health and health facilities in the development of family-focused, multidisciplinary HIV/AIDS prevention, care, and treatment programs.
Support for Programmatic Activities
ICAP-supported activities in Swaziland include:
- Enhanced PMTCT/MTCT-Plus services for HIV-infected pregnant women, including provision of antiretroviral therapy (ART)
- Family-centered HIV/AIDS prevention, care, and treatment, including provision of ART
- Pediatric HIV/AIDS care and treatment, including early infant diagnosis and ART provision
- Linkages to tuberculosis (TB) control programs for TB/HIV co-infected patients
- Ongoing clinical training, mentoring, and quality improvement in delivering HIV/AIDS care and treatment, MTCTPlus, ART, and monitoring and evaluation
- Strengthening medical records systems
- Adherence and psychosocial support, and the development of follow-up systems
- Enhancing laboratory and pharmacy services
- Community linkages for PMTCT and HIV prevention, care, and treatment programs
- Development of managerial and technical capacities to administer HIV/AIDS programs