C ommo nwe a l t h memb e r c o u n t r i e s become more level but continue on an incline. In 2012 there were 295 reported cases of malaria in Swaziland. There was a considerable fall in deaths from malaria in the decade 2001–12, however, the number of reported cases increased significantly in the period 2008–11, before decreasing by almost half. In the period 1990–2013 there was a great increase in the estimated incidence of tuberculosis (TB) in Swaziland, accompanied by an increase of more than 100 per cent in estimated mortality (when mortality data excludes cases comorbid with HIV) from the disease. Non-communicable diseases (NCDs) in Swaziland accounted for an estimated 28 per cent of all mortality in 2012. The most prevalent NCDs in Swaziland are cardiovascular diseases, which accounted for ten per cent of total deaths across all age groups in 2012. Noncommunicable variants of respiratory diseases, cancer and diabetes contributed three per cent each to total mortality in 2012. Injuries accounted for nine per cent of deaths in 2012. There is a lack of recent data regarding the most commonly diagnosed mental illness in Swaziland. Health systems: In 2012 government expenditure on health was 6.3 per cent of GDP, equivalent to US$192 per capita. In the most recent survey, conducted between 1997 and 2010, there were 16 doctors, and 320 nurses and midwives per 100,000 people. Additionally, in 2010, 82 per cent of births were attended by qualified health staff and in 2013, 85 per cent of one-year-olds were immunised with one dose of measles. In 2012, 72 per cent of people were using an improved drinking water source and 57 per cent had access to adequate sanitation facilities. The most recent survey, conducted in the period 2000–11, reports that Swaziland has five pharmaceutical personnel per 100,000 people. The health system is based on the concept of primary, secondary and tertiary levels of health care. At primary level there are community-based health care workers, clinics and outreach services. At secondary level, there are health centres that also serve as referral points for primary levels. The tertiary level comprises hospitals, specialised hospitals and national referral hospitals. There are 14 hospitals, six of which are private; five government health centres; six public health units; and 215 clinics and outreach sites. The clinics, which are managed by nurses, are mostly located in rural areas, with only 23 having maternity facilities. The country’s main referral hospital is the Government Hospital in the capital, Mbabane. There is also a large market for traditional healers. Under-five mortality 150 120 90 60 30 1990 1995 2000 2005 2010 2015 Under-five mortality per 1,000 live births 2015 MDG 4 target 60 50 274 Commonwealth Health Partnerships 2015 0 Life expectancy and HIV/AIDS 30 25 20 15 10 5 1980 1990 2000 2013 Prevalence of HIV/AIDS among those aged 15–49 Life expectancy Prevalence of HIV, total (% of population aged 15-49) Life expectancy in years 40 0 Mortality by cause of death (% of all deaths), 2012 Injuries Communicable diseases, maternal, perinatal and nutritional conditions Non-communicable diseases Tuberculosis: Incidence and mortality 1990 2000 2010 Mortality excluding cases comorbid with HIV (per100,000 people) Incidence of tuberculosis (per 100,000 people) – including cases comorbid with HIV 1500 1200 900 600 300 0
Commonwealth Health Partnerships 2015
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