Country Spotlight: Swaziland

Country Overview

There are currently 220,000 people living with HIV in Swaziland. Less than half of both children (0-14) and adults (aged 15 and up) living with HIV were receiving life-saving antiretroviral medications as of 2013.

Our Work in Swaziland

The Elizabeth Glaser Pediatric AIDS Foundation (EGPAF) began supporting the Kingdom of Swaziland in 2003 to prevent mother-to-child HIV transmission (PMTCT) and to provide HIV and AIDS care and treatment services. EGPAF-Swaziland’s work aims to ensure every client has access to HIV testing, high-quality counseling, and psychosocial support within a variety of easily accessible health settings throughout the country.

EGPAF-Swaziland provides support to improve local infrastructure and health systems through trainings, mentorship, and procurement of essential HIV drugs and commodities. We also work to increase community engagement in PMTCT, early infant HIV diagnosis, and male circumcision. Currently, EGPAF-Swaziland provides comprehensive support to 56 sites in the Hhohho and Shiselweni regions with PMTCT, ART, and tuberculosis (TB) related services.

In addition, Swaziland has conducted several research studies aimed at improving program implementation and efficacy. Our research has focused on evaluations of mother-to-child HIV transmission, best practices in HIV counseling and testing, and approaches which foster community engagement in PMTCT and maternal, newborn and child health care services. 

 

Key Projects in Swaziland

Strengthening High Impact Interventions for an AIDS-free Generation (AIDSFree) Project

(2015 - 2019) The AIDSFree project aims to: expand coverage of high-quality integrated, decentralized, and comprehensive HIV and TB/HIV prevention, care and treatment; build the capacity of regional health management teams in leadership, management, and governance of the health systems; and ensure performance efficiency, quality, and effectiveness in the management of the HIV/AIDS, TB, and sexually transmitted illness programs. Through AIDSFree, EGPAF provides technical assistance in maternal, neonatal, and child health (MNCH) issues to Swaziland’s Sexual Reproductive Health Unit and National AIDS Program. The project also provides HIV testing and counseling mentorship to health workers and lay counselors.

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Investing in Pediatric HIV Diagnostics to Save the Lives of HIV-Infected Infants

(2015 – 2019) This UNITAID-supported project is currently implemented in nine African countries, and aims to increase pediatric HIV diagnosis and early initiation of HIV-positive infants on ART. In Swaziland, the project aims to increase the number of HIV-exposed infants tested before the 12th week of life, while also generating a 40% cost savings for HIV diagnostics. The project lays the foundation for universal access to pediatric care and treatment in Swaziland.

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Expanding Access to Pediatric HIV Testing and Treatment through Intensified Case Finding and Universal Offer of HIV Testing

(2015-2019) This goal of this three-year project is to rapidly scale-up pediatric HIV testing for children aged 18 months and older, and initiate HIV-positive children on ART. This is a comprehensive and innovative collaboration with ELMA Philanthropies, complementary to the UNITAID project. This project advocates for local policies which advance utilization of pediatric HIV services, such as task shifting, decentralization, community-based services, and regulation. Health care workers are trained, through this program, on intensified case finding of HIV-positive infants and children, and on community engagement to enhance demand-generation of HIV care services. 

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Advancing Community-Level Action for Improving Maternal and Child Health and Prevention of Mother-to-Child Transmission of HIV (ACCLAIM)

(2012-2017) ACCLAIM seeks to increase community demand for, uptake of, and retention in MNCH and PMTCT services. The project is supported by the Department of Foreign Affairs, Trade and Development Canada and is being implemented in Uganda, Swaziland, and Zimbabwe over four years. ACCLAIM’s goal is to increase engagement in MNCH and PMTCT among men and women through community-based interventions. This project focuses on operations research to better understand communities perceptions and behaviors around PMTCT and aims to use this research to change HIV, MNCH, and gender-related health behaviors through community-based interventions that shift community norms and attitudes toward healthy behaviors.

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Supporting Operational AIDS Research (Project SOAR)

(2016 - 2019) The goal of Project SOAR in Swaziland is to evaluate the effect of the family-centered care model to improve pediatric retention and ART adherence to increase the rates of viral suppression among HIV-positive children on ART. In the family-centered care model, after a child is identified as HIV-positive, active HIV testing of all family members is conducted and all HIV-positive family members are seen together as a unit and receive their care together. The project will have four implementation and four control health facilities, which will allow EGPAF to assess the impact of this model.

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Publications

EGPAF Country Fact Sheet: Swaziland

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Swaziland Annual Report 2014

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An Exploratory Study of the Behaviors and Practices That May Increase HIV Risk among Pregnant and Lactating Women in Communities in Swaziland (2014)

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Haba Na Haba: Spotlight on Pediatric Care and Treatment (2015)

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Program Brief: Lessons learned from early implementation of B+: The Elizabeth Glaser Pediatric AIDS Foundation experience (2014)

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Bringing Rural Sub-Saharan African Communities and the Global Response to the HIV and AIDS Epidemic (2015)

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End-Of-Project Report: Eliminating Pediatric AIDS in Swaziland (2016)

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BRIDGING RURAL SUB-SAHARAN AFRICAN COMMUNITIES AND THE GLOBAL RESPONSE TO THE HIV AND AIDS EPIDEMIC

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ACCLAIM Toolkit

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