Maternal, newborn and child health (MNCH)
MNCH programme in Eswatini
While Eswatini made significant gains in child survival during the 1980s and 1990s, the tragic combination of HIV, poverty and food insecurity saw a reverse in these gains over the ensuing decade. The U5MR doubled from 60 per 1,000 live births in 1992 to 120 in 2006/2007, while the MMR more than doubled from 229 per 100,000 live births in 1996 to 589 in 2006-2007 (DHS 2006/2007). HIV accounts for nearly half of all under-5 deaths (47 per cent) (CHERG, 2007).
Among under-5 child deaths, 27 per cent occurred during the first month of a child’s life, arising from problems such as premature birth, asphyxia, infection and congenital disorders. Childhood pneumonia and diarrhoea also contributed 12 per cent and 10 per cent of under-5 deaths respectively. Regional disparities exist with under-5 mortality highest in the Lubombo and Manzini regions.
Limited access to quality health education and health care, along with weak integration of essential services, impact negatively on health outcomes in Eswatini. The chance of children born to uneducated mothers not living beyond their fifth birthday is three times higher than for children born to mothers with tertiary education.
Poor health and poverty are inextricably linked. Illness and death have serious financial repercussions for a household, while those who are poor are more likely to become sick and less likely to have access to basic services if they do.
On a positive note, there has been considerable success in containing malaria in endemic areas, with a decline in number of laboratory-confirmed cases from 4,000 per year between 1995 and 2000, to fewer than 100 cases per year between 2006 and 2007. Improved case management and availability of drugs contributed to this decline, along with strong collaboration with bordering countries.
Eswatini also has a relatively high vaccination coverage, of over 80 per cent among children aged 12-23 months, and has introduced two new vaccines – PCV 13 and rotavirus – which markedly reduced mortality and morbidity from pneumonia and diarrhoea respectively.