The evaluation of the Extended Multisectoral HIV and AIDS National Strategic Framework (eNSF) 20142018 was commissioned to assess progress in meeting the HIV and AIDS response targets as well as the country’s progress towards achievement of the Umgubudla targets. The findings of the evaluation will inform the strategic direction for a new strategy 2018-2022.
The main objective of this predominately ethnographic, mixed methods study was twofold: first it was explore adolescents’ access to and utilisation of available HIV services including testing, and antiretroviral treatment as well as adherence to the treatment and retention in HIV care. The second objective was to gain in-depth insight into the experiences of adolescents living with HIV in different family contexts in Swaziland, from the perspective of adolescents themselves.
The National HIV Operational Plan (NOP) operationalizes the Extended National Multisectoral HIV and AIDS Framework (eNSF) 2014-2018. The NOP was developed through collective efforts by HIV implementers and partners in the country. The NOP translates the eNSF strategies into key and sub-activities, defines leading partners, targets and the estimatedcosts for these interventions.
Spectrum is a suite of easy to use policy models which provide policymakers with an analytical tool to support decision making processes. Spectrum was used in modelling the magnitude of the HIV epidemic and the demographic, social and economic impacts in Swaziland. The projections were generated by a Mutisectoral Estimates and Projections Core Team led by NERCHA, in 2015.
The National TB Control Program (NTCP), based on the internationally recommended Directly Observed Treatment Short-course (DOTS) strategy, was launched in 1997 and it expanded across the country in a phased manner with support from the World Bank and other development partners.
The objectives of the program are:
• To achieve and maintain TB case detection of at least 70% of the estimated NSP cases in the community.
• To achieve and maintain TB treatment success rate of at least 85% among New Sputum Positive (NSP) patients
The implementation of prevention and treatment and care components of the HIV program has resulted in a number of results. In terms of prevention; the Service Availability Mapping 2013 shows that HTC coverage has increased from 76% in 2008 to 92% in 2013, 150 facilities in 2010 to162 in 2013 for PMTCT and 24 in 2010 to 45 in 2013 facilities providing VMMC.
Antiretroviral therapy has been identified as one of the interventions that can help lower the risk of HIV transmission from one person to another. The protective nature of ART was demonstrated in the HPTN 052 study, but this protection is at the individual level and translating this to the entire population is a function of ART coverage and efficiencies at the national level.
The TB Control programme of the Kingdom of Swaziland has been implementing a National TB Control Strategic Plan (TB NSP) covering the period 2010 - 2014. Before it elapsed and to inform the development of a successor plan, the government through the Ministry of Health requested WHO to lead a joint external review of the implementation plan and to assess its impacts on the TB situation in the country. The review was designed to identify successes and best practices to be enhanced and built upon, opportunities to be optimized, gaps to be embraced, and challenges to be addressed.
In response to key knowledge gaps regarding HIV among key populations (KP) in Swaziland and the Ministry of Health's expressed interest in addressing the needs of KP, two complementary research studies were conducted. The first, a quantitative study, was designed to evaluate HIV prevalence among KP in Swaziland and describe behavioral social, and structural factors associated with HIV infection in KP. The specific aims of this study were:
1. To calculate an unbiased estimate of HIV and Syphilis prevalence among FSW and MSM in Swaziland;