INTRODUCTION. Background to the MDGs

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1 INTRODUCTION Background to the MDGs In 2000, the Kingdom of Swaziland signed the United Nations Millennium Declaration and in so doing, embraced the Millennium Development Goals (MDGs) thus committing to achieve them by These inter-related and mutually-reinforcing goals are centred on important development priorities pertaining poverty eradication, education, gender equality, health, HIV/AIDS, environmental sustainability, and global partnership for development. From the onset, Swaziland believed that the MDGs are consistent with the country s development imperatives and their achievement would lead to a significant improvement in the welfare of the Swazi people. In practice, throughout the era of the MDGs, the country remained fully committed and exerted concerted efforts towards fulfilling this pledge. The Country s Platform for Development Swaziland s development process is guided by the National Development Strategy (NDS) and the Poverty Reduction Strategy and Action Programme (PRSAP), both of which complement the development ideals of the MDGs. The NDS was formulated in 1997 and encompasses the country s long-term vision of being among the top 10 percent of Medium Human Development Countries by The PRSAP, officially launched in 2008, kicked started the NDS and is assumed to be the strategic programme for achieving Vision However, it became imperative for the country to develop an Economic Recovery Strategy (ERS) as a result of the global economic crisis which led to the huge decline in South African Custom Union (SACU) revenue inflows. The ERS does not seek to replace the NDS, PRSAP or the Fiscal Adjustment Roadmap (FAR) but rather complements and supports these and other national frameworks in delivering accelerated socio-economic growth. Furthermore, the NDS is currently reviewed and updated taking into account the various development imperatives and emerging issues of the country within the context of promoting inclusive and sustainable growth and prosperity. Swaziland s 2015 MDG Report To date, Swaziland has developed four consecutive MDG progress reports during the years of 2003, 2007, 2010, and During these reporting periods, significant progress was observed in each succeeding period in almost all the MDGs. In the 2015 terminal report, more progress has been noted and yet the overall performance of the country in terms of achieving the MDGs depicts mixed scenarios. Swaziland Millennium Development Goals 2015 Report Page 1

2 The report highlights a number of important achievements in the country, such as the introduction of the State Funded Primary Education Programme in It however notes the many challenges that tend to deter progress towards the goals, which include slow economic growth and the continued high incidence of HIV/AIDS. It seeks to deepen national understanding of why progress is being made in some MDG indicators but not in others, and proposes the means for advancement. In this way, the report serves as a key document for stakeholders to continue expediting actions particularly in the Post-2015 development agenda. The Report-Writing Process The report writing process involved a number of stages, the first being the establishment and restrengthening of MDG Technical Writing Teams (TWTs). Members of the MDG TWTs were drawn from all stakeholders, which include, Government of Swaziland, NGOs, civil society, private sector, donor community, and development partners. After the establishment of the MDG TWTs, a series of orientation workshops were held to formally launch the 2015 report development process. This was followed by data collections and consultations with stakeholders led by the MDG TWT. This process culminated in the production of a first draft MDG report which served as the basis for further stakeholder discussions. This final report is a product of a validation workshop in which all stakeholders participated and further endorsed. Organisation of the Report The report is organised according to the UN guidelines on MDG country reports. It begins with a 2015 MDG Status and trends. This presents the baseline for each of the MDGs and the terminal status as of the end of It also presents all the eight MDGs, together with their targets and indicators as well as progress made at the end of 2015.This is followed by the inequality analysis of each MDG, the supportive environment that existed towards the achievement of the goals, as well as key bottlenecks constraining progress and how the country tried to address them. Swaziland Millennium Development Goals 2015 Report Page 2

3 MDG 1: ERADICATE EXTREME POVERTY AND HUNGER Table 1.1 Status and Trends MDG INDICATORS BASELINE FIGURE STATUS IN 2012 STATUS IN TARGET STATUS AT GLANCE TARGET 1.A HALVE, BETWEEN 1990 AND 2015, THE PROPORTION OF PEOPLE WHOSE INCOME IS LESS THAN ONE DOLLAR A DAY 1.1 Poverty Head Count Ratio (2001) (2010) 1.2 Poverty Gap Ratio (2001) (2010) 1.3 Share of Poorest Quintile in National Consumption 4.3 (2000) 1.39 (2010) - 8 TARGET 1B ACHIEVE FULL AND PRODUCTION EMPLOYMENT AND DECENT WORK FOR ALL, INCLUDING WOMEN AND YOUNG PEOPLE 1.5 Employment to population ratio (2007) (2010) (2013) 1.6 Proportion of employed people living below the poverty line 49.5 (2007) 37.4 (2010) Proportion of own account and contributing family 12.2 (2007) 12.1 (2010) 11.2 (2013) - TARGET 1C HALVE, BETWEEN 1990 AND 2015, THE PROPORTION OF PEOPLE WHO SUFFER FROM HUNGER 1.8 Prevalence of underweight Children under five years of age 1.9 Proportion of the population below minimum Level of Dietary Energy Consumption 11 (1990) 5.8 (2010) 5.8 (2014) 5 Proxy indicators; 1.9a. Maize Production (Mt) 68,565 81,934 99, , b. Food Deficit population (2004) 160,989 (2012) 289,920 (2014) 200,065 - (2009) (2012) (2014) Swaziland Millennium Development Goals 2015 Report Page 3

4 Percentage TARGET 1.A HALVE, BETWEEN 1990 AND 2015, THE PROPORTION OF PEOPLE WHOSE INCOME IS LESS THAN ONE DOLLAR A DAY Indicator 1.1: Proportion of the population below the national poverty line. Proportion of the population below the National Poverty line is the percentage of population living on less that US$ 1 a day. The US$1 a day poverty line is compared to consumption or income per person and includes consumption from own production and income in kind. In Swaziland, the prevalence of poverty as measured by the proportion of population living below the poverty line (US$1) increased from 66 percent in 1995 to 69 percent in 2000, (CSO; SHIES, 2001). A decline of 6 percent to 63 percent was observed during the period 2000/01 to 2009/10. The country was unable to conduct a study to determine any changes in the state of poverty between 2010 and The prevalence is more pronounced in rural areas than the urban at 73 percentin The Shiselweni Region is still the poorest although it recorded the highest levels of decline during the perion under review. Figure 1.1 shows that the country has begun a downward trend towards the target but the decline is still minimal. Figure 1.1: Poverty Headcount Ratio National Rural Urban Hhohho Manzini Shiselweni Lubombo Source: CSO; SHIES (2010) Swaziland Millennium Development Goals 2015 Report Page 4

5 Indicator 1.2: Poverty gap ratio The Poverty Gap Ratio (PGR) is the proportion by which the average consumption level of the poor households fall below the poverty line. The indicator measures the poverty deficit of the entire population where the poverty deficit is the per capita amount of resources that would be needed to bring all poor people above the poverty line. In 2001 the PGR was 32.4 percent reflecting a high rate relative to the population size of the country. On the other hand, in 2010 there was a reduction to 30.4 percent indicating a more than 10 percent decline in urban areas from 20 percent to 10.3 percent whilst an improvement of 0.2 percent in rural areas from 37 to 37.2 percent (CSO; SHIES, 2010). This shows that the country still needs to inject more resourcs to uplift the poor to above the poverty line. Indicator 1.3: Share of poorest quintile in national consumption The share of the poorest quintile in national consumption is the income that accrues to the poorest fifth of the population. The consumption of the poorest fifth is expressed as a percentage of total household consumption (or income) and it gives a relative inequality measure. The poorest quintile consumed 4.3 percent of the country s total consumption in 2001, which further declined to 1.4 percent in This indicates a worse-off situation for the poor and this makes them unable to make meaningful contribution to economic growth. The richest quintile is consuming more than half of national income thus widening the income inequality in the country. TARGET 1B: ACHIEVE FULL AND PRODUCTIVE EMPLOYMENT AND DECENT WORK FOR ALL, INCLUDING WOMEN AND YOUNG PEOPLE Indicator 1.5: Employment to population ratio The employment to population ratio is the proportion of the country s working age population that is employed. The ratio shows a fluctuating situation in the country (Figure 1.2), indicating that more employment creating initiatives still need to be put in place. An improvement of 3.6 percent was observed from 2007 to 2010 (from 37.2 to 33.6 percent). However the increase to 36.2 in 2014 indicates a worsening situation as more people of working age are unemployed. Urban areas show high levels of the working age population that is employed compared with the rural areas with 54.4 percent observed in All regions recorded rates of above 30 percent except for the Shiselweni Region with the highest of 28 percent in Swaziland Millennium Development Goals 2015 Report Page 5

6 Percent Figure 1.2: Employment to Population Ratio National Rural Urban Hhohho Manzini Shiselweni Lubombo Source: LFS, 2013, (MoLSS) Indicator 1.6: Proportion of employed people living below $1 per day The proportion of employed people living below the poverty line is the percentage of employed people living below the poverty line, sometimes referred to as the working poor. According to the Labour Force Survey (LFS) of 2010, the country attained a positive trend between 2007 and 2010 decreasing from 49.5 to 37.4% Indicator 1.7: Proportion of own-account and contributing family workers in total employment This indicator is sometimes referred to as vulnerable employment rate. It is the rate of selfemployed workers and the relatives of the self-employed working in the establishment. Figure 1.3 below shows a steady trend around 12 percent (2007 and 2010) and improved to 18.6 percent in This means that this kind of employment is not mostly pronounced in the country given its low contribution to employment. It is mostly the females that are gainfully employed within this sector with the levels of 15.3 percent observed in On the other hand, the rural areas show high employment rates of around 14 percent while the Manzini Region provides more opportunities than the others. Swaziland Millennium Development Goals 2015 Report Page 6

7 Percent Figure 1.3: Proportion of Own-account and Contributing Family Workers in Total Employment National Male Female Rural Urban Hhohho Manzini Shiselweni Lubombo TARGET 1 C: HALVE, BETWEEN 1990 AND 2015 THE PROPORTION OF PEOPLE FOR SUFFER FROM HUNGER Indicators 1.8: Prevalence of underweight children under five years of age. Prevalence of underweight children under five years of age is defined as the percentage of children whose weight for their age is less than minus two standard deviations from the median for the international reference population aged 0 to 59 months. Figure 1.4 shows that the rate of underweight improved from 9.6 percent in 2000 to 5.4 percent in However for the periods 2010 and 2014 the rate has remained the same at 5.8 percent resulting in only a 0.8% away from reaching the target of 5percent. Swaziland Millennium Development Goals 2015 Report Page 7

8 Figure 1.4: Prevalence of underweight children under five years of age. Source MICS 2000, 2010 and 2014, SDHS 2007 Wasting is still less than 5%, which is at normal level according to WHO standards and stunting remains high even though the results show a decline from 31% (2010) to 25.5% (2014). Indicator 1.9: Proportion of population below minimum level of dietary energy consumption The proportion of population below minimum level of dietary energy consumption is defined as the percentage of the population whose food intake falls below the minimum level of dietary energy requirement of 2100 kilocalories per person per day. Maize is the staple food crop for the country and its level of production is used as a measure of food availability or as a proxy indicator. Food production for the country increased from 68, 565mt in 2004/5 to 70, 065mt in 2008/9. A futher improvement was realised in production year 2012/13 where total production reached 81,934mt and the 2013/14 production reached the highest level of 101,041mt against a Gross Domestic requirement of 118,000mt (MOA, Food Balance Sheet 2014/5). The shortage of maize, which is a staple food, leads to an increase in the population that falls below minimum level of dietary energy consumption. Swaziland Millennium Development Goals 2015 Report Page 8

9 Metric Tones Figure 1.5: National Maize Production by 000 Metric Tonnes 120, ,000 80,000 60,000 40,000 20, /5 2008/9 2012/ / /15 National 68,565 70,067 81, ,041 99,162 Source: MOA (Food Balance Sheet), National Agricultural Survey Maize prices are used as a measure of food access in the country and this is an indication of whether households will be able to meet their food needs. Figure 1.5 shows the trend in maize prices per tonne from 2007 to A sharp increase was observed between the periods 2010 and 2012 due to high shortages in domestic production. This allows for market forces to be at play as high demand triggers high prices given limited supply. While high prices made people struggle to purchase the staple food they needed, it is important to note that the farmers who managed to grow enough and were able to sell surplus benefited from this price increase and this could have improved their household income and livelihoods. Food Deficit Population Figure 1.6 reveals that food deficit populations have been fluctuating over the years from about 161,000mt reaching high levels of about 290,000mt (Swazi VAC, 2014). This indicates that more people are unable to meet their daily food needs, the kl2100 per day. There are many factors that have contributed to these levels of population at risk, they include the effect of climate change which has led to unusual seasonal patterns affecting crop production negatively. Swaziland Millennium Development Goals 2015 Report Page 9

10 Population Figure 1.6 Food Deficit Populations / / / / /14 Population Source: DPM; SVAC, (2014) COUNTRY SPECIFIC INDICATORS Indicator 1.10 Economic dependency ratio The Economic Dependency Ratio (EDR) is the ratio of the total employed expressed as a percentage of the total popultion. The EDR is high in the country as total labour force in gainful employment is far less than the burden of people dependent on them. In other words, there are many people in the country that are dependant on the few people that are in employment drawing them below the poverty line. This is shown by the existence of a high percentage of the working poor, which are the people in employment but due to a lot of people dependent on them, they cannot meet their basic needs. According to the 2007 LFS, 19 economically inactive people are dependent on 10 economically active individuals compared to the 2010 levels of 23 economically inactive persons per 10 economically active individuals. Indicator 1.11 Income gap ratio The Income Gap Ratio (IGR) is the proportion by which the average income level of the poor falls below the poverty line. The average consumption among the poor in 2009/10 was 48.4 percent below the poverty line of which 50.5 percent are in rural areas compared to 33.1 percent in urban areas. On the other hand, the 2001 SHIES Report indicated that IGR was 46.9 percent nationally with urban and rural areas having 35.2 and 48.7 percent, respectively. Swaziland Millennium Development Goals 2015 Report Page 10

11 Percent Indicator 1.12 Gini coefficient The Gini Coefficient is the extent to which income distribution deviates from a perfectly normal distribution within the country. According to the SHIES report, the coefficient increased from 0.48 in 2007 to 0.51 in The inequality is most pronounced within the males than females at 50.4 percent and slightly high in rural areas than the urban. Hhohho Region shows high levels of inequality in 2010, at 53.2 percent, than the rest although it is a decline from This means that the country has higher income inequality given that the internationally acceptable level is 0.3 percent. Figure 1.7: Gini Coefficient National Male Female Rural Urban Hhohho Manzini Source: LFS 2007, 2010 Shiselwen i Lubombo Indicator 1.13 Extreme poverty incidence Extreme Poverty Incidence or food poverty is the proportion of the population that is unable to meet its daily nutritional requirement of 2100 kcl. According to the SHIES 2010, the incidence stood at 30 percent in 2001 and declined to 29% in A significant improvement has been observed in the Shiselweni Region and the opposite is true for the Lubombo Region. One in two people who are poor in the country also suffer from food poverty. Indicator 1.14 Labour underutilization Labour under-utilisation is defined based on three categories, the strictly unemployed, the discouraged and hours worked. A declining trend is observed for the period under review from 47.2 percent in 2007 to 29.1 percent in Swaziland Millennium Development Goals 2015 Report Page 11

12 Percentage Figure 1.8 shows a high rate of 48 percent of the labour force that is underulitized with a trifling reduction in 2010 to 45 percent. This is a very high rate for a country with a population of just above a million and producing over 2000 graduates every year. Figure 1.8: Labour Underutilization National Male Female Rural Urban Hhohho Manzini Source: MOLSS; LFS (2007& 2010)\ Indicator 1.15 Youth Unemployment Shiselwe ni Lubombo Youth unemployment is defined as the number of youth aged between 15 and 24 who are without a job and who are available for a job. Unemployment among the youth in the country shows a fluctuating trend during the period under review with a high of 53.3 percent in 2007 declining to 51.6 percent in The urban areas show high levels of youth unemployment with 56.7 percent observed in The females have less employment opportunities than the males at 65.3 percent in The Shiselweni Region leads the rest with the highest rate of 61.2 in The country is a youth population based with the majority of its citizens resident in the rural areas, youth focused investments are a priority. Swaziland Millennium Development Goals 2015 Report Page 12

13 Percent Figure 1.9: Youth Unemployment National Rural Urban Male Female Hhohho Manzini Shiselwe ni Lubombo Sources: MoLS LFS 2007, 2010, 2013 INEQUALITY ANALYSIS Poverty incidence is higher in rural areas than in urban areas in the country. The Lubombo and Shiselweni Regions remain the poorest and as such, there is need to prioritise and channel development interventions towards them.. Table 1.2 Proportion of Population Below $1 per Day by Administrative Region Year Hhohho Manzini Shiselweni Lubombo National Source: CSO; SHIES (2010) Food security remains a challenge in the country with the Lubombo Region showing the highest number of people (33,111) classified as vulnerable to food insecurity (DPM;SVAC, 2011). Consequently interventions towards achieving food security should be selective and should target the two regions. Swaziland Millennium Development Goals 2015 Report Page 13

14 Table 1.3 Populations Vulnerable to Food Insecurity by Administrative Region Year Hhohho Manzini Shiselweni Lubombo National ,781 4,507 6, ,111 55, ,217 34,167 25,368 63, , , , , , Source: DPM; SVAC ( ) The Lubombo and Shiselweni Regions are still the lowest maize producing regions in the country. Yet maize is the staple crop. There is therefore a need to introduce diversification of crop production in the two regions to meet household food needs. Briefly; The country is doing very well on the control of prevalence of underweight children. However, stunting still presents chronic malnutrition which posses a threat to future populations. Youth unemployment remains a challenge in the country and the fact that most of the coutry s population is young calls for increased initiatives that target the youth. The country has a huge income inequality gap, indicating that an extremely rich population coexists with an extremely poor population. Therefore there is a need to bridge this gap. There is a large labour force in the country but its utilization is limited. Therefore employment creation initiatives have to be prioritised. The share of the poorest quintile in national consupmtion continues to decline as less income accrues to the poor. ACHIEVEMENTS Introduction of the National Child Immunization Program Establishment of the Youth Enterprise Fund Establishment of the Regional Development Fund Establishment of the Poverty Reduction Fund Establishment of the subsidies farming inputs program (tractor hire, seeds, fertilizers, insectside, lime) Introduction of the social safety nets (eldely, OVC, disabled grants). SUPPORTIVE ENVIRONMENT Over the past five years, Swaziland has implemented the high impact child survival interventions and has reported equitable access and uptake of all vaccinations including measles for under-five children as well as Vitamin A supplementation. Other interventions that are implemented by the country at community level include awareness Swaziland Millennium Development Goals 2015 Report Page 14

15 campaigns on food diversification as well as home management, food preparation, preservation and processing. The aim of these interventions is to ensure availability and utilization of food at household level to improve the health and nutrition status in the country. Interventions to address food insecurity among poor and vulnerable households have included food assistance and recovery strategies by humanitarian organizations. Though not sustainable, food assistance has saved the lives of many people and provided a platform for the development of resilience mechanisms. A number of sectoral policies aligned to the national development policy framework have been developed to enhance the implementation of programmes targeted at reducing poverty and hunger in line with the MDG targets. One of the policies is the Comprehensive Agriculture Sector Policy (CASP). The policy focuses on the contribution of the agricultural sector to the realization of the country s Vision 2022 and to the achievement of national development goals. Commitment to resource allocation and fiscal discipline is key to achievement of the set targets. The regional and international protocols such as the Maputo Declaration on Food Security in 2003 and the Abuja Declaration on Health in 2001, which encourage national governments to dedicate 10% and 15% respectively of their national budgets to these sectors are other guiding principles. The availability of technical capacity within various institutions (both government and non government) is another major resource that is essential for the implementation of planned programmes. Establishment of institutions like Swaziland Investment Promotion Authority (SIPA) creates a condusive environment to attract investors into the coutry to create the much needed employment opportunities. The process of finalising the Land Policy is on-going and has reached advanced levels. Water resources availability for productive use is prioritised. In the Water Act, 2003, water for primary purposes is made available witout the need to apply for a water permit. Existance of the National Nutrition Council wich monitors nurition status of children in the coutry. KEY BOTTLENECKS CONSTRAINING PROGRESS AND HOW TO ADDRESS THEM There is need to build capacity at national level for a coordinated approach in the fight against poverty. The unfavourable terms for agricultural credit particulalry for commodities that do not have very organized marketing channels are bottlenecks. The high risk associated with agricultural production is also a major limitation in enhancing the sector s contribution to job creation and economic growth. Diminishing foreign direct investment (FDI) has resulted in reduced employment opportunities. Swaziland Millennium Development Goals 2015 Report Page 15

16 The small size of the economy and the inability of the labour market to absorb available human resource in the country constitute major constraints to development. HOW SWAZILAND WILL ACCELERATE PROGRESS IN ACHIEVING THIS MDG Co-ordinated implementation of the poverty focused initiatives and the other sector development policies. Attain high priority to agriculture by allocating resources and by encouraging private sector including civil society and other agencies to invest in the sector. Full implementation of employment creation initiatives, the Investor Road Map and allocating resources for the implementation of the Economic Recovery Strategy (ERS). Swaziland Millennium Development Goals 2015 Report Page 16

17 MDG 2: ACHIEVE UNIVERSAL PRIMARY EDUCATION In recent years, Swaziland has taken huge strides towards achieving universal primary education. The progress achieved by the country under this goal at a glance is presented in table 2.1 below: Table 2.1: Status and Trend BASE MDG LINE INDICATORS FIGU RE PROGRESS ACHIEVED BY 2010 (OR NEAREST YEAR) PROGRE SS ACHIEV ED BY 2011 PROGR ESS ACHIE VED BY 2012 PROGR ESS ACHIE VED BY TARGE T STATUS AT A GLANC E TARGET 2A: ENSURE THAT, BY 2015, ALL BOYS AND GIRLS COMPLETE A FULL COURSE OF PRIMARY SCHOOLING 2.1 Net Enrolment Ratio in Primary Education (MDG Indicator) 2.2 Proportion of Pupils Starting Grade 1 who Reach Last Grade of Primary (%) (MDG Indicator) 2.3 Literacy Rate of Year-Olds, Women and Men (%) (MDG Indicator) 2.4 Primary School Repetition Rate (%) (Country-Specific) 79.2 (2000) 59.8 (2007) 83.7 (1986) 16.5 (2000) 92.0 (2010) 73.9 (2010) 95.4 (2007) 16.0 (2010) 93.5 (2011) 73 (2011) 15.0 (2011) 95.6 (2012) 76.4 (2012) 16.0 (2012) 97.7 * (2015) 77.9 *(2014) 94.3 (2014) 14.5% *(2015) Source: Education Statistics ; Free Primary Education Handbook 2008; EMIS Survey Report 2008; Annual Education Census Report 2009, 2010, 2011 & 2012; Calculated from Swaziland Population Projections MICS * Indicates projections. Swaziland Millennium Development Goals 2015 Report Page 17

18 TARGET 2A: ENSURE THAT, BY 2015, ALL BOYS AND GIRLS COMPLETE A FULL COURSE OF PRIMARY SCHOOLING Despite the progress made, this goal has not been achieved. Still, a lot needs to be done in order for this crucial development goal to be fully achieved. Indicator 2.1 Net Enrolment Ratio (NER) at primary school The Net Enrolment Ratio (NER) is the number of children that are of official primary school-age and enrolled in primary school over the total population of children of official primary schoolage (UNESCO, 2012). Data for this indicator is presented in table 2.2 below. The data for this indicator is further broken down and desegregated by enrolment at national level (Figure 2.1) and by regions (Figure 2.2). Table 2.2: Trends in Primary School Enrolment and Net Enrolment Ratio, Year Primary School Enrolment Net Enrolment Ratio Boys Girls Total * Source: Education Statistics ; Free Primary Education Handbook 2008; EMIS Survey Report 2008; Annual Education Census Report 2009, 2010, 2011 & 2012 & 2013; Calculated from Swaziland Population Projections * Indicates projections. Swaziland Millennium Development Goals 2015 Report Page 18

19 Axis Title Figure 2.1: Primary School Enrolment at National Level Source: AEC Report, 2012 *projection *2015 Students Table 2.2 and Figure 2.1 indicate that both primary school enrolment and the Net Enrolment Ratio have increased significantly since The Net Enrolment Ratio increased from 72.1% to 97.7% between 2002 and 2015; respectively. The increase in primary school enrolment is a particularly impressive achievement given the decrease in the primary school-aged population between 1997 and 2010 (Swaziland Population and Housing Census [SPHC] 1997 & Swaziland Population Projections ). The increase in the net enrolment rate is a reflection of increasing efforts by the Government of Swaziland to ensure that all children have access to education irrespective of their socio-economic status. Net enrolment rates increased steadily from 2000; however, the impact of the FPE was witnessed between 2009 and The significant increase in 2009 was because the new Constitution of the country had indicated that education will be free by The communities anticipating this began enrolling their children in Government at the time could not introduce the programme but only did so in 2010 in grades 1 and 2. A gross enrolment rate of above 100% is a strong indicator that Government had created enough capacity for its primary aged population. Also Net enrolment rates improved over the same period from 72.1% in 2000 to an estimated 97.7% in This was largely due to the investments made in primary levels in the form of free textbooks, free stationery and an average capitation grant of E560 (US $80) per child at primary level. What is observed is that although boys participated more efficiently in the past, girls had taken over as their net enrolment figures rose above that of boys in 2009 and have Swaziland Millennium Development Goals 2015 Report Page 19

20 remained higher since then. The impact of the FPE can be observed in the increase in primary enrolment, which increased from in 2009 to in 2012 and is projected to be at in The system suffered a shock between 2009 and 2010 which was due to an increased demand for education. Figure 2.2 shows the primary enrolment by the different regions of Swaziland. Relatively, Manzini has the highest number of primary enrolment when seen from a regional perspective. This may be attributed to the fact that the Manzini Region has the highest number of schools and it is also a central place in the country. Figure 2.2: Primary Enrolment by Regions Hhohho Manzini Shiselweni Lubombo Source: AEC Report, 2012 This widening of access to primary education began in 2002 with the introduction of the Orphaned and Vulnerable Children (OVC) initiative, which entails the Government providing bursaries to OVC in order to make school more affordable for them. Funding for the OVC initiative has increased substantially since its inception - rising from E20.6 million in 2004/05 to E170.5 million in 2014/15 (Government of Swaziland Estimates). The OVC fund together with the Free Primary Education (FPE) grant has contributed to the increased participation of Orphaned and Vulnerable Children (OVCs) at primary school level. The table below shows the amount of money that was paid by government for OVC s from Swaziland Millennium Development Goals 2015 Report Page 20

21 Table 2.3: Number of OVCs and School Fee Payments from (Emalangeni): NUMBER OF OVC'S AND SCHOOL FEE PAYMENTS ( ): PERIOD NUMBER OF TOTAL OVC EXAMINATION GRANT OVCs FEES FEE TOTAL 2009/ ,706 98,720, ,137 98,968, / , ,703,664 21,637, ,341, / , ,340,405 22,464, ,804, / , ,320,376 20,852, ,173, / , ,646,523 26,187, ,834, / , ,621,383 30,556, ,177,779 Source: Deputy Prime Minister s Office, Social Welfare, To further improve access to, and the quality of, primary education, feeding schemes have been introduced and stationery (text books and exercise books) are now free in primary schools. A Care and Support for Teaching and Learning (CSTL) Programme has also been initiated to enhance both enrolment and retention. The Government of Swaziland is receiving support in the implementation of the Free Primary Education programme from the European Union Support to Education Programme (EU-SET) through the payment of fees for all pupils enrolling in Grade 1. A major milestone was recorded in 2010 with the launch of the State Funded Primary Education Programme which has been implemented in phases with one grade being incorporated each year. The introduction of the State Funded Primary Education Programme was facilitated through a provision in the Constitution of Swaziland which makes primary education a right for every child, compulsory and free. The programme is commonly referred to as the Free Primary Education (FPE) Programme. The introduction of the FPE programme saw Government absorbing the financial costs of primary education. Swaziland introduced the Free Primary Education Programme (FPE) in 2010 in Grades 1 and 2. This was brought about by the Constitution which declared primary education a right. The FPE Act adjusted the entry requirement from age 6, to a range of 6 9 years for Grade 1 to allow for older children to enrol. The apparent intake rate fluctuated during the period between a low of 94.5% in 1999 to a high of percent in It dropped a bit in 2009 only to increase to a high of percent in 2010 the year the implementation of the FPE programme commenced. This might have been due to the high demand for education that was created by the declaration of the state funded free primary education programme. On average, more boys seem to benefit at primary levels than girls. Swaziland Millennium Development Goals 2015 Report Page 21

22 Figure 2.3: Intake Rates Primary Level male female male female Source: AEC Report, 2012 When Government introduced the FPE programme a number of communities enrolled some marginalized children (poor, vulnerable and orphans) some who were above the official age. Since Government also set the maximum entry age limits to 9, some communities then delayed those aged six for the older to benefit from the programme, this may be the reason why from 2010 the rate increased as more over aged children enrolled. What was also observed after the Ministry of Education introduced the FPE programme was a sudden drop in Net Intake rates. This was to a large extent due to the fact that the appropriately aged were held back for the marginalized to enrol. Another fact is that when the programme was introduced due to the demand for education some school community only enrolled children who had reached age 6 by the beginning of the term. This is witnessed in the age profile of Grade1 children where the majority of learners are aged 7 (See Table 2.4 below). Swaziland Millennium Development Goals 2015 Report Page 22

23 Table 2.4: New Entrants to Grade 1 (2012) Age Total Female 65 5,573 7,531 1, ,831 Male 71 5,458 8,097 1, ,745 Total ,031 15,628 2, ,576 Source: AEC Report, 2012 This initiative may have affected the indicators in 2010 and after because the education system was not behaving normal due to FPE. Some children who had never attended schools got the opportunity to enrol in school, and it can be observed that the prescribed age limit of 9 years was not observed. In most cases children aged 10 years and above blocked spaces of the appropriately aged. The Net intake rates after the declaration of FPE dropped to an average of about 40 percent. This meant that most of the grade 1 learners were over the age of 6, the official age at this level of education. Intake rates also imply some policy shifts. Swaziland witnessed an increase in Early Childhood Care and Development Education (ECCDE) centres during the same period a factor which influenced some primary schools to begin demanding a child to possess a pre-primary experience before they enrolled them. As a consequence, some children could have spent an additional year in such centres before enrolling. This is also driven by the quest to enrol children in the schools of choice, which had upped their entry requirements despite the policy of the Ministry suggesting the opposite. The Government of Swaziland continued to make substantial investments in primary education in the form of free text books, exercise books and stationery, school infrastructure and facilities as well as the capitation grants per child that varies from one grade to the other. The programme started with grade 1 and 2 in 2010 and was rolled out to higher grades gradually. The system suffered a shock between 2009 and 2010 which was due to an increased demand for education. The primary net enrolment ratio increased significantly as over children who were previously without access to primary education were enrolled in Grades 1 and 2. The Programme has since been rolled out to grade 3, 4, 5 and 6 in 2011, 2012, 2013 and 2014 respectively. In 2015, the programme reached Grade 7 meaning that primary education is now 100% funded by the state. What has been observed is that although boys participated more efficiently in the past, girls had taken over as their net enrolment figures rose above that of boys in 2009 and have remained higher ever since. Swaziland Millennium Development Goals 2015 Report Page 23

24 Challenges The increase in the Net Enrolment Ratio from 72.1% in 2002 to 95.6% in 2012 is a very laudable achievement. However, this still implies that slightly less than 5% of children of primary schoolage were not in school in The demand for education due to the FPE also led to some schools adjusting the Ministry of Education and Training (MOET) policy for entry age into Grade 1. The requirement for a child to have reached 6 years on the first day of school denied a lot of children the opportunity to start on time, hence in Grade 1 it has been observed that the majority of children are aged 7. The children who are aged six, after being denied entry were forced to stay at home, some continued enrolling in non - formal ECCDE sites (neighbourhood care points (NCPs)) and preschools. Indicator 2.2; the proportion of pupils starting grade 1 who reach the last grade of primary school Indicators suggest that Swaziland is on track to achieve universal access to primary education. Achievement of access is but one aspect of the progress, there was need to ensure that all children reach the end of primary education. The above mentioned indicator which is sometimes referred to as the Survival rate for the primary education levels improved over the reporting period. In 2006/2007 the survival rate was about 59.3 percent, it increased to 76.4% in 2012, suggesting that more children stayed on to complete primary education. This is an improvement, which implied that more children are being retained by the system. The improvement in the survival rates is likely to be a result of the abolishment of fees at this level which have contributed significantly in retaining pupils in the school system particularly those from poor socio- economic backgrounds. The progress made by Swaziland between 2000 and 2012 in terms of improving the proportion of children who started Grade 1 and reached Grade 7, having not repeated more than twice, is presented in Figure 2.4. Figure 2.4: Proportion of Children Starting Grade 1 Who Reach Grade 7, Those who repeated no more than two times 2000/ / / 2003 Source: Annual Education Census Reports ( ), EMIS Department (Ministry of Education & Training); Swaziland MDG Report 2007, 2010 and 2012 * Projection Swaziland Millennium Development Goals 2015 Report Page / / / / / / 2012 *2013 /

25 As partially indicated above, beyond the progress made to achieve universal access, there was need to ensure that all children reach the end of primary education. Survival rates at primary levels suggested that repetition and dropout may have still pushed some of the children out of the system. The Ministry s policy is that children may not repeat a grade more than twice. The survival rate at primary school level in 2012 can be seen in Table 2.5. Table 2.5: Survival Rate 2012 Gender Grade 1 Grade 2 Grade 3 Grade 4 Grade 5 Grade 6 Grade 7 Female 100.0% 97.4% 97.2% 93.8% 93.6% 90.5% 78.3% Male 100.0% 97.5% 96.5% 95.4% 92.2% 87.1% 73.7% Total 100.0% 97.5% 98.2% 95.2% 93.5% 89.4% 76.4% Source: AEC, 2012 At Grade 7 children in the country sit for an external examination, the Swaziland Primary Certificate. The exam has to a great extent influenced the number of children who complete primary education and transition to secondary education. The transition rates have been above 90%, which suggested that most of our primary level graduates reach Form 1. Challenges The figure of 76.4 % is likely to be overstated since they capture children who have re-entered (as well as entered) primary education following the advent of state funded primary education in It also suggested that repetition and dropout may have still pushed some of the children out of the system. The Ministry s policy is that children may not repeat a grade more than twice. The retention of pupils in the primary education system is a serious challenge. Such a low figure (76.4%) can be explained by the country s high repetition rate and high dropout rate. Repetition has remained above the official rate of 10% over the last five years. The repetition rate improved slightly from 13.80% to 12.90% between 2010 and 2012 (AEC Report, 2012). The overall dropout rate as stated in the 2012 Annual Education Census report is decreasing gradually. According to this report, it declined from 3.89% in 2011 to 1.12% in Such high levels of dropout, as well as repetition, have long been a feature of the primary education system in the country and are unacceptable. A deeper analysis of dropouts reveals that sickness, death, pregnancy, school fees, abscondment, family reasons, and disciplinary factors are all contributing factors. Projections from the Ministry of Economic Planning and Development s long-term forecasting model, Swaziland Threshold 21, indicate that the proportion of pupils who start grade 1 and reach grade 7 will remain low for the foreseeable future if no policy interventions are made to address the challenges. Despite the introduction of state funded primary education programme, pupils continue to face the financial challenge which prevents them from accessing primary education. Most primary schools find it difficult to sustain their operations throughout the school calendar with the grant provided by the Government. This has unfortunately led to a phenomenon where schools are now charging a top-up fee. This has created problems for Government because not all pupils Swaziland Millennium Development Goals 2015 Report Page 25

26 can afford to pay the top- up fees. Pupils who fail to pay the top-up fees are eventually forced out of the school system. Government is already working towards addressing this issue. Indicator 2.3: Literacy rate of 15 to 24 year olds The literacy rate of 15 to 24 year olds - also termed the youth literacy rate - is the percentage of the population aged 15 to 24 years who can read and write, a short simple statement in any language with understanding. Table 2.6 indicates that literacy rates for 15 to 24 year olds have risen steadily over the past two decades. The youth literacy rate increased from 83.7 percent in 1986 to 91.7 percent in 1997 before further improving to 95.4 percent in 2007 (CSO,SPHC 1986, 1997 & 2007), But has since remained constant at 95.3% according to the MICS Table 2.6: Literacy Rates of Year Olds, Year % 92.6% 96.1% % 90.7% 94.5% % 91.7% 95.4% 95.3% Source: CSO; SPHC (1986, 1997 & 2007 Vol. 1), MICS 2014 This youth literacy rate of 95.3% is higher than the overall literacy rate in the country, which stood at 89.1 percent in 2007 (CSO; SPHC, 2007). It captures and encapsulates improvements the country has made in terms of education. Youth literacy has the potential to increase further as education becomes more accessible and of better quality. It is important here to not ignore those children and young adults who have altogether missed out on primary education and are now over-aged. Rural education centres need to be adequately supported along with Sebenta which offers non-formal universal primary education (NUPE). Swaziland Millennium Development Goals 2015 Report Page 26

27 Figure 2.6: Literacy Indicator by National, Rural and Urban National Rural Urban National Rural Urban Sources: CSO; SPHC (1986, 1997 & 2007 Vol. 1), MICS 2014 Figure2.7: Literacy Indicator by Region Hhohho Shiselweni Manzini Lubombo Sources: CSO; SPHC (1986, 1997 & 2007 Vol. 1), MICS 2014 Swaziland Millennium Development Goals 2015 Report Page 27

28 Percentage (%) Indicator 2.4 Primary School Repetition Rate (%) The primary school repetition rate can be defined as the proportion of children enrolled in primary school who are studying in the same grade as they were in the previous school year. The Education Policy recommends that a child should not repeat more than two times and the repetition rate at national level should be below 10%. In 2000, the primary school repetition rate was very high at 16.5 percent but it decreased to 15.8% in In 2010 it increased to 16% and then dropped to 15% in In 2012 it rose again to 16%. (Annual Education Census Reports 2009, 2010, 2011 & 2012). Assuming that all policies were well implemented, the projected repetition rate for 2014 decreased to 14.5%. This is shown in figure 2.8. In addition to the personal distress that repetition causes a child, it also results in children eventually dropping out of school, especially for those who repeat regularly. Figure 2.8: Primary School Repetition Rates, *2014 Series Source: Calculated from Education Statistics , EMIS Survey Report 2008 and Annual Education Census Report 2009, & 2012 *Indicates projection. Challenges It has been observed over the reporting period that Grade Repetition rates appear highest in grades 1, 3 and 6 while they have remained lowest in grade 7. The high repetition rate in Grade 1 is worrying. This might be due to the inequity in accessing pre-school education. Some schools might be using preschool attendance as a standard for passing Grade 1. This suggests a need for all children to have exposure to Early Childhood Care and Education (ECCE) programmes so as to level the playing field. This repetition phenomenon that occurs at Grade 6 is likely to be a result of the external examinations administered at Grade 7 which is used to determine access to a higher level of Swaziland Millennium Development Goals 2015 Report Page 28

29 Axis Title education. Schools have a tendency of making children repeat Grade six not because they have failed but they are not good enough to get excellent results that would make the school shine when the Grade 7 external examination results are released. This negates the whole purpose of education. As a result, the average performing pupil ends up spending two years preparing to pass an external exam. It is also not an abnormal occurrence to find that there are children who have repeated more than twice within their primary education life (before Grade 7). The lack of implementation of a national policy on repetition may also suggest that a child could repeat all the Grades. In some cases this could explain why there are so many over aged children at the basic education levels. It is currently estimated that it takes an average child more than 11 years to complete the 7-year primary education cycle. This demands a rethink on Repetition Policy in the country s education system. In addition to this, it has been observed that the repetition rate for boys is relatively higher than that of girls and more boys are not within the official age limit than girls. This suggests that there is need to improve on the internal efficiency measures for boys. Over the past decade, little progress has been made in reducing repetition rates which have always been above 15 percent, and this contributed to waste in terms of educational resources. There is need for the country to revisit the issue of repetition and how this affects survival rates and the achievement of universal primary education. Country Specific Indicators Indicator 2.5 on Primary School Completion Rates/Gross Primary Graduation Rate (GPGR) Figure 2.9: Gross Primary Graduation Rate (GPGR) 90.00% 88.00% 86.00% 84.00% 82.00% 80.00% 78.00% 76.00% Females 80.40% 86.40% 86.50% 88.20% Male 85.60% 88.30% 88.10% 87.90% Total 82.90% 87.30% 87.30% 88.10% Sources: AEC, 2012 Swaziland Millennium Development Goals 2015 Report Page 29

30 GPGR indicates the level of primary graduation, where graduation is reaching the end of the last grade in primary education irrespective of age and whether the child is repeating or not. It is the total number of pupils enrolled in Grade 7, irrespective of age and repetition status expressed as a percentage of the theoretical age at Grade 7. A GPGR of less than 100% may suggest that not all of the 12 year olds are enrolled in Grade 7. This is the case for Swaziland, and because of the over agedness of the pupils, the space is taken over by some pupils who are above 12 years of age. ACHIEVEMENTS Introduction of FPE. Establishment of school feeding schemes. Increase in the school infrastructure. Recruitment of more teachers to improve quality of education. Care and Support for Teaching and Learning (CSTL) Programme. SUPPORTIVE ENVIRONMENT FOR EDUCATION The country s new Constitution provided for free primary education, making it an explicit constitutional right for every Swazi child to go to school. Primary education has become more accessible due to the State Funded Primary Education Programme, which should be extended to all primary grades by Disadvantaged children continue to be supported by the OVC initiative. The country s new Education and Training Sector Policy adopted in April 2011, has made significant contribution towards improving primary education in the country. It has comprehensively addressed prevailing issues in the education and training sector and replaced the out-dated Draft Education Policy of KEY BOTTLENECKS CONSTRAINING PROGRESS AND HOW TO ADDRESS THEM The key bottlenecks that contribute to the underachievement in this MDG are summarized below: Shortage of appropriately qualified teachers: The high demand for the primary education created a need for additional teachers. However, there was a shortage of appropriately qualified teachers. According to the Annual Education Census Report (2010), 25% of the primary school teaching staff was not appropriately qualified to teach at that level. This situation necessitated the deployment of irrelevantly qualified teachers into the primary level, mainly teachers qualified for the secondary level, thus compromising the quality of education. This is because in Swaziland secondary level teachers sometimes take a single major and cannot offer all the subjects like primary trained teachers, regrettably they do not possess the pedagogy to teach young children yet even skills are needed to teach children between the ages 6 to 18 years in one class in some cases. Charging of top-up fees: As government took over the payment of fees, schools income gradually declined in some schools which were previously charging above the government Swaziland Millennium Development Goals 2015 Report Page 30

31 approved grant per learner. This has unfortunately led to a phenomenon where schools are now charging a top-up fee alleging that the government grant is not sufficient enough to run the school costs. This has created problems for government as those marginalized children who had entered under the FPE are gradually being forced out of the system by the charging of top-up fees which are most of the time high and unaffordable. However, the government is looking into these issues with the view of obtaining a lasting solution that will make education fees reasonable to both the learner and the schools thus making education free and accessible to all. None adherence to policy on repetition, admission by schools: There is a high repetition rate at primary level which counters the effectiveness of the FPE programme. In 2012, there were about learners repeating and these represented 16% of the total enrolment which is a waste. The Ministry is working on finding out what are the causes of such high repetition rate in the country. Mainstreaming Special Education needs: A majority of teachers in primary schools are still not capacitated to support learners with special needs. Furthermore, the teaching and learning material and equipment is still not enough to cater for all the learners enrolled. Infrastructure disparity: The disparities between the rural and urban schools cause rural urban migration. Many people end up leaving the rural areas because they want to go and learn in good schools to get better education, thus shifting from the rural areas and causing congestion in the urban areas. This usually leads to high teacher to pupil ratio in urban schools to the extent of 1:60. HOW SWAZILAND WILL ACCELERATE PROGRESS IN THIS MDG Strengthen in-service capacity building for teachers on special needs and inclusive education. Address the issue of proper deployment of teachers for primary schools. Develop infrastructure in schools that are not well resourced and this will lead to reduction of rural urban migration Review the FPE grant and standardize the school fee structure. Develop strategies to ensure adherence to policy with regards to repetition, and put in measures for the retention of learners in the school system. Reconsider introducing Free Basic Education (Forms 1 to 3). This will not only address the post 2015 agenda but also ensure that most of the pupils that graduate from primary education under the FPE programme progress to secondary levels. This will demand major investments in the sub-sector, like extra classrooms, teachers, laboratories, etc. Introduce long distance learning in colleges to increase the number of appropriately qualified teachers Adjust entry requirement at tertiary level Strengthen career guidance Swaziland Millennium Development Goals 2015 Report Page 31

32 MDG 3: PROMOTE GENDER EQUALITY AND EMPOWER WOMEN Table 3.1: Status and Trends MDG INDICATORS BASELINE FIGURE (OR CLOSEST YEAR) STATUS 2010 STATU S 2011 STATU S 2012 STATU S TAR GET STATUS AT A GLANCE TARGET 3.A ELIMINATE GENDER DISPARITY IN PRIMARY AND SECONDARY EDUCATION PREFERABLY BY 2005, AND IN ALL LEVELS OF EDUCATION NO LATER THAN Ratio of girls to boys: i) Primary (MDG indicator) ii) Secondary (MDG indicator) 0.99 (1990) 0.99 (1990) 0.91 (2010) 0.98 (2010) 0.90 (2011) 0.93 (2011) 0.92 (2012) 0.90 (2012) 0.97 *(2015) 0.90 (2012) iii) Tertiary education (MDG indicator) 3.2 Share of women in wage employment in the nonagricultural sector 3.3 Proportions of seats held by women in National Parliament (2004) (2010) (2011) (2012) (2012) % 30 (2003) (2008) (2013) Swaziland Millennium Development Goals 2015 Report Page 32

33 TARGET 3.A ELIMINATE GENDER DISPARITY IN PRIMARY AND SECONDARY EDUCATION PREFERABLY BY 2005, AND IN ALL LEVELS OF EDUCATION NO LATER THAN 2015 Indicator 3.1: Ratio of girls to boys in Primary, Secondary and Tertiary education The ratio of girls to boys in primary, secondary and tertiary education is the number of female students enrolled at that level to the number of male students enrolled. Table 3.2 shows the trend of the ratio of girls to boys for all levels of education. Table 3.2 Gender Parity at Primary, Secondary and Tertiary Education ( ) Indicator Ratio of girls to boys in primary (GER) Ratio of girls to boys in secondary Ratio of girls to boys in tertiary education * 1.01 Source: Annual Statistics Bulletin 1990, Education Statistics & AEC reports 2011& 2012 Since 2000, the ratio of girls to boys in primary education has remained almost constant, averaging 0.93; highlighting that there are more boys enrolled in primary school than girls. However, in Swaziland there are more girls of school going age than boys, and the desired ratio is Hence at this level of education, boys are more advantaged compared to girls Primary Education Gender Equality indicators Gender Parity at Primary Education level The available data suggests that there are no significant differences in the educational performance of girls and boys. With regard to the Net Enrolment Ratio, boys outperformed girls in both 2009 and 2010, as shown in Table 3.3 Yet for both these years, females possessed a higher Net Intake Rate (NIR) compared to boys (44.3 percent versus 41.0 percent, in 2010), which may indicate greater access to primary education for those of primary school-entrance age Swaziland Millennium Development Goals 2015 Report Page 33

34 Primary Enrolment Table 3.3 Primary School Enrolment and Net Enrolment Ratio by Gender from 2009 to 2014 Year Boys Girls Primary School Enrolment NER Primary School Enrolment NER * Source: Calculated from Annual Education Census Report 2009, 2010, 2011 & 2012 and Swaziland Population Projections Figure 3.1 Primary School Enrolment and Net Enrolment Ratio by Gender , , , , , , , , **2014 Boy 121, , , , Girl 110, , , , Boy Girl Sources: AEC, 2012 In terms of access to primary education, girls were still trailing behind their male counterparts in 2009 and After 2010, the enrolment rates declined slightly. However access for girls improved as compared to their male counterparts. The national average, suggested that out of every 5 girls enrolled, 4 boys were enrolled in primary education. The decline in the net enrolment rate for boys is likely to be due to the fact that there is high repetition rate especially in lower grades and the high dropout rate by boys. Swaziland Millennium Development Goals 2015 Report Page 34

35 Table 3.4: Gender Parity at Primary Education Level Year Gender Parity (GER) Gender Parity (NER) Avg Source: AEC Reports 2009, 2010, 2011 &2012 Generally, Swaziland does not discriminate according to gender. In cases where there are discrepancies it is usually due to a specific reason, may be finances, distance to school or other social and health factors. The Gender Parity Index indicated that boys are generally dominating the primary levels sub sector; this has been the case over the years. This is noted with the GER (GPI) less than However, there are also indications that this index is on the increase implying more girls may be benefitting from the FPE programme and other facilitating programmes such as the CSTL. The primary Net Enrolment Ration (NER) is the share of children of primary school age that are enrolled in primary school while the Gross Enrolment Ratio (GER) is the total number of children enrolled at primary school regardless of the their age, relative to the population of the primary school age. Table 3.5: Gender Parity Primary: GER Year Hhohho Lubombo Manzini Shiselweni National Average Source: AEC 2012 Table 3.6: Gender Parity Primary: NER Year Hhohho Lubombo Manzini Shiselweni National Average Source: AEC 2012 When one considers the Gender Parity Index (GPI) for net enrolment rate, the ratios are higher, suggesting that at this level girls are making more efficient use of educational resources. More Swaziland Millennium Development Goals 2015 Report Page 35

36 girls are in age when compared to boys. This suggested that girls flow through the system more efficiently than boys. When considering the Gender Parity Index for those who are of official age (NER), the index is slightly better, but males still dominate. This scenario confirmed that first, there are more males enrolled at primary levels than females. It also suggested that most of these males are probably over-aged. This is why this indicator is better than the gross enrolment parity index. Table 3.7: Gender Parity: Higher Secondary GER Year Hhohho Lubombo Manzini Shiselweni National Average Source AEC 2012 Table 3.8: Gender Parity: Higher Secondary NER Year Hhohho Lubombo Manzini Shiselweni National Average Source: AEC 2012 At secondary levels the gender parity indexes indicated that girls take over boys. The notion that girls are of appropriate age is evident from the GPI (NER) which is above 100%. This suggests that boys are generally over-aged than the girls. Reasons for the discrepancy could be due to the fact that boys repeat more than girls or that they repeat more often than girls resulting in them being older. Swaziland has not achieved gender parity at both primary and secondary levels; boys are still dominating the system. However, indications are that as one approaches higher levels of education girls stay on and complete their education. Primary School Repetition Rates by Gender The primary school repetition rate also has an impact on the proportion of children who start grade 1 and reach the last grade of primary school. In terms of this country-specific MDG indicator, girls have persistently performed better than boys, as illustrated in the Figure 3.2. A study to ascertain the reason why boys repeat more than girls needs to be undertaken. Swaziland Millennium Development Goals 2015 Report Page 36

37 Figure 3.2: Primary School Repetition Rates by Gender, % 20.00% 15.00% 10.00% 5.00% 0.00% Boys 18.50% 18.40% 19.80% 19.60% 17.80% 17% 17% 17.70% girls 14.30% 13.70% 15.20% 14.50% 13.50% 13% 13% 13.30% Boys girls Source: Calculated from Education Statistics and Annual Education Census Report Primary School Dropout Rates by Gender In terms of dropouts, the highest dropout rate was observed for boys in all the grades up to Grade 6, followed by the girls in Grade 7. This suggested that beginning at Grade 6, girls may have already begun to engage in unprotected sex. This suggests that a targeted intervention in the upper grades is necessary. The issue of dropout due to pregnancy is becoming a concern because even boys are falling into the same situation. There is a need to come out with a solution because it may mean that for every pregnancy two pupils will ultimately dropout. Overall, dropout is decreasing gradually as FPE is being institutionalized. The situation is better for girls where the figures dropped from in 2009 to in Swaziland Millennium Development Goals 2015 Report Page 37

38 Figure 3.3: Dropout Rate by Sex, 2009 to 2012 Source: AEC, Secondary Education Gender Equality indicators Gender Parity at Secondary Education level The available data suggests there are no significant differences in the enrolment of girls and boys at lower secondary school level. With regard to the Net Enrolment Ratio, girls outperformed boys in the years between 2009 and 2012, as shown in table 3.9. Table 3.9: Gender Parity at Secondary Education Level Year Gender Parity (GER) Gender Parity (NER) Average Source: AEC Reports 2009, 2010, 2011 &2012 Nationally the results suggested that the Gender Parity indexes at this level of education were better than at primary levels. This may be due to the fact that more boys drop out than girls, thus their dropping out may have created a balance. When the NER parity is considered, girls fared quite well because the index is above 1. This suggested that parents could be appreciating the need to invest in girls education for their development potential. Swaziland Millennium Development Goals 2015 Report Page 38

39 Repetation rate (%) Repetition Rate by Gender The same trend is also observed in high school education. Repetition has always been around 10 percent. The incidences of repetition for girls have been declining while they have been increasing for boys since The chances of a boy child repeating a level is much higher than that of a girl child at secondary school level. This needs further assessment and study. Figure 3.4: Repetition Rate by Sex and Year, 2009 to Repetition rate (%) - Female Repetition rate (%) - Male Source: AEC Dropout Rate by Gender On average more girls dropped out than their male counterparts at this level of education. The highest proportion of dropout is due to pregnancy. Pregnancy remains a problem in country s r school system, and the results suggested that about 2 in 5 of high school pupils dropped out because of pregnancy. The incidence of male dropout due to pregnancy also seems to confirm that indeed that some male pupils also are affected by the situation. Dropout due to pregnancy is the highest contributor at this level followed by pupils who abscond. This could be attributed to socioeconomic situation of the families, and if the reasons, i.e. absconding, family reasons and school fees are combined they also suggested a notion that some dropout is due to lack of financial support to some students. Swaziland Millennium Development Goals 2015 Report Page 39

40 Figure 3.5: Dropout Rate by Sex and Year, 2009 to Average Dropout rate (%) - Female Dropout rate (%) - Male Source: AEC report, 2012 Indicator 3.2 Share of women in wage employment in the non-agricultural sector In the country, wage employment data is differentiated by private and public sectors. The share of women in wage employment in the non-agricultural sector is the share of female workers in wage employment in the non-agricultural sector expressed as a percentage of total wage employment in the sector. Figure 3.6 shows that the private sector has not been performing well towards the target as expected. In the years , there was a downward trend reaching a low of 29 percent. However in 2010 wage employment showed marked improvement rising from 29 percent to 33 percent (MOLSS; LFS, 2010). Swaziland Millennium Development Goals 2015 Report Page 40

41 Figure 3.6: Share of women in wage employment in the non-agricultural sector Baseline to current Baseline to target Source: MOLSS; LFS (2007&2010), CSO; employment and wages ( ) Indicator 3.3 Proportion of seats held by women in National Parliament The Government of the Kingdom of Swaziland recognizes the significance of including women in politics and decision making positions. It works tirelessly to ensure equal representation and participation of women. The country has in place the National Constitution which makes provision of 30% women representation in parliament, National Gender Policy advocating for 30% women representation as well as ratified the SADC protocol on Gender and Development which also advocates for 50% women representation in politics and decision making positions. A study on women and decision making was conducted in 2013 to determine the status of women representation in decision making structures however it reflects that women in Swaziland continue to be underrepresented in politics and decision making positions where their voices matter the most. Following the September 2013 National parliamentary elections, women constitute 15% representation in parliament; 25% in Cabinet and 12% in the local government. There was only one woman elected out of fifty five constituencies. The elected members of Parliament voted 5 women into Senate and 5 were appointed by His Majesty making the total number of women in Senate 10 out of 30, bringing the percentage of women in the House of Senate to thirty-three percent (33.33%). In the House of Assembly, His Majesty King Mswati 111 nominated three women constituting 6.15% seats. Swaziland Millennium Development Goals 2015 Report Page 41

42 Percentage (%) From the figure below it can be observed that the country was trending well towards achieving this indicator from 20% in 2003 rising to 22% in 2008 but then it declined to 15% in the last election which now is far from the target of 30% woman who are supposed to be in parliament. Figure 3.7: Seats held in parliament 35% 30% 25% 20% 15% 10% 5% 0% Baseline to current 20% 22% 15% Baseline to target 20% 30% Baseline to current Linear (Baseline to target) Baseline to target Source: EBC, 2014 This result is despite the fact that statistics show that majority of registered voters ( of the country s citizens) were women. Women s participation and representation in parliament is limited by the following factors; Patriarchy, socio-cultural stereotypes, lack of confidence among potential women to aspire for high level positions, and unequal power relations between men and women in society. Required strategies are as follows; Women and men need to be empowered to embrace the idea of voting women into leadership positions Involve all sectors of society in advocacy campaigns and activities to promote women representation in decision making structures Encourage men to fully engage in gender equality and women s empowerment programmes so as to create a more conducive environment for women to participate in decision making positions Promote gender sensitive socialization at family level to instil a notion of equal opportunities between males and females. Swaziland Millennium Development Goals 2015 Report Page 42

43 Currently the Government of Swaziland is in the process of developing a national strategy on women s participation and representation in politics and decision making as well as an advocacy strategy. This is to serve as a key instrument to be used for advocating for increased levels of participation and representation of women in all sectors. COUNTRY SPECIFIC INDICATORS Indicator 3.4 Number of Gender Based Violence (GBV) cases reported Gender Based Violence (GBV) is the general term used to capture violence that occurs as a result of normative role expectations associated with each gender, along with the unequal power relationships between the two genders, within the context of a specific society. It is violence that is directed against a woman because she is a woman or that affects women disproportionately, thereby underlining that violence against women is not something occurring to women randomly, but rather an issue affecting them because of their gender. It is the acts that inflict physical, mental or sexual harm and suffering, threats of such acts, coercion and other deprivations of liberty. Men can also become targets of physical or verbal attacks for transgressing predominant concepts of masculinity, for example because they have sex with men. Men can also become victims in the family, by partners or children. However, it has been widely acknowledged that the majority of persons affected by gender-based violence are women and girls, as a result of unequal distribution of power in society between women and men. From the table below, it can be noted that GBV cases from 2007 to 2014 are rife in rural areas than in urban areas. Most of the people living in rural areas are poverty stricken. They cannot afford to build proper structures in their homesteads that will protect them from being exposed to GBV. For example most of the rape survivors suffer rape while in their homes. The perpetrators have easy access to their house because they are not safely locked. Table 3.10: Statistic of GVB cases from 2007 to 2014 at national and regional levels Year National Rural Urban Hhohho Manzini Shiselweni Lubombo Source: RSP; Annual Report ( ) Swaziland Millennium Development Goals 2015 Report Page 43

44 The vulnerable group being women and children live in remote homesteads making them to travel long distances to access water, school, hospitals, churches and police stations. As a result they encounter violence in the thick bushes they travel in and thus making it difficult for them to get help as soon as possible. In rural areas, there is less access to the different forms of media which educates them on how to protect or prevent themselves from all forms of violence. Some of the families in rural areas do not have radios and televisions which are vital in providing educational programmes that aims at reducing the escalating rate of violence. Most of the people living in urban areas take advantage of the vulnerable group in the rural area, subjecting them to abuse in order to get food or any kind favours. For example forcing them to perform unwanted sexual acts and later give them food, gifts, money or provide employment. The level of education for the people living in rural areas is lower than those in urban areas and as a result it limits their knowledge and understanding of issues pertaining to GBV as well as their rights. The formal settings are not properly used in issues of GBV. If the abuser is within the family and is the one who supports and maintain them financially, the likelihood is that the abuse will not be reported or they will opt to report to traditional structures. The likelihood is that within those structures it may be ridiculed or concealed. SOME IDENTIFIED CAUSES OF GBV: lack of job opportunities, lack of communication, high sex drive, influence of extended family, economic / financial problems, myth: having sexual intercourse with a virgin can cure an HIV Positive rapist, psychosocial abuse experienced in childhood leads to some people being violent adults, alcohol and drugs abuse, unequal power relations between men and women in societies, masculinity, modern infrastructure; allowing family members (different sexes) sleeping in one roof and so on. These and other elements require a collective effort from all stakeholders as it contributes to the prevalence of crimes and social depletion of the society s wellbeing thus complicating the policing environment. CHALLENGES: The delay in trying and finalization of cases in court has always been a major challenge. The complainants of these cases turn to have loss of memory because sometimes they experience GBV at their tender ages and as such when it is tried 5 years later, some of the key important aspects of the case may be forgotten. This may have implications to the prosecution of the case as well as the conviction. Survivors of GBV cases suffer their effects differently, depending on the manner in which they experienced the ordeal. Swaziland Millennium Development Goals 2015 Report Page 44

45 Also the delay in enactment of The Domestic Violence and Sexual Offences Bill is also a challenge because it has stiffer sentences that will help as deterrence of such offences in future. Indicator 3.5: Proportion of girls enrolled in technical schools Post - Secondary Education Gender Equality Indicators (a) Technical and Vocational Education (TVET) Technical and Vocational Education (TVET) is offered at different educational levels in Swaziland depending on the entry requirements and qualifications. TVET which requires a successful completion of senior secondary is classified as post- secondary or tertiary. Some TVET in Swaziland are at secondary levels, i.e. may require completion of Basic Education. (b) Higher Education Higher Education includes post-secondary and tertiary levels. Most of the colleges and university will fall under tertiary. Only a few TVET institutions have been presented here, it is only the formal TVET which are recognized by the Ministry of Education and Training. Most private TVET are not included. This will require a complete analysis of the entry requirements, content and duration and importantly for them to comply with Government Standards and Regulations. This indicator tracks the enrolment of girls in technical and science subjects. These include maths, science, and engineering (mechanical, electrical, quantity surveying, etc.). It should be noted that there are new Universities in the country that have been established and it is pleasing to note from the table below that the gap between males and females is not that much. The administration of student records at the University of Swaziland (UNISWA) is automated. Hence errors in gender registration are minimal. The intake of Swaziland College of Technology (SCOT) and UNISWA with the intake of girls averaging just below 40 percent between the periods 2007 and To increase girls enrolment in this field, there should be vigorous interventions from Government to promote technical and science subjects at an early age. Career guidance should be available in schools especially when it comes to the choice of subjects. Swaziland Millennium Development Goals 2015 Report Page 45

46 Table 3.11 Enrolment at Post Secondary Education Level by Gender ( ) Type of Institution Female Male Female Male TVET MITC SITC NASTIC VOCTIM SCOT LIMKOKWENG TERTIARY UNISWA SANU SCU NGWANE TEACHER TRAINING COLLEGE WILLIAM PITCHER TEACHER TRAINING COLLEGE Total Source: AEC Report, 2012 Indicator 3.6 Number of women in decision making positions The total labour force in the country in 2013 was of which were females, whilst in 2010 the total labour force was at of which were females. It can be observed that the labour force has decreased significantly in total and its even worse to also observe the number of women in decision making position decreasing. Despite progress made in this indicator, there is still need to further explore other leadership roles in the public sector. It is observed from the table below that most females are employed in jobs like professionals, clerks and service workers. This shows that leadership positions in government are still male dominated and there is a need to ensure that capable females and males are given equal opportunities. Swaziland Millennium Development Goals 2015 Report Page 46

47 Table 3.12: Occupational Structure by Sex Occupations Male Female Total Male Female Total Male Female Total Legislators Professionals Technicians Clerks Service workers Skilled agriculture Craft and related Plant & machinery Elementary occupations Total Sources: MLSS, LFS (2007, 2010, 2013) ACHIEVEMENTS Integration of Gender issues into developmental planning. The strategic positioning of the Gender and Family Issues Unit in the Deputy Prime Minister s Office is a major contributor to the progress made towards achieving this goal. Placement of career guidance officers at the regional offices has helped improve gender sensitivity SUPPORTIVE ENVIRONMENT FOR GENDER His Majesty the King signed the SADC Protocol on Gender and Development, which shows the country s commitment to promotion of gender equality and equity. The National Gender Policy has been approved and is operational. The Domestic Violence Child Protection and Sexual Offences Unit have been established in all 24 police stations, one police post, and preparations to include other posts are underway. The establishment of the toll free lines, 9664 for education, 999 for police, and 975 for human trafficking have all assisted in curbing gender-related violence. Swaziland Millennium Development Goals 2015 Report Page 47

48 KEY BOTTLENECKS CONSTRAINING PROGRESS AND HOW TO ADDRESS THEM VIOLENCE AGAINST WOMEN AND CHILDREN The incidence of violence persists in society and it pause a threat in pursuit. Women and children are the most vulnerable groups. According to studies previously conducted in the country, Approximately 1 in 3 females experienced some form of violence as a child. It further shows that 79% is committed by people known or related to the victim. Most cases reported are said to happen at home, work and in public spaces. It is confirmed that 85% of the perpetrator are men. However 1 in 7 survivors do not report cases due to the culture of silence. Other hindering factors includes; the delay in the enactment of then Sexual Offences and Domestic Violence Bill, prevailing attitudes that deter women from reporting cases within community structure, and inadequate capacity for service providers in handling gender-based violence cases. The Government has made significant strides in policy and legislative reform in addressing the challenges of gender based violence. The National Gender Policy approved in 2010 outlines the key thematic policy objectives and strategies to address gender based violence as well as the enactment of the Child Protection and Welfare Act of The Multi-Sectoral Coordination Mechanism has been established to oversee prevention and response to issues of gender based violence in the country. This team includes both government and civil service organizations. The construction of child friendly courts, toll free lines, establishment of the Domestic Violence and Victims support Centres in police stations, establishment of one stop centres (to provide care and support for gender based violence survivors) and the enactment of People Trafficking and People Smuggling Act. CHALLENGES The existing constraints on issues of Gender based Violence / Violence Against Children / persons living with disability includes; Inadequate capacity for service providers in handling GBV/VAW cases. Lack of safety homes for survivors of abuse Weak coordination mechanism for GBV/VAW response Prevailing attitudes that deter women from reporting cases within community structures HOW TO ACCELERATE THIS MDG Strengthening of the coordination mechanism on violence Capacity building of service providers and law enforcement agents Institution of an incorporated system for documentation and data management. Finalization and implementation of the national draft strategy on violence Sensitizing people on reporting cases of abuse Swaziland Millennium Development Goals 2015 Report Page 48

49 MGD 4: Reduce Child Mortality Table 4.1: Status and Trends MDG INDICATORS BASELINE FIGURE STATUS IN 2012 STATUS IN TARGET STATUS AT A GLANCE TARGET 4.A: REDUCE BY TWO-THIRDS, BETWEEN 1990 AND 2015 THE UNDER 5 MORTALITY RATE 4.1Under 5 Mortality rate 4.2 Infant mortality rate 4.3 Proportion of 1 yearold immunized against measles TARGET 4.A: REDUCE BY TWO-THIRDS, BETWEEN 1990 AND 2015 THE UNDER 5 MORTALITY RATE International targets for this MDG are shown in the table above. Using these as a benchmark, Swaziland is expected to reduce under-five mortality to 30, infant mortality to 24 and increase immunization of measles coverage to 100% by Indicator 4.1 Under-Five Mortality Under-Five Mortality rate refers to the probability of dying per 1000 live births before reaching the age of 5 if subjected to the prevailing age-specific mortality rates. Swaziland under-five mortality rate is still high; however there is great improvement. The estimates from the 2014 MICS report show a decline from 120 deaths in 2007 to 67 deaths per 1000 live births in The figure below show trends from 1990 to The data shows that for Swaziland to reach the goal of 30 deaths per 1000 live births in 2015 as per MDG4, in 2014 the country should have achieved 40 deaths per 1000, as opposed to the 67 deaths. Swaziland Millennium Development Goals 2015 Report Page 49

50 Rates Figure 4.1: Under- Five Mortality Rate Under-five mortality rate Required Under-five mortality rate Sources: CSO: SDHS (1991& 2007), SPHC (1997), MICS (2000, 2010 &2014), MoH: SEPI Annual Reports, UNICEF 2010 Indicator 4.2 Infant Mortality Rate Infant Mortality Rate refers to the probability of dying before reaching the age of 1 year. Evidence shows that Swaziland loses about 20 children per 1000 within the first 28 days of life (MICS 2014), mainly attributable to the high HIV prevalence among pregnant women. With interventions on maternal, new born and child health, a significant improvement is seen on the infant mortality as well. In 2007 infant mortality rate was estimated at 85 deaths per 1000 live births. The deaths declined to 50 deaths per 1000 live births in 2014 according to the 2014 MICS report. The MDG target requires Swaziland to achieve 24 deaths per 1000 live births by 2015 and the target has not been met. Swaziland Millennium Development Goals 2015 Report Page 50

51 Number of Deaths Figure 4.2: Infant Mortality Rate Infant mortality rate Required Infant Mortality rate Target Sources: CSO: SDHS (1991& 2007), SPHC (1997), MICS (2000, 2010 &2014), MoH: SEPI Annual Reports, UNICEF 2010 Indicator 4.3 Proportion of 1 year old children immunized against measles. The indicator refers to the proportion or percentage of one year old children who receives immunisation for measles. There has been an increase in the number of infants immunized against measles since The measles immunization target was achieved in According to the MICS repot 2010, measles immunization coverage for Swaziland was at 97.8% decreasing to 89% in The decrease in immunization coverage in the last 3 years means that extra effort is required to achieve the MDG target of 100% of children under 1 immunized against measles. Swaziland Millennium Development Goals 2015 Report Page 51

52 Percentages Figure: 4.3 Proportion of 1 Year Old Children Immunized Against Measles Projected 1 year old children immunized 0 Proportion of 1 year old children immunized Sources: MICS (2000, 2010 &2014) COUNTRY SPECIFIC INDICATORS Indicator 4.4 Deaths and Admission due to Pneumonia Pneumonia is an inflammation of lungs caused by bacteria, viruses or chemical irritants and can affect children of any age group; however, it is more common in children less than 5 years. According to WHO pneumonia is a number one killer among children under five years in developing countries. The country has reported a decline in the number of pneumonia admissions for children under 5 years, from 434 in 2010 to 399 in The figure below shows trends in in-patient admissions for pneumonia cases. Swaziland Millennium Development Goals 2015 Report Page 52

53 Percent Number of admissions Figure 4.4: Admissions and Deaths due to Pneumonia 1600 Admissions Admissions % Deaths % deaths Source: HMIS, 2014 Deaths due to pneumonia have also been declining. According to Health Management Information System (HMIS 2014), deaths for under-five due to pneumonia declined from 89 to 48 between 2011 and Viral pneumonia deaths on the other hand have increased from 23 in 2011 to 29 in Swaziland Millennium Development Goals 2015 Report Page 53

54 Indicator 4.5 Deaths and Admissions due to Diarrhea Diarrhea in children is another leading cause of death, especially in low-middle income countries. Diarrhea is a common symptom of gastro-intestinal infections caused by a range of pathogens including bacteria, viruses and protozoa with rotavirus being the leading cause of acute diarrhea which contributes to about 40% of hospital admissions for children under the age of 5 years. In the figure above, an increase is noted in number of admissions in 2014 for diarrheal diseases among children. This increase was mainly due to the rotavirus outbreak in 2014, which led to 62 children dead. Swaziland has made major achievements that have contributed to reduction in diarrheal cases for children under 5 such as improvement in safe drinking water, from 67% in 2010 to 72% in 2014 (MICS). Exclusive breastfeeding has also improved from 44% (MICS 2010) to 63.8% (MICS 2014) within the first 6 months of birth. Figure 4.5: Admissions and Death due to Diarrheal Diseases Swaziland Millennium Development Goals 2015 Report Page 54

55 Percent Number of Admissions Admissions Admissions Deaths % Deaths Axis Title Source: HMIS, 2014 The country has made significant progress towards reducing mortality due to diarrhoea among under aged 5 and under. Deaths due to diarrhoea among children under 5 years has decreased from 175 in 2010 to 74 in INEQUALITY ANALYSIS Swaziland Millennium Development Goals 2015 Report Page 55

56 Table 4.2: IMR and UMR Across Regions Region Infant mortality rate Under-five mortality rate Hhohho Manzini Shiselweni Lubombo Residence Urban Rural Source: CSO; MICS (2014) The MICS 2010 report showed that there is no significant difference in IMR and UMR according to rural and urban settings, implying that the risk of dying early remains identical in both settings. Differentials in mortality levels by region are somewhat larger. Manzini has the highest mortality levels in both UMR (114 deaths per 1000 live births) and IMR (86 deaths per 1000 live births) whilst Hhohho has the lowest for both UMR (78 deaths per 1000 live births) and IMR (57 deaths per 1000 live births). This could be the result of low post-neonatal mortality rates in the latter region. Table 4.3: Proportion of 1 Year-Old Children Immunised Against Measles Region Proportion of 1 year-old children immunised against measles (%) Hhohho 78 Manzini 78 Shiselweni 95 Lubombo 75 Source: MOH; SEPI Annual Report. (2013) The immunisation rate for the three regions Hhohho, Manzini, and Lubombo are below the minimum level of 80 per cent, which predisposes the regions to the risk of measles virus transmission. Shiselweni has highest (95 per cent) coverage of infants immunised against measles. One of the contributing factors towards this high coverage is stems from maximising Swaziland Millennium Development Goals 2015 Report Page 56

57 the use of available resources within the region to reach all infants by using an integrated package of immunisation services. ACHIEVEMENTS There is universal access to PMTCT services that are critical in the reduction of child and infant mortality. Establishment of structures for delivery of child survival interventions. Introduction of Essential Health Care packages for children according to levels of healthcare. Introduction of and free access to ART. Increase national budget for the Health sector. SUPPORTIVE ENVIRONMENT The presence of the National Health Policy, Health Sector Strategic Plan, Integrated Child Survival Strategic Plan and Annual Action Plans gives the required framework to address issues of child mortality. Integrated Child Survival Interventions have been defined and are being followed where possible. Swaziland introduced the PCV 13 vaccine in 2014 to help reduce pneumonia among children. Increase in Vitamin A supplementation. KEY BOTTLENECKS CONSTRAINING PROGRESS AND HOW TO ADDRESS THEM Health Systems: There are challenges in the health systems, in the areas of drug chain management to limit stock outs. Addressing human resource shortages, uneven distribution, and decentralization of services are crucial. There is need to strengthen the health systems in many areas. Access to outreach services: The non-regular access to outreach services is a challenge, however in 2014 MOH procured vehicles for all Public Health Units to address this issue. There is need to increase resource allocation for outreach services. NEW CHALLENGES Epidemics (new and re-emerging childhood communicable diseases) such as measles and TB. There is need to increase awareness and epidemic preparedness and responses. There is limited linkage between paediatric HIV diagnosis and ART initiation. Capacity to deal with issues of child and infant mortality has been further worsened by the recent Global Economic Recession. Swaziland Millennium Development Goals 2015 Report Page 57

58 Mushrooming of informal settlements compromises sanitation and waste disposal (MICS, 2014 from 61% to 55%). Increased under five wasting is a threat to child health (MICS, 2014, 0.8% to 2%). HOW SWAZILAND WILL ACCELERATE PROGRESS IN THIS MDG Accelerate the pace of implementation of High Impact Child Survival Interventions which have proven to work well as far as reducing infant and child mortality is concerned. The continued fight against HIV/AIDS is critical in the fight against child and infant mortality. Implement the Integrated Community Management of Childhood illnesses to improve delivery of child survival interventions to disadvantaged populations. Increase the advocacy of communication and social mobilisation of child survival integrated services. Review and strengthen Primary Health Care Strategy and Programming. Intensify surveillance of epidemic prone childhood diseases such as measles, TB and A/H1N1. Monitoring and evaluation of all health interventions. Improve health infrastructure for effective health service delivery. LESSONS LEARNT Involving communities and working collaboratively on the ground in improving water and sanitation contributed in the reduction of diarrheal cases. The coordination of the Department of Water Affairs and Ministry of Health to ensure clean water supply The implementation of an early warning system is critical to inform decision making. Regular monitoring and review of health data is critical towards this end. MGD 5: Reduce Maternal Mortality Swaziland Millennium Development Goals 2015 Report Page 58

59 Table 5.1: Status and Trends MDG Indicators Baseline figure Status 2012 in Status 2014 in 2015 target Status at a glance Target 5A: Reduce by ¾ between 1990 and 2015, the maternal mortality ratio 5.1 Maternal mortality ratio per live births (National DHS, Census) 5.2 Proportion of births attended by skilled health personnel % 82% 88.3% 100 Target 5B: Achieve, by 2015 universal access to reproductive health 5.3 Contraceptive prevalence 5.4 Adolescent birth rate per 1000 live births 59.3% 65.2% 66.1% Antenatal care coverage (at least 1 visit and at least 4 visits) 97% 97% 76% 98.5% 76.1% Unmet need for Family Planning - 13% 15.2% 10 Target 5A: Reduce by three quarters between 1990 and 2015, the maternal mortality ratio Swaziland Millennium Development Goals 2015 Report Page 59

60 MMR/ Indicator 5.1: Maternal mortality ratio The Maternal Mortality Ratio (MMR) is the number of women who die from any cause related to or aggravated by pregnancy or its management (excluding accidental or incidental causes) during pregnancy and childbirth or within 42 days of termination of pregnancy, irrespective of the duration and site of the pregnancy, per 100,000 live births. The data sources of the NSS indicate that maternal mortality has been stagnant in the country during the recent period 2012 to Significant progress has been made towards the achievement of the universal access to reproductive health services. For instance the proportion of deliveries for which a skilled birth attendance is present is about 88 percent and a proportion of women who delivered in health facilities is 87.7 percent. Despite the latter, Maternal Mortality Ratio has remained high at 593 in 2014 from 589 in The Ministry of Health has continued to put in place interventions to address the MMR. Thus, given the importance of overcoming the prevailing setbacks in maternal health in the country, Swaziland took part in the preparation of the MDG Acceleration Framework (MAF) Country Action Plan in 2012 (CAP). Some of these interventions include; development and launch of the National SRH policy with focus on Reproductive Maternal Neonatal Child Adolescent Health (RMNCAH), initiation of the supportive mentoring and supervision ensuring quality implementation of RMNCAH services in health care facilities, Maternal Death Surveillance and Response (MDSR). Figure 5.1: Maternal Mortality Ratio MMR/ Source: MICS 2000, 2010, 2014 Indicator 5.2: Proportion of births attended by skilled health personnel Percentage of births attended by skilled health personnel (doctors, nurses or midwives) is the proportion of deliveries attended by health personnel trained in providing lifesaving obstetric care, including giving the necessary supervision, care and advice to women during pregnancy, Swaziland Millennium Development Goals 2015 Report Page 60

61 labour and the post-partum period. It also includes conducting deliveries on their own; and caring for new-borns (International Confederation of Midwives 2011). Traditional birth attendants, even if they receive a short training course, are not included. The highest incidence of maternal and perinatal mortality occurs around the time of birth with the majority of deaths occurring within the first 24 hours after birth. Skilled birth attendance at every childbirth is essential in saving the lives of women and new-borns (State of the World Midwives Report, 2014). Skilled birth attendant at delivery as well as immediate postnatal care is important in averting maternal and neonatal mortality and morbidity. In addition to the appropriate skills, these health professionals should be motivated and located in the right place at the right time. They need to be supported by appropriate policies, essential supplies including medicines and operating under appropriate regulatory frameworks. Swaziland has a supportive policy environment regarding reproductive maternal new-born child and adolescent health. According to the survey on availability of contraceptives and lifesaving maternal health drugs in service delivery points report ( ) all the tertiary facilities had the required seven lifesaving maternal medicines. Swaziland continues to have a high maternal mortality ratio (593 per live births) despite the high skilled birth attendance which has increased from 82% (MICS 2010) to 88.3% (MICS 2014) and 87.7% institutional deliveries. The latter may imply that skilled birth attendance alone is not enough to reduce maternal mortality as the factors associated with maternal deaths are beyond the capacity of health facilities. The Maternal Death Review report , indicated that about 67% of the women who died during that period were admitted in critical conditions, highlighting that patient factors also contribute significantly to maternal deaths. Figure 5.2: Proportion of Births Attended by Skilled Health Personnel 1 Ministry of Health Survey On Availability Of Contraceptives And Lifesaving Maternal Health Drugs In Service Delivery Points Report. Mbabane: Printpak Swaziland Millennium Development Goals 2015 Report Page 61

62 Percent PROPORTION OF BIRTHS ATTENDED BY SKILLED HEALTH PERSONNEL Source: MICS 2000, 2005, 2010, 2014 TARGET 5B: ACHIEVE BY 2015, UNIVERSAL ACCESS TO UNIVERSAL HEALTH Indicator 5.3 Contraceptive prevalence rate Contraceptive prevalence rate is the proportion of women, married or in union, of reproductive age (15 to 49 years) using a contraceptive method. In Swaziland contraceptive prevalence rate is relatively high at 66.1% (MICS 2014) which indicates an increase from 65.2% (MICS 2010). The total fertility rate in the country is declining from 3.7 to 3.3 births per woman between 2007 and The Ministry of Health has continued to prioritize and support family planning programs in the promotion of modern contraceptives can impact maternal health in two ways. The direct effect comes from the reduction in the number of births that occurs as contraceptive use increases. With fewer births, the risk of maternal death is lower and the total number of deaths is lower. Therefore, increasing contraceptive use may also have indirect benefits that reduce the average risk of mortality associated with each birth as a result of a change in the distribution of births toward fewer at-risk births. In addition, by reducing unintended pregnancies, particularly among teenagers, contraception can also result in fewer abortions, which can lead to a decline in maternal mortality. Indicator 5.4 Adolescent Birth Rate Swaziland Millennium Development Goals 2015 Report Page 62

63 The Adolescent Birth Rate (ABR) measures the annual number of births to women 15 to 19 years of age per 1,000 women in that age group. It is also referred to as the age-specific fertility rate for women aged years. The high rate of adolescent fertility is a concern in both developed and developing countries. Having children this early in life exposes adolescent women to unnecessary risks. Their chance of dying is twice as high as that of a woman who waited until her 20s to begin childbearing. In addition, early childbearing greatly reduces the likelihood of a girl advancing her education and limits her opportunities for training and employment. This is more serious in developing countries. Globally, teenage pregnancy is a public health challenge; the same is for Swaziland. In Swaziland, adolescent fertility, although declining is still high at 87 births per 1000 adolescents aged indicating a decline from 89 in 2007 (MICS 2014). Teenage pregnancy is attributable to early and unprotected sexual activity which rapidly increases from 4 percent by age 15 years to 50 percent by the time adolescent girl reaches 17 years. Although 75% of health facilities provide adolescent health services only 26% provide youth friendly services. Contraceptive use among unmarried adolescent girls remains low at 15.5 percent and condom use at 9 percent. Other causes of teenage pregnancy include low levels (56 percent) of comprehensive knowledge on sexuality and HIV; sociocultural factors including intergenerational sex, sexual violence and weak legal and traditional protection systems. Indicator 5.5 Antenatal Care Coverage Antenatal care coverage (ANC) is the percentage of women who used antenatal care provided by skilled health personnel for reasons related to pregnancy at least once during pregnancy, as a percentage of live births in a given time period. Antenatal care (ANC) coverage is a success story in Africa, since over two-thirds of pregnant women (69 %) have at least one ANC contact. However, to achieve the full life-saving potential that ANC promises for women and babies, four visits providing essential evidence based interventions a package often called focused antenatal care is required. Swaziland has a high ANC coverage, as 98.5% of pregnant women attend ANC at least once whilst 76.1% attend at least four times according to the 2014 MICS report. The Ministry of Health has continued to support implementation of focused ANC package that include essential interventions such as identification and management of obstetric complications, tetanus toxoid immunization, and identification and management of infections including HIV, syphilis and other sexually transmitted infections (STIs). ANC is also an opportunity to promote the use of Swaziland Millennium Development Goals 2015 Report Page 63

64 skilled attendance at birth and healthy behaviours such as breastfeeding, early postnatal care, and planning for optimal pregnancy spacing. Indicator 5.6 Unmet need for family planning The number or percent of women currently married or in union who are fecund and who desire to postpone childbearing, but who are not currently using a contraceptive method is referred to as unmet need for family planning. The total number of women with an unmet need for family planning (FP) consists of two groups of women: (a) those with an unmet need for limiting, and (b) those with an unmet need for spacing. According to the MICS (2010) the unmet need for family planning was 13 percent increasing to 15.2 percent in However, there are still major disparities that influence access to family planning services and information particularly unmet need for family planning is high among rural based poorest and lowly educated young women (40%), and unmarried adolescents (28.6%). Inequitable distribution of integrated family planning services; inadequate in-depth evidence around socio cultural impediments of contraception including condoms affects uptake of family planning services. INEQUALITY ANALYSIS Table 5.2 Contraceptive Prevalence Rates, Proportion of Births Attended by Skilled Health Personnel (%) and Unmet Need for Family Planning Contraceptive prevalence rate Proportion of births Unmet need for attended by skilled family planning health personnel (%) Region Married or in union All women Hhohho Manzini Shiselweni Lubombo Residence Urban Rural Source: CSO; MICS (2010) Swaziland Millennium Development Goals 2015 Report Page 64

65 The contraceptive prevalence rate is high among women married or in union in the regions and among rural and urban dwellers. The access to family planning services and distribution of health skilled personnel is however biased towards the urban areas due to relatively more facilities. Hhohho and Manzini regions both have high proportion of births attended by skilled health personnel and are better equipped compared to the other regions. ACHIEVEMENTS Implementation of integrated approach for RMNCAH particularly SRH and HIV including Family Planning Focused and systematic maternal death audits Free RMNCAH services in Public Health Facilities promote utilization of such services. There are capacity building projects in training, logistics, infrastructure, essential medicines and equipment through commitments of government and its development partners to support RMNCAH. SUPPORTIVE ENVIRONMENT There is political will, leadership and commitment to RMNCAH as evidenced by supportive policy framework, budget allocation and human resource for health. The Government of Swaziland has prioritized the Ministry of Health and this places the health MDGs at an advantage with respect to accelerated support. Effective management and coordination mechanism for RMNCAH through the Inter- Agency Technical Coordination Committee (IATCC), Civil Society Organizations and various technical working groups which provide technical guidance and oversight to the RMNCAH programming. Evidence generation to inform programming in RMNCAH, such as the Client and Service Providers satisfaction survey on SRHR and HIV integration, Survey on Availability of Contraceptives and Life Saving Maternal Health Drugs in Service Delivery Points, Quantification of family planning commodities, SRHR and HIV integration best practices, Maternal Death Audit Review Reports. The MAF aims at supporting government and stakeholders to better understand the key bottlenecks in improving maternal health and to formulate an effective action plan to reduce the obstacles hindering progress with MDG 5 (Maternal Mortality). The MAF Swaziland Millennium Development Goals 2015 Report Page 65

66 Action Plan for Accelerated Progress on Maternal Health aims at complementing existing interventions. KEY BOTTLENECKS CONSTRAINING PROGRESS AND HOW TO ADDRESS THEM Programmatic challenges: Late timing and low frequency of ANC Poor adherence to Lifelong ART amongst Pregnant and Lactating Women Stagnant Maternal Mortality Ratio and Adolescent Fertility Rate Coordination of IATCC (limited transparency and adherence to commitments) Health System Related Challenges: Shortages of skilled health personnel Weak Logistics Management Information System Weak Health Management Information Systems as well as Civil Registration and Vital Statistics System for routine measurement of Maternal Mortality Ratio Inadequate infrastructure and equipment Weak linkages and systems for cross-referral Community Systems Challenges: Weak linkages and referral mechanisms between community and health facilities Low levels of accurate knowledge and information on HIV protective behaviours Low levels of male involvement and participation in RMNCAH interventions NEW CHALLENGES HIV and AIDS have great impact on maternal mortality and remain a challenge and as such there is a need to strengthen the integrated approaches that have been developed to deal with it. Retention of pregnant and lactating women on ART. HOW SWAZILAND WILL ACCELERATE PROGRESS IN THIS MDG The Ministry of Health, particularly the Sexual Reproductive Health Programme (SRHP) is going: Promote the development of policy documents on RMNCAH to guide implementation of services, with much focus on postpartum care where above 60% of maternal deaths occurs. Derive a unified road map for the provision, monitoring and evaluation of Reproductive Maternal New born Child and Adolescent Health, including postpartum which accounts Swaziland Millennium Development Goals 2015 Report Page 66

67 for 60% of all maternal deaths, compared to only 15.5% for intrapartum and 23.9% for antepartum. Conduct training needs assessment and skills audit in collaboration with partners, midwifery schools and regulatory bodies and provide specialized trainings in postnatal care to ensure a competent midwifery workforce is maintained. Engage partners and regulatory bodies to review evidence on the competencies of midwives in line with the midwifery curriculum to ensure that nursing schools teach a competent-based curriculum as approved by ICM to equip graduates with knowledge and skills necessary to render quality maternal new born child health services. Carry out constant advocacy to development partners to continuous support capacity building among midwifery lectures for their abilities to teach relevant and evidencedbased programmes. Continue strengthening the integration of family planning into all service delivery points, with emphasis on the use of long acting family planning commodities Support the roll-out and implementation of Comprehensive Life Skills Education including ASRH information among in-school and out of school. Support the roll-out of the Maternal Perinatal Death Surveillance Response guidelines at all levels to improve early notification. LESSONS LEARNT UN estimates and National data presents challenges in processing SRH information as trends at times move in opposite directions thus care should be taken in the research. Reduction of MMR is a multi-stakeholder initiative thus MMR has remained high despite improvements in other reproductive health indicators. Development of strategic policy documents focusing on RMNCAH has a positive impact in mobilizing for resources to improve maternal health care. Involvement of communities in RMNCAH programming aids in improving indicators such as unmet need, skilled birth attendant and institutional delivery. Provision of integrated SRH and HIV services expands coverage across the country at all levels of healthcare delivery system. Capacity building of healthcare workers in Youth Friendly Services has proven to be an efficient means to increase provision of youth and adolescent friendly services Swaziland Millennium Development Goals 2015 Report Page 67

68 MDG 6: COMBAT HIV/AIDS, MALARIA AND OTHER DISEASES Table 6.1: Status and trends MDG INDICATORS BASELINE FIGURE STATUS IN 2012 STATUS IN TARGET STATUS AT GLANCE TARGET 6.A: HAVE HALTED BY 2015 AND BEGAN TO REVERSE THE SPREAD OF HIV/AIDS 6.1 HIV prevalence among population aged years General population males and females(overall) Pregnant women 14.3% (2007) 18.4% (1994) 12.0% ( 2012) 34.7% (2010) 11.3% ( 2014) 35.0% (2014) 9.2% 6.2 Condom use at last high risk sex among people aged years: Females Males 6.3 Proportion of population aged years with comprehensive knowledge of HIV/AIDS Females Males Overall: 61.3% 54.2% 70.4% (2007) Overall: 52.2% 52.1% 52.3% (2007) 73.1% 90.6% (2010) Overall: 56.0% 58.2% 53.6% (2010) 70.9% 93.4% (2014) Overall: 50.0% 49.1% 50.9% (2014) 100% 100% 100% 6.4 Ratio of school attendance of orphans to school attendance of nonorphans aged years 0.97 (2007) 0.99 (2010) TARGET6.B: ACHIEVED BY 2010, UNIVERSAL ACCESS TO TREATMENT FOR HIV/AIDS FOR ALL THOSE WHO NEED IT Swaziland Millennium Development Goals 2015 Report Page 68

69 6.5 Proportion of population with advanced HIV infection with access to antiretroviral drugs Incidence rates associated with Malaria Death rates associated with Malaria 42.1% (2007) 78% (2011) 58.5% (2014) % 6.9a: Incidence rates associated with tuberculosis Indicator 267 (1990) 1287 (2010) 1382 (2013) b: Prevalence rates associated with tuberculosis 629 (1990) 704 (2010) 945 (2013) c: TB mortality rate (excluding HIV) 45% (2000) 32% (2010) 11% (2014) 29% 6.10a: TB Case Detection rate (%) 34 (2002) 84 (2010) 38 (2014) b: TB treatment Success rate (%) 42 (2006) 71 (2010) 79 (2014) 85 TARGET 6.A: HAVE HALTED BY 2015 AND BEGUN TO REVERSE THE SPREAD OF HIV/AIDS Indicator 6.1: HIV prevalence and incidence among population aged years HIV prevalence among population aged is the proportion of people who are living with HIV in the general population aged In Swaziland young females and males aged account for 22% of the total population in Swaziland. According to HIV Estimates and Projections (2015), HIV prevalence among people aged is estimated to be 15.5% for females and 7.2% for males. The country last had a population based survey that included HIV testing in 2007, wherein HIV prevalence for those aged was found to be 14.3%. HIV Swaziland Millennium Development Goals 2015 Report Page 69

70 Percentage prevalence for young people aged is 16.3%, comprised of 26.5% females and 4.8% for males (Swaziland HIV Incidence Measurement Survey, 2011). HIV Incidence is the number of new infections over a specified period of time, ie. 12 months. In this case the HIV incidence rate among adults aged is 2.38%, two percent (1.7%) among men and 3.1% for women. HIV incidence peaks at 18-19, and in women and at ages in the case of men. Figure 6.1: HIV Incidence, MEN Women Source: Swaziland HIV Incidence Measurement Survey, 2014 Indicator 6.2: Condom use at last high-risk sex among people aged Condom use at last high-risk sex is the percentage of young men and women aged 15 to 24 reporting the use of a condom during sexual intercourse with a non-cohabiting, non-marital sexual partner in the last 12 months. Condom use in high risk sex has increased for women, from 70.4% in 2007 to 93.4% in Condom use among girls has increased from 54.2% in 2007 to 73.1% in 2010, but reduced to 70.9% in This is probably due to their inability to negotiate condom use and collaborate with trends in new infections, which show that young women are more vulnerable to HIV acquisition and have higher HIV prevalence than their male counterparts. Swaziland Millennium Development Goals 2015 Report Page 70

71 Indicator 6.3: Proportion of population aged years with comprehensive correct knowledge of HIV/AIDS The proportion of population aged 15 to 24 years with comprehensive correct knowledge of HIV/AIDS is the percentage of young persons aged 15 to 24 who correctly identify the two major ways of preventing the sexual transmission of HIV (using condoms and limiting sex partners to one faithful, uninfected partner); who reject the two most common local misconceptions about HIV transmission; and who know that a healthy-looking person can transmit HIV. The level of knowledge about HIV transmission and means to prevent infection has reduced among young people. Among young women aged comprehensive knowledge has reduced from 58.2% to 49.1% in Similarly, comprehensive knowledge among men has reduced from 53.6% to 50.9%. The decline in knowledge is attributed to an under investment in HIV education, which is mainstreamed in other HIV programmes, including school s curriculum under life skills education. Indicator 6.4: Ratio of school attendance of orphans to school attendance of non-orphans aged years The ratio of the current school attendance of orphans to school attendance of non-orphans aged 10 to 14 years is defined as the proportion of the current school attendance rate of children aged 10 to 14 years whose biological parents have died divided by the proportion of current school attendance rate of children aged 10 to 14 years whose parents are still alive and who currently live with at least one biological parent. The country has performed considerably well in facilitating access to both primary and secondary education for school going children. In 2010 the country introduced the Free Primary Education (FPE) programme to ensure that all children get access to basic education in grades 1 to 7. In addition to FPE, since 2002, Government has provided scholarships to orphaned and vulnerable children in secondary and high schools. As a result of these efforts, there is no difference in school attendance between orphans and non-orphaned children, since 98% of both orphans and non-orphaned children aged attend school. The ratio of school attendance was 1.01 in 2007, in favour of OVC as government intervened for OVC through the OVC schools grants. The introduction of Free Primary Education programme in 2010 made school attendance OVC and non-ovc alike. Swaziland Millennium Development Goals 2015 Report Page 71

72 Percent TARGET 6.B: ACHIEVE, BY 2010, UNIVERSAL ACCESS TO TREATMENT FOR HIV/AIDS FOR ALL THOSE WHO NEED IT Indicator 6.5: Proportion of population with advanced HIV infection with access to antiretroviral drugs This is the proportion of HIV positive adults and children who are currently receiving antiretroviral therapy according to nationally approved treatment protocols and guidelines. By the end of 2014 there were 125, 421 people living with HIV who were on ART, comprised of 117,515 adults and 7,906 (children under 15 years. This translates to 58.5% (60% of adult and 43% children) of the estimated 214, 342 people who are living with HIV (PLHIV). The low ART coverage for children is attributed to limited linkage to care and other social issues for consenting to start treatment. Progress in this indicator is satisfactory. In the past, this indictor looked at the ART coverage for PLHIV with advanced HIV disease. Advanced HIV disease in this case referred to patients with CD4 counts less than 200 cells/mm 3 and WHO clinical staging. Since then the eligibility criteria for initiating ART has expanded significantly with an increase in the CD4 threshold to 350 and 500. In addition, the country has removed CD4 eligibility and WHO criteria for certain population groups like; HIV + children less than 5 years, HIV+ pregnant and lactating women, sero-discordant couples, HIV associated nephropathy and TB and HBV co-infection. Figure 6.2: Proportion Of Population with Advanced HIV Infection with Access To Antiretroviral Drugs Proportion of pop with advanced HIV Accessing ART Proportion of pop with advanced HIV Accessing ART Source: MOH; M&E database 2014 Swaziland Millennium Development Goals 2015 Report Page 72

73 INEQUALITY ANALYSIS Table 6.2: HIV Prevalence Among Population Aged Years, Condom Use at Last High Risk Sex and Proportion of Population Aged Years with Comprehensive Correct Knowledge of HIV/AIDS HIV prevalence among population aged years Condom use at last high risk sex Proportion of population aged years with comprehensive correct knowledge of HIV/AIDS Regions Males Females Males Females Hhohho Manzini Shiselweni Lubombo Area Urban Rural Source: CSO; MICS (2014) HIV prevalence among youths living in urban areas is slightly higher than that of rural areas (18 percent compared with 13 percent). Youth in the Hhohho region have the highest HIV prevalence compared with those from other regions. Condom use at last high risk sex is higher amongst males than females across the regions and in both rural and urban areas. The opposite is true for proportion of population aged years with comprehensive correct knowledge of HIV/AIDS. The ratio of school attendance of orphans to school attendance of non-orphans aged years is almost the same in both urban and rural areas and also in all four regions. Swaziland Millennium Development Goals 2015 Report Page 73

74 Table 6.3: Ratio of School Attendance of Orphans to School Attendance of Non-Orphans Region Ratio of school attendance of orphans to school attendance of non-orphans Hhohho 1.01 Manzini 0.99 Shiselweni 1.00 Lubombo 0.93 Area Urban 0.98 Rural 0.99 Source: CSO; MICS (2014) HIV prevalence among youth living in urban areas is slightly higher than that of rural areas (18 percent compared with 13 percent respectively). The youth in the Hhohho region have the highest HIV prevalence compared with those from other regions. The Hhohho region is also the lowest in wealth quintile. ACHIEVEMENTS Introduction of and free access to ART. The establishment of NERCHA. The revision of CD4 count rate. SUPPORTIVE ENVIRONMENT The country declared HIV as a national disaster in This led to the creation of the national AIDS Council, NERCHA in 2003 which coordinates multisectoral action to ending AIDS by % of total financial resources for HIV are mobilised by domestic sources (The government of Swaziland and private sector) During the Declaration period , the following Policies have been put in place to support the HIV response Swaziland Millennium Development Goals 2015 Report Page 74

75 o National Strategic Framework (NSF) and Extended National Strategic Framework (ENSF) These provide a blueprint for multisectoral action for HIV. Objectives of the ENSF are to half HIV incidence rate, Avert 15% deaths amongst PLHIV and in particular those with TB/HIV co-infection, Alleviate socio-economic impacts of HIV and AIDS among vulnerable groups and Improve efficiency and effectiveness of the national response. o Health Sector Strategic Plans I and II (HSSP I and II). These provide the strategic focus of the health sector service delivery system. The objective of the HSSP II is to reduce morbidity, disability and mortality that is due to disease and other social conditions; Promote effective allocation and management of health sector resources; and reduce the risk and vulnerability of the country s population to social welfare problems as well as the impact thereof. o National Male Circumcision Policy (2009). The aim of the Policy is to scale up male circumcision as a proven HIV prevention strategy, alongside other prevention interventions. o National Policy on Children (2009). The policy aims to ensure that appropriate interventions are put in place to adequately care for and protect children in general; and orphaned and vulnerable children in particular. o HIV Treatment Guidelines (2003, 2008, 2011, 2014). These provide operating procedures for administering HIV treatment for infected people. Eligibility thresholds have been constantly expanded to current CD4 count 500 cells/mm3 and removed CD4 eligibility and WHO criteria for certain population groups. o Swaziland HIV Investment Case (draft). This is a pathway towards the national vision of attaining an AIDS-free Swaziland by 2022, which is also aligned to the global objective of ending AIDS by Availability of data to support HIV programming. The Swaziland Demographic and Health Survey in 2007, The Modes of Transmission Study 2009, Multiple Indicator Cluster Surveys (2010 and 2014), Swaziland HIV Incidence Measurement Survey, 2011, Antenatal Care HIV Surveillance ( ), and Sectors that have existing database systems include, MoH, MTAD, National Children s Coordination Unit (NCCU), Central Statistical Office (CSO), MoE, regions SHAPData and development partners. KEY BOTTLENECKS CONSTRAINING PROGRESS AND HOW TO ADDRESS THEM Inadequate funding for the National response: funding for the response is not sufficient to implement all required action. The dependency on two main external donors Global Fund and PEPFAR create concerns about the sustainability of the national response. Strengthen public private partnership for a more robust social responsibility by private companies. Inadequate systems for appropriate resource allocation. The NASA (2011) reported that approximately 41% of the total funding in the last fiscal year was spent on coordination and management, followed by treatment, care and support (26%), and impact mitigation (25%). HIV prevention which is the key priority for Swaziland consumed only 8% of total expenditure. Swaziland Millennium Development Goals 2015 Report Page 75

76 Multisector collaboration of the ministries involved in the holistic care and treatment of People Living with HIV (PLHIV) needs strengthening to ensure the commitment of resources for HIV synergies and that set goals are achieved. Weak community systems- Inadequate involvement of communities and in particular realization of their potential to improve community-based service delivery. Slow social and behavioural change to accelerate HIV prevention benefits. NEW CHALLENGES The global economic and financial crisis has had an impact in the wellbeing of people in Swaziland just like many other countries. With the job losses that the country has experienced because of the financial crisis, some of the survival mechanisms that people have resorted to are leading to new HIV infections. High HIV infection amongst female sex workers and young women Infrastructure in health facilities to accommodate the increasing number of PLHIV initiated on treatment due to the improved eligibility criteria. HOW SWAZILAND WILL ACCELERATE PROGRESS IN THIS MDG Coordination of HIV/AIDS interventions need to be strengthened. The country needs to effectively implement the HIV/AIDS National Strategy. There should be tailor made services targeting MARPS LESSONS LEARNT Service delivery Decentralization improved access and retention to ART services Mentoring was beneficial to decentralize services as well as ensure that quality ART services are offered as per national guidelines. Strengthening Mother baby Pair facilities: Regional Hospitals and Health centres provide sustainable mentoring and technical support to surrounding clinics. Integration of other services within the ART clinics (TB, FP) Renovations of sites and provision of Park homes to create more space for consultations Involvement of rural Health motivators to help educate as well as do patient follow up to improve access, use and retention Roll out of Life Long ART for all HIV positive pregnant and lactating mothers Swaziland Millennium Development Goals 2015 Report Page 76

77 Laboratory Sample transport To transport blood samples from the clinic to the nearest national laboratory for analysis. Most sites are visited at least twice a week. Point of care CD4 machines Phlebotomist placement in some facilities Drug supply and stock management Government commitment in the procurement of drugs Health information Ongoing scientific research to evaluate programme performance and guide future priorities o SHIMMS study (2011) National and Regional HIV Semi-annual Data review meetings incepted and used for improving indicators and quality of service provision. Human resource Task shifting of responsibility to help lower facilities to cope with increasing work demand (Expert clients both facility and community, nurse led ART initiations, placement of phlebotomist, and data Clerks. Leadership National office working closely with supporting partners and the regions Swaziland Millennium Development Goals 2015 Report Page 77

78 Target 6. C: Malaria Table 6.4: Malaria incidence and deaths Year 2004 / 2005 / 2006 / 2007 / / / / / / /2014 Incidence rates associate d with Malaria Death rates associate d with Malaria Source: HMIS 2014 Indicator 6.6: Incidence and death rates with malaria The incidence of malaria is the number of new cases of malaria per people each year whilst the death rate associated with malaria is the number of deaths caused by malaria per people per year. Swaziland Millennium Development Goals 2015 Report Page 78

79 Number of cases Figure 6.3: Incidence Associated with Malaria 1,600 1,400 1,200 1, Source: HMIS Confirmed Cases 1, The country has long achieved this indicator, such that in 2009 it was chosen by the Southern African Development Community and European Union to move towards the goal of eliminating malaria in the country by A lot of progress has been made since adoption of the elimination strategy in 2009, and there has been a significant decrease in the number of malaria cases and death reported by the different health facilities. A robust surveillance system was put into place that allowed for easy detection and reporting of malaria cases and deaths. Looking at figure 6.3 above, the trend shows an increase in cases which reflects the strengthened robust surveillance system that is able to pick up all cases and not necessarily an increase in the confirmed malaria cases. During the malaria season 2013/2014, a total of 685 confirmed malaria cases were reported, of which 535 (78%) cases were investigated( 2013/2014 Annual Report). A strategic plan has been developed to guide the country after achieving malaria elimination in 2015 up until WHO certification in 2018 and beyond. Swaziland Millennium Development Goals 2015 Report Page 79

80 Mortality rate Figure 6.4: Deaths due to Malaria Mortality Rate Source: HMIS 2014 As the country pursues its goal of eliminating malaria, its aim is to have zero malaria deaths. Confirmed malaria deaths are still being seen in our health facilities mainly due to late treatment seeking behaviours and co-occurring conditions. During the malaria season , three locally transmitted malaria deaths were reported in the country. Indicator 6.7: Proportion of children under 5 sleeping under insecticide-treated bed nets The proportion of children sleeping under an insecticide-treated bed net (ITN) is the percentage of children under five years of age in malaria endemic areas who slept under an insecticidetreated bed net the night preceding the survey. Since 2009, when the programme adopted the elimination policy, the programme has been distributing Long Lasting Insecticide Treated Nets (LLINs) to all people in the malaria endemic areas regardless of the age group. As the programme moves towards elimination, all people residing in malaria risk areas are equally susceptible to malaria and universal coverage should be aimed. The LLINs are defined as the nets that have been impregnated with the insecticide during manufacture and are expected to last for a period of 3-5 Years. According to the Knowledge Attitudes and Practices (KAP) survey of 2014, 54.7 percent of children under the age of five years were reported to be sleeping under LLINs in the last 12 Swaziland Millennium Development Goals 2015 Report Page 80

81 months, which showed an increase as compared to the KAP survey of 2012 where 51 % of children were reported to have slept inside a net. Indicator 6.8: Proportion of children under 5 with fever who are treated with appropriate antimalarial drugs This indicator is no longer relevant because the National Malaria Diagnosis and Treatment guidelines advocates for confirmed diagnosis, patients are not treated based on the clinical presentation but, there has to be definitive diagnosis before treatment is given. All patients presenting with fever are to be tested and confirmed before treatment is initiated. Confirmation is by RDT and or microscopy since rolling out of RDTs to clinic level in Country specific indicators Indicator 6.8a: Percentage of households covered with Indoor Residual House Spraying (IRS) A total of structures of the targeted structured have been sprayed during the 2014/2015 malaria season, achieving a coverage of 94.3 %. There is an increase in the spray coverage when looking at the previous years (2013/2014) malaria season whereby a coverage of 90% was reached. ACHIEVEMENTS Establishment of the Malaria Control Programme. The country is the model for Africa in this target. SUPPORTIVE ENVIRONMENT Strengthen mass media messages on malaria treatment seeking behaviour, and prevention. Develop a malaria early warning system model. MALARIA BEST PRACTICES Both the incidence and deaths rates of malaria in the country have significantly dropped as the country draws closer to elimination. The success could be attributed to; The strengthened health facility mentoring and monitoring visits by the programme to ensure adherence to the National Diagnosis and Treatment guidelines by health care workers The strong management and resource mobilisation mechanism which has enabled the programme to secure resources up to 2018 Swaziland Millennium Development Goals 2015 Report Page 81

82 The introduction of active case surveillance of all confirmed cases by the programme. Cases are followed up immediately after confirmation before possibilities of onward transmission. The consistent IRS coverage of above 90% annually CHALLENGES Low incidence of malaria in the country poses as a threat towards health seeking behaviour as people no longer regard it as a threat. Global warming, resurgence of malaria in areas that did not have malaria in the past 5-10 years. TARGET 6D: TUBERCULOSIS The Ministry of Health re-established a National TB Control Programme (NTCP) in 2007 at both national and regional levels, allocated budget line for TB control, funded procurement of qualityassured first and second line drugs, provided personnel and constructed a national TB hospital. The NTCP developed appropriate strategic documents, plans and guidelines for effective management of tuberculosis. The country currently ranks first among countries with the highest tuberculosis (TB) incidence in the world at 1,382 cases per 100,000 population. The TB/HIV co-infection rate among incident TB cases has remained above 80 percent and equally challenging is the increasing burden of drug resistant TB cases in the country. The recognition of TB as a major public health challenge prompted high level political commitment by declaring TB a national emergency in March To address these emerging challenges, the country s National TB Strategic Plan had set out to expand and enhance high quality DOTS by ensuring an uninterrupted supply of anti- TB drugs and free management to all TB patients. Furthermore, the strategy sought to engage all health providers in public and private sectors to promote universal access to treatment and care. Decentralization of integrated TB/HIV and DR-TB services also became a key approach to reach the most vulnerable populations, which was enhanced through greater involvement of patients and their communities in TB control. In 2014, Swaziland notified 5,582 TB cases of all forms (505 cases per 100,000 population). An Epidemiological Analysis conducted during the WHO-led NTCP External review in April 2014, revealed a declining trend in the TB case notification rate, against the WHO modelled estimates. The total number of TB cases and notification rate increased progressively from 2002 to reach a peak in 2010, following which the yearly number of TB cases decreased successively with a mean percentage change of 16 percent. This decline was concomitant with an important scale-up in the provision of antiretroviral treatment to PLHIV with advanced disease. While the TB case detection rate improved from 35 percent in 2002 to 74 percent in 2010, the treatment success rate improved from 42 percent in 2003 to 68 percent in 2007 cohorts. However, a lot still needs to be Swaziland Millennium Development Goals 2015 Report Page 82

83 Axis Title done in view of 70 percent minimum target for case detection and 85 percent minimum for treatment success in line with WHO recommendations. Indicator 6.9: Incidence, prevalence and death rates associated with tuberculosis Incidence, prevalence and death rates associated with tuberculosis indicators refer to the estimated number of people getting ill with TB in a population, the number of TB cases in a population and the number of death per 100,000 populations in a specific time period (usually per year), respectively. Tuberculosis constitutes a one of the major public health problems currently confronting the Kingdom of Swaziland. Compared to a 1990 level of 267 all forms of TB cases per 100,000 population, the incidence of the disease according to estimates from WHO has increased more than five-fold. The country is among those with an estimated TB incidence of 1,382per every 100,000 population. TB-related mortality has increased from 76 per 100,000 in 1990 to the current level of 91 per 100,000 populations in This mortality figure translates to about 800 deaths annually due to TB alone. In the 2013 cohort of TB patient; a total of 780 (11 percent) patients died during treatment. Even though the estimated incidence and prevalence rates have been increasing over the years, they actually number of TB cases being diagnosed and enrolled on treatment have been declining steadily at a rate of 15 percent to 20 percent year on year since the highest notification rate was recorded in Figure 6.5: Incidence, Prevalence and Notification Rate of Tuberculosis Prevalence Incidence 1,227 1,257 1,287 1,317 1,349 1,382 Notfication rate Source: HMIS WHO. Global TB Report 2014 Swaziland Millennium Development Goals 2015 Report Page 83

84 Axis Title Indicator 6.10: Proportion of tuberculosis cases detected and enrolled on directly observed treatment short course The tuberculosis detection rate is the ratio of notified TB cases (all forms) and the estimated incident cases in a specific population in a year. The National TB Control Strategic Plan has forged national, regional and community based responses to curb the sweeping endemic through introduction of Directly Observed Treatment Short Course (DOTS), expanded case detection, and adherence to medication. A cured TB patient is a pulmonary TB patient with bacteriologically confirmed TB at the beginning of treatment who was smear- or culture-negative in the last month of treatment and on at least one previous occasion. TB was declared a national emergency in 2011 and in 2010 the TB case detection rate reached 84 percent and the treatment success stood at 69 percent. The number of cases registered and notified to the NTCP stood at 5582 at the end of This represents more than a 50 percent decline from a peak of cases notified in Overall TB notification rates have been falling at an average rate of about 16 percent year on year since Figure 6.6: Number of Tuberculosis Cases Detected and Enrolled into Directly Observed Treatment Short Course 12,000 10,000 8,000 6,000 4,000 2, Notified cases 6,85 6,80 6,86 7,86 8,37 8,86 9,19 9,63 9,56 11,0 11,1 9,18 7,73 6,66 5,58 Source: MOH; NTCP database (2014) Swaziland Millennium Development Goals 2015 Report Page 84

85 COUNTRY S SPECIFIC MDG INDICATORS Indicator 6.11: Deaths from all forms of TB including HIV/AIDS Tuberculosis death rate is the number of deaths from tuberculosis per 100,000 population. Incidence, prevalence and mortality estimates include patients with HIV. The WHO estimates that 91/100,000 population TB deaths for the country in Trends in TB mortality rates are shown in the table below. From national data in 2014, about 11 percent (724/6647) of TB patients died during the course of treatment. Table 6.5: Estimates TB mortality per 100,000 Population Year Absolute % change % % Source: World Bank INEQUALITY ANALYSIS Figure 6.7, below presents TB cure and success rates for the year 2014 by region. TB treatment success rate stood at 79% nationally. Cure rate continue to be on the low side due a combination to a high percentage of patient enrolled on treatment without a bacteriological confirmation and poor sputum collection during treatment monitoring. From the figure below, we observe that the Shiselweni region has by far the best TB treatment outcomes in the country. Treatment success rates still fall below the recommended WHO target of 85%. Notably, Lubombo Region has the lowest cure and treatment success rates compared to the other of the regions. This could be mainly attributed to poor treatment monitoring and follow-up due to the inadequate resources in the region. Swaziland Millennium Development Goals 2015 Report Page 85

86 Figure 6.7: TB Cure and Treatment Success Rates % 80% 79% 80% 80% 76% 79% 70% 61% 60% 49% 51% 50% 44% 50% 40% 30% 20% 10% 0% Hhohho Manzini Shiselweni Lubombo NATIONAL Cure Rate Treatment success rate Source: MOH; NTCP (2014) ACHIEVEMENTS Establishment of the National TB Control Programme. Construction of the TB Centre. Introduction of gene expert for improved TB diagnosis. SUPPORTIVE ENVIRONMENT The presence of National Tuberculosis Control Programme, HIV/AIDS Prevention and Care Programme including PMTCT, and Malaria Control Programme are all critical in dealing with Tuberculosis, HIV/AIDS and Malaria. The recognition of TB as a major public health challenge prompted high level political commitment by declaring TB a national emergency in March To address these emerging challenges, the country s National TB Strategic Plan had set out to expand and enhance high quality DOTS by ensuring an uninterrupted supply of anti-tb drugs and free management to all TB patients, while The current TB NSP dedicates much emphasis on active case finding. The government of Swaziland has committed to procuring drugs for Drug susceptible TB. Furthermore, the strategy sought to engage all health providers in public and private sectors to promote universal access to treatment and care. Decentralization of integrated TB/HIV and DR-TB services also became a key approach to reach the most vulnerable populations, which was enhanced through greater involvement of patients and their communities in TB control. Swaziland Millennium Development Goals 2015 Report Page 86

87 KEY BOTTLENECKS CONSTRAINING PROGRESS AND HOW TO ADDRESS THEM Key populations that may have disproportionately low access to prevention, treatment, care and support services, and the contributing factors to this inequity. Declining case notification rates against WHO modelled estimates and increasing levels of drug resistance among new cases. Weak vital registration systems contribute to inaccurate data and difficulty in quantifying TB related mortality. Decentralization of TB treatment initiation to lower level facilities has been compromised due to inadequate infrastructure resulting in severe Infection Prevention and Control (IPC) challenges. Weak M&E: Reporting and recording for TB screening in PMTCT and other HIV sites need to be strengthened. TB treatment is not available in all clinics providing ART and PMTCT services as a one stop-shop even though these far outnumber TB treatment initiating sites. There is evidence of loss of patients in the diagnostic pathway associated with cross referral practices between facilities. NEW CHALLENGES Increasing Drug Resistance: The emergence of Multiple Drug Resistant Tuberculosis and Extreme Drug Resistant Tuberculosis has compounded the situation in the country. More research and new methods of dealing with drug resistance TBs need to be conducted There is low coverage with confirmatory first line Drug Susceptibility Testing (DST) for First Line Drugs (FLD) for GeneXpert diagnosed cases and Second-line DST (SLD) for confirmed MDR-TB cases as per national and international recommendations. This has resulted in less than 50 percent of expected MDR-TB cases being detected based on the 2009 DRS and a low treatment success rate. There is a challenge with inadequate Human Resource at NTRL and NTCP level as 83 percent of staff are donor funded. The community outreach unit of the TB hospital is grossly understaffed to sufficiently support the outreach sites HOW SWAZILAND WILL ACCELERATE PROGRESS IN THIS MDG Scale-up of GeneXpert for faster and improved TB diagnosis Implementation of the active case finding strategy Collaboration with SNAP to develop integrated TB/HIV reporting and recording tools. Expansion of TB Treatment initiation sites to from 85 to 145 by 2019 including PMTCT sites. The Swaziland Government has shown commitment by securing a loan from the World Bank for infrastructure refurbishment which will partly address IPC challenges in health facilities to support the BMU decentralization process. A DRS is planned for 2015 to assess levels of drug-resistance in Swaziland Swaziland Millennium Development Goals 2015 Report Page 87

88 The national diagnostic algorithm has been amended to facilitate compulsory FLD on all MTB positive patients and monthly compulsory culture FLD for all MDR-TB patients. The NTRL has been upgraded to Biosafety Level 3 (BSL3) and capacity building for SLD is being conducted in collaboration with the SNRL in Uganda Community treatment supporters and adherence officers have been recruited to enhance community-based TB management and support MDR-TB Doctors and nurses have been recruited and trained on MDR-TB management to strengthen the community based MDR-TB management The Ministries of Health and Public Service have been engaged to develop a Strategy to facilitate the absorption of donor-funded positions within the NTCP into Government establishment. The MoH is facilitating the strengthening of the M&E and Vital Registration systems including development of the Client Management Information System (CMIS). Studies are planned for 2015 to assess the levels of under-reporting of childhood TB and identify gaps in case detection. The NTCP will also conduct a national TB Prevalence survey in 2015/2016. LESSONS LEARNT The scale-up of GeneXpert in improving and making TB diagnosis faster Implementation of an Active case finding strategy Collections of two specimen at diagnosis to improve diagnosis of Drug Resistant TB Introduction of second line drug susceptibility testing Scale up of the laboratory network to increase access to diagnostic services Introduction of new TB drugs into the TB regimen Swaziland Millennium Development Goals 2015 Report Page 88

89 MDG 7: ENSURE ENVIRONMENTAL SUSTAINABILITY Table 7.1 Status and trends MDG INDICATORS BASELINE FIGURE STATUS IN 2012 STATUS IN TARGET STATUS AT GLANCE TARGET 7A: INTEGRATE THE PRINCIPLES OF SUSTAINABLE DEVELOPMENT INTO COUNTRY POLICIES AND PROGRAMMES AND REVERSE THE LOSS OF ENVIRONMENTAL RESOURCES TARGET 7.B: REDUCE BIODIVERSITY LOSS, ACHIEVING BY 2010, A SIGNIFICANT REDUCTION IN THE RATE OF LOSS 7.1 Proportion of land area covered by forests 36 (1990) 7.2 CO2 Total (Mt) Emissions (2000) Per Capita 19.5 (2000) Per GDP $ (2000) 7.3 Methyl Consumption bromide (2009) of Ozone HCFC-141b Depleting (pre (2009) Substances blended polyol) HCFC (2009) 7.5 Proportion of total water resources used (Mm 3 ) 7.6 Ratio of area protected to maintain biological diversity to surface area 1057 (2005) 3.7 (2000) 45 (1999) (2000) 19.5 (2000) (2000) (2010) (2009) (2009) 1370* (2015) 4.5 (2009) 62 (2014) (2013) 32.8 (2013) 21.4 (2013) 1370* (2015) 4.14 (2014) Total phase out 10% reduction 10% reduction - - TARGET 7.C: HALVE, BY 2015, THE PROPORTION OF PEOPLE WITHOUT SUSTAINABLE ACCESS TO SAFE DRINKING WATER AND BASIC SANITATION 7.8 Proportion of Population Using an improved water source 7.9 Proportion of Population using an improved sanitation facility *Projection 39.7 (1997) 74.5 (1997) 67.3 (2010) 53.8 (2010) 72.4 (2014) 53 (2014) Swaziland Millennium Development Goals 2015 Report Page 89

90 TARGET 7.B: REDUCE BIODIVERSITY LOSS, ACHIEVING, BY 2010, A SIGNIFICANT REDUCTION IN THE RATE OF LOSS Indicator 7.1: Proportion of land area covered by forest Forests are a source of timber, firewood and other goods. They also play an important role in soil and water conservation, maintaining a healthy atmosphere and biological diversity of plants and animals. Forests are renewable and, when managed in a way that is compatible with environmental conservation, can produce goods and services to assist in development. The proportion of land area covered by forests is the forest area as a share of total land area, where land area is the total surface area less the area covered by inland waters such as major rivers and dams. Swaziland is endowed with extensive cultivated and natural forests. The forest cover includes natural forests of mostly wattle forests and commercial plantation forests. The country s forest and flora resources accounted for an average coverage of 36 percent in 1990 and 45 percent in 1999 (FAO, 2015). Forest coverage figures from 2000 to 2015 were obtained through linear extrapolation and they show that the land covered by forests is still increasing as indicated in Table 7.2 below. Table 7.2 Total Forest Area ( ) Classification Area (1000 hectares) * 2010* 2015* Forest Other wooded land Inland water bodies Total Land Area Proportion of land area covered by forests (%) Source: FAO; Global Forest Resources Assessment 2015, country Report-Swaziland The worst forest wildfire disasters of 2007 and 2008 where more than 40,000 hectares of timber plantation was destroyed and was followed by the closure of Sappi Usutu, the only pulp producing company in Swaziland. Forest cover continues to increase especially because of the afforestation and reforestation programmes in the commercial forest plantations. Commercial forestry in Swaziland is entirely run by private companies, of which Montigny Investments, Peak Timbers and Shiselweni Forest Company are the largest. These three companies together with some smaller ones manage a total of more than 130,000 hectares covered by forest plantations. Main species are pine predominantly Pinus patula, but also Pinus. radiata and Pinus. taeda) and eucalyptus (mainly Eucalyptus salinga and Eucalyptus. grandis), covering about 80 percent and 20 percent respectively of the planted area. Even though commercial plantations are in a good state, forest degradation continues to be a major challenge in natural forests. The current deforestation and degradation of natural forests and woodlands is caused by a combination of factors such as conversion of land to agriculture Swaziland Millennium Development Goals 2015 Report Page 90

91 Percentage and other land uses, uncontrolled extraction of forest products from communal land, large livestock populations and expanding infrastructure development. Forest degradation is further compounded by a number of underlying socio-economic conditions caused by increasing population pressure. The associated problems include poverty, hunger, and access to land, lack of cheap alternative energy sources, jobs and income generating opportunities. The impact of invasive alien plant species can be observed over much of the country, and the results of the survey and mapping of 2010 revealed that more than 47 percent of the country s land area is invaded. Amongst the worst invaders are Lantana camara, Chromolaena odorata, Psidium guajava and Acacia mearnsii have spread over large areas while the herb Parthenium hysterophorus is often evident in the grass layer in disturbed areas. Figure 7. 1 Proportion of Land Area Covered by Forests 70 Proportion of land area covered by Forests Forest Area Source: FAO; Global Forest Resources Assessment 2015, country Report-Swaziland Indicator 7.2: Carbon Dioxide emissions, total, per capita and per $1 GDP Total carbon dioxide emissions refer to the total greenhouse gas emissions converted to carbon dioxide equivalent, where greenhouse gases (GHG) are the gases responsible for human induced climate change as addressed by the United Nations Framework Convention on Climate Change (UNFCCC). GHGs include, inter alia, carbon dioxide (CO2), methane (CH4), Nitrous Oxide (N2O), oxides of Nitrogen (NO, NO2), and Hydrofluorocarbons (HFCs). Swaziland Millennium Development Goals 2015 Report Page 91

92 Swaziland is party to the UNFCCC and its Kyoto Protocol, which seeks to reduce the level of GHG emissions in the atmosphere, with a view to address human induced climate change. However, as this needs to be achieved without negative impacts on sustainable development, negotiations under the UNFCCC recognise and appreciate that for developing countries GHG emissions will continue to increase and reach peak point around In partial fulfilment of the country s commitment to the UNFCCC, GHG inventories are prepared as required under the convention. So far this has been an inventory for 1994 (submitted in 2002) and 2000 (submitted in 2012). The preparation of the inventories is a data intensive exercise, and the country has relied on resources provided by the UNFCCC secretariat to undertake it, hence 1994 and 2000 are the only available data points as shown in Table 7.3 except for the energy sector where a series is available from 1994 to 2004 as shown in Figures 7.2 and 7.3 Table 7.3: GHG emissions by sector (metric tons CO 2 Equivalent) YEAR Energy Industrial Process Agriculture Land Use, Land Use Change and Forestry Waste Total Emission Estimates ,055,950 3,194,100 1,233, , ,980 6,330, ,333,800 9,063,500 1,602,910 1,105,130 6,657,800 19,763,140 Source: MEPD; MDGR (2010) Table 7.4: CO 2 emissions: Total, Per Capita and Per GDP T/$ CO2 emissions (metric tons) 6,330,000 19,763,140 CO2 emissions per capita (T/capita) CO2 emissions per GDP (T/$) Source: CO 2 related MDG indicators. Population and GDP data used to derive the indicators sourced from World Bank Data ( last updated June 2012) Table 7.4 shows that there was a large increase in emissions between 1994 and 2000 mainly due to industrial processes, the waste sector and, to a lesser extent, land use, land use change and forestry. With land use, land use change and forestry, not only has there been a change in methodology, but there have also been notable changes in land use patterns and the quality of the country s natural forest. The country is, however, putting efforts to the preservation of its forest and the quality. Among other things, the demand for forest resources is being managed through the development of community woodlots, rural electrification, promotion of energy efficient wood Swaziland Millennium Development Goals 2015 Report Page 92

93 stoves and renewable energy sources. In addition, the Forest Bill of 2010 is envisaged to further enforce the management and increase of carbon sinks in the form of forests. The waste sector also saw a major change in emission estimation methodology, which may account for a large percentage of the observed increase. The uncertainty levels of the emission estimation are also quite high as data has not been properly collected in waste management sites, more so in the rural areas where a large proportion of the populace resides. Efforts are being made to address these emissions as new improved waste management sites are being constructed in some of the towns around the country. Communities of which Msunduza) is one, are also embarking on waste reusing/recycling projects that will reduce the volumes of our waste stream. Industrial processes show the largest increase. The uncertainty level is high on information obtained from customs declarations data. However, with the improved monitoring systems that have since been implemented at the country s ports, uncertainty is likely to drop significantly. Another contributing factor may be the elimination of ozone depleting substances (indicator 7.3), which are being replaced by HFCs. Though ozone depleting substances are also GHGs, they are not accounted for when estimating total CO2 emissions as the UNFCCC does not account for gases controlled by the Montreal Protocol. However, the replacement gases are then accounted for, which then reflects a significant increase in emissions from industrial processes. The public sector, in collaboration with the private sector, has currently embarked on a project to reduce the emissions from this sector, particularly the HFCs. Figure 7.2: CO 2 emissions for the energy sector ( ) Source: World Bank public data ( last updated June 2012) Swaziland Millennium Development Goals 2015 Report Page 93

94 Figure 7.3: CO 2 emissions per capita and CO 2 emissions per Dollar GDP Source: World Bank public data ( last updated June 2012) Consideration of the MDG indicators, as reflected in Figure 7.3, shows a steady increase of CO2 emissions per capita, ranging from metric tons per capita in 1995 to Mt per capita in Energy use per capita is expected to increase in the country as a characteristic of developing countries. However, the offsetting of these emissions need to be continually improved through energy efficiency, use of renewable energy source, etc. On the other hand, the increase in CO2 emissions per dollar GDP has been at a higher rate until it peaked in 2002 at Mt tons per dollar. The observed decrease between 2003 and 2004 reflects improved efficiency during these years. The country is in the process of developing a Climate Change Strategy and Action Plan (CCSAP), which will also provide for managing GHGs in the form of a Long Term Carbon Strategy and a Nationally Appropriate Mitigation Action (NAMA) (as proposed under the UNFCCC). This will assist in the integration of CO2 mitigation. In addition the CCSAP will contain an adaptation plan. This will help minimise the negative impacts of climate change on the country s development, which are already being observed in some sectors such as agriculture, and if not addressed will render the country s efforts to sustainable development ineffective. Furthermore, the country is part of the Stockholm Convention, which was adopted in 2001 and entered into force in The objective of the Convention is to protect human health and the environment from persistent organic pollutants (POPs). The country is committed to implementing the Institutional Arrangement Framework and Policy for the Stockholm Convention on POPs and as part of the implementation of the Convention, the country has Swaziland Millennium Development Goals 2015 Report Page 94

95 generated quality inventories to assess the presence of various POPs as well as an implementation plan. The plan is intended to reduce emissions from the burning of waste and to establish a monitoring system for emissions and their effects on human health and the environment. Indicator 7.3: Consumption of ozone-depleting substances Ozone Depleting Substance (ODS) are chemical substances, usually consisting of some combination of chlorine, fluorine, or bromine plus carbon, such as chlorofluorocarbons (CFCs) and hydrofluorochlorocarbons (HCFCs) that have been shown to destroy stratospheric ozone. Swaziland still consumes ODS i.e. HCFCs, and the major ones being chlorodifluoromethane commonly referred to as HCFC 22 widely used in air conditioners, the domestic and commercial/industrial sectors; and HCFC 141 which is used as a blowing agent in the polyurethane foam for insulation in the manufacture of refrigerators. Swaziland has ratified a number of treaties on environment to protect the ozone layer including the Vienna Convention and Montreal Protocol which regulate the production and consumption of ozone depleting substances. The Vienna Convention on the Protection of the Ozone Layer and its Montreal Protocol on Substances that Deplete the Ozone Layer were ratified in All the amendments to the Protocol were ratified in ODS regulations were promulgated in 2003 to regulate the import of ODS into the country by providing a licensing system that allocates quotas to all importers of the chemical. The ODS Regulations were recently amended in 2014 to increase the capacity to monitor ODS imports. Consumption of ozone depleting substances (ODS) in Ozone Depleting Potential (ODP) tonnes is the sum of the consumption of the weighted tons of the individual substances in each groupmetric tons of the individual substance (defined in the Montreal Protocol on Substances that deplete the Ozone layer) multiplied by its ozone depleting potential. In addition to the licensing system, the country is also actively involved in the implementation of the activities of the Protocol. Funding from the Multilateral Fund through Implementing Agencies; UNDP and UNEP. Through these activities the country has been able to comply with its phase out obligations under the Protocol. CFCs and carbon tetrachloride as shown in Table 7.5 have been completely phased out since 2007 (see Table 7.6 and Figure 7.4), enabling compliance with the 1 st January, 2010 target. Agricultural uses of methyl-bromide have been entirely replaced by alternatives and only the exempted quarantine and pre-shipment (QPS) uses remain. Swaziland Millennium Development Goals 2015 Report Page 95

96 Table 7. 5 Consumption of all Ozone-Depleting Substances in ODP Year Value Source:National Ozone Unit Database 2014 Table 7. 6 Consumption of Ozone-Depleting Substances by Type Year HCFC22 HCFC (Preblended Polyol) Methyl bromide Total Source: National Ozone Unit Database 2014 Figure 7. 4 Consumption of HCFCs ODS metric tonnes BASELINE TOTAL ODS CONSUMPTION Source: National Ozone Unit 2014 Swaziland Millennium Development Goals 2015 Report Page 96

97 Table 7. 7 Consumption of Ozone Depleting HCFCs in Metric Tonnes Year Value Source: National Ozone Unit 2014 The next phase out plan of HCFCs is about to commence as the project has already been approved. HCFCs were introduced in the early 1990s as an alternative to CFCs. Conversely, they also destroy the ozone layer and the Montreal Protocol provides for their replacement. The country s baseline for HCFC reduction is the 2009 consumption of metric tonnes as shown in figure 7.5. This quantity will gradually be reduced by 10 percent and 35 percent by 2015 and 2020 respectively. Total eradication of HCFCs has a target to Presently the major HCFCs in the country are HCFC-141b (pre polyol) used in foam production in the manufacture of refrigerators; and HCFC-22, which is used in the servicing sector. Other chemicals in this sector are the alternative HCFCs and hydrocarbons, which are not ozone depleting. Indicator 7.5: Proportion of total water resources used The proportion of total water resources used is the total volume of ground and surface water withdrawn from their sources for human use (in the agricultural, domestic and industrial sectors), expressed as a percentage of the total volume of water available annually through the hydrological cycle. This indicator shows the degree to which total renewable water resources are being exploited to meet the country's water demand. It is a measure of a country's pressure on its water resources and therefore on the sustainability of its water uses. The country is well endowed with renewable water resources. This water is stored in major dams and reservoirs located in different parts of the country. Over the years, the country has been able to store 765 million cubic metres (Mm 3 ) per annum, representing 17 percent of the available renewable water resources. The combined mean discharge for all the rivers leaving the country is 144 cubic metres m 3 per second or 4.5 million m 3 (Mm 3 ) per annum. Table 7.8: Water Demand In Million Cubic Meters per Annum (Mm 3 /a) Water Use Urban rural and industrial Livestock Irrigation Alien vegetation Afforestation Total Swaziland Millennium Development Goals 2015 Report Page 97

98 Source: MNRE; Integrated Water Resources Master Plan, (2011) Indicator 7.6: Ratio of area protected to maintain biological diversity to surface area The ratio of area protected to maintain biological diversity to surface area is defined as nationally protected area as a percentage of total surface area of a country (UN, 2003). The International Union for Conservation of Nature ( IUCN)-World Conservation Union defines a protected area as an area of land or sea dedicated to the protection and maintenance of biological diversity and of natural and associated cultural resources and managed through legal or other effective means. Swaziland has a rich diversity of natural forests and woodlands comprising up to 45 percent of the country s landscape as of This rich diversity contains plant species endemic to Southern Africa that are of greatest socioeconomic, medical, cultural and aesthetic importance to the region. In support of the International Convention and National Forest and Environmental Policy (ICNFEP), the government is developing and implementing programmes to conserve biodiversity in liaison with stakeholders. According to the Swaziland National Trust Commission (SNTC), the first six nationally gazetted Protected Areas (PAs) include Malolotja, Mlawula and Mantenga managed by the Swaziland National Trust Commission (SNTC) and Mlilwane, Hlane and Mkhaya managed by Big Game Parks (BGP). Mlilwane and Mantenga adjoin each other as do Hlane and Mlawula. the largest of these areas is the Hlane-Mlawula complex comprising 37,888 ha followed by Malolotja (16,292 ha) and Mkhaya (10,050 ha) and lastly the Mlilwane-Mantenga complex (5,300 ha). Together these formally protected areas comprise 69,530 ha i.e. 3.9 percent of the country. In 2015, a number of areas have been gazetted as protected areas and they include Emantini nature reserve, Lomati nature Reserve, Phophonyane conservancy, Libetse nature reserve and Lubuyane nature reserve. These areas make a total of hectares or km 2, contributing an additional 0.24 percent to the country s protected area, which brings the overall total to 4.14 percent. Table 7.9: Proportion Of Areas Protected To Maintain Biological Diversity Ratio of Area Protected to Maintain biological diversity Year 2000 (%) Currently (2012) % Target Wetlands protected - 1 (2009) 10% Coverage Legally Proclaimed Protected Areas % Coverage 2015 Proclamations (SNTC Act ) 0.24 Informal Protected Areas Unknown Total Area Protected Sources: SNTC; (2015), Swaziland Government Gazette Extraordinary VOL.LIII MBABANE, Monday FEBRUARY 16th 2015 Swaziland Millennium Development Goals 2015 Report Page 98

99 Indicator 7.7: Proportion of species threatened with extinction Plant Species A total of 40 plant species are categorised as species falling under the upper threatened (Extinct, Critically endangered, and Vulnerable) categories as listed in the Table below. These species are a proportion of the estimated 3441 plant species recorded as occurring in the country. The principal causes of the species loss is habitat loss, due to over exploitation and the spread of alien species. The threats of climate change and desertification, though not fully captured are also contributing to this species increase under the threatened category. Table 7.10: Number Of Plant Species Threatened With Extinction, 2015 Threat Category Number of Species Extinct 1 Critically Endangered 7 Endangered 20 Vulnerable 12 Total 40 Source: SNTC SNPASS Project 2015, Fauna Species The country hosts a total of 19 vertebrate species on the IUCN (2013) Globally Threatened Species list which are native to Swaziland out of a total of 132 species consisting of 11 species of fish, 4 species of amphibians, 14 species of reptiles, 55 species of birds and 48 species of mammals. The current distribution of these species was considered based on up to date records in relation to the PA network. Of the 19 globally threatened vertebrate species, 6 are locally extinct in Swaziland and 11 are found within Gazetted PAs. The Table below further categorises the species. Table 7.11: Number of animal species threatened with extinction Threat Category Number of Species Extinct 6 Critically Endangered 1 Endangered 6 Vulnerable 12 Total 25 Source: SNTC SNPASS Project 2015 Swaziland Millennium Development Goals 2015 Report Page 99

100 Table 7.12: Number of Vertebrate Species Threatened With Extinction Threat category Number of Species Fishes Amphibians Reptiles Birds Mammals Regionally Extinct Critically Endangered Endangered Vulnerable Sub-total Threatened Subtotal others Total (11%) 48 Source: SNTC SNPASS Project; (2015) TARGET 7.C: HALVE, BY 2015, THE PROPORTION OF PEOPLE WITHOUT SUSTAINABLE ACCESS TO SAFE DRINKING WATER AND BASIC SANITATION Indicator 7.8: Proportion of population using an improved drinking water source The proportion of the population using an improved drinking water source is the percentage of the population that uses any of the following types of water supply for drinking: piped water from a protected source, public tap from a protected source, borehole or pump, protected well and protected spring or rainwater if collected appropriately. Improved water sources do not include tanker trucks, and bottled water. Streams, rivers and unprotected wells are unimproved water sources but a significant proportion of the population still uses them. However, the demand for designs and construction for both micro and macro water supply schemes is increasing with population growth. However, effort is made to align these with objectives and targets set at the national and/or international levels. Examples of set targets include, but are not limited to: the National Development Strategy (NDS) that seeks to achieve the country s water supply coverage to 100 percent by 2022; and the Millenium Development Goals (MDGs). Swaziland Millennium Development Goals 2015 Report Page 100

101 Percentage Figure 7.5 Proportion of Population Using An Improved Drinking Water Source In Urban And Rural Areas Rural (%) Urban (%) National (%) Source: CSO; SPHC vol.4 (1997), SDHS (2007), MICS (2000, 2010 &2014), The target is to halve by 2015, the proportion of people without access to safe drinking water. This means by 2015 we should be having coverage of 69.9 percent if 1997 is taken as the base year and ultimately 100 percent coverage by 2022 as envisaged by the National Development Strategy (NDS). Based on the latest Multiple Indicator Cluster Survey (MICS 2014) Swaziland stands at a national coverage of 72.4 percent which is 2.5 percentage points above the target of 69.9 percent. The proportion of people with access to safe drinking water has improved, by 16 percentage points by increasing from 56.4 percent in 1997 to 72.4 percent in 2014 at national level. The improvement is observed in both the rural and urban areas. In 2014, 63.4 percent of the rural population had access to improved water sources compared to 95.8 percent for urban areas. Despite the distributional differences, the country has made substantial progress in increasing the proportion of the population with access to safe drinking water. Efforts aimed at increasing use of improved water sources should be scaled up in the rural areas as the majority of the population (850,203) resides in the rural areas (CSO: SPP, ). The Poverty Reduction Strategy and Action Programme (PRSAP) targets that by 2015, rural communities should have sufficient number of properly maintained water supply schemes and that these should allow a maximum walking distance of 2-kilometres to the nearest water supply Swaziland Millennium Development Goals 2015 Report Page 101

102 Percentage systems. Currently 46.5 percent of the household population has water within their premises and 17.4 percent travel a distance of less than 30 minutes round trip, to fetch water. The Ministry of Natural Resources and Energy has since started Water Point mapping of all existing water points in the rural communities of the country. The pilot water point mapping exercise seeks among others, to determine the number of water supply schemes that exist and their functionality status. A further goal of the exercise is to compare infrastructure levels with population served in each of the 55 Constituencies (Tinkhundla). Therefore, the outcomes of the water point mapping exercise will inform Government and cooperating partners to determine areas for support and investments. A total of 32 Tinkhundla have been mapped, and an additional 23 Tinkhundla will be completed by Indicator 7.9: Proportion of population using an improved sanitation facility The proportion of the population using an improved sanitation facility is the percentage of the population with access to facilities that hygienically separate human excreta from human contact. A household is classified as having an improved toilet if the toilet is used only by members of one household (i.e., it is not shared). Figure 7.6: Proportion of Population Using An Improved Sanitation Facility by Urban And Rural Areas Rural (%) Urban (%) National (%) Source: CSO; SPHC vol.4 (1997), SDHS (2007), MICS (2000,2010& 2014), Data from national surveys shows a decline in the use of improved sanitation facilities in the country. The proportion of the population using an improved sanitation facility dropped by 0.8 Swaziland Millennium Development Goals 2015 Report Page 102

103 percentage points in 2014 from 53 percent in The target for the population using improved sanitation facilities is 87.3 percent. In 1997 which is the base year, use of improved sanitation facilities was at 74.5 percent. This translates to a 21.5 percentage points decline between 1997 and The Poverty Reduction Strategy and Action Programme (PRSAP), targets that by 2015 every household will be having at least one pit latrine or any other modern form of excreta disposal. The 2010 MICS showed that in the urban areas access to improved sanitation stood at 50.7 percent and did not improve much from Relatively rural areas had a better coverage 0f 54.7 percent. This can be attributed to the Government s programme in collaboration with relevant stakeholders to increase the construction of Ventilated Improved Pit latrines (VIP) by more than double from 2000 to Communities are capacitated on the construction and maintenance of their sanitation facilities. The sanitation coverage in both rural and urban areas is off track. The decline in coverage over the years ( ) is mainly due to the mushrooming of informal settlements around urban areas. The informal settlements are structured such that each compound has a number of one room flats which are rented out to tenants and one sanitation facility is usually provided and shared by the different households. According to the MICS, if for an example there are ten households in each compound sharing one sanitation facility, the other nine are regarded as having no access to improved sanitation thus contributing to the decline of sanitation coverage. Moreover when urban boundaries are extended these households further reduce sanitation coverage in urban areas. Indicator 7.10: Proportion of urban population living in slums Slum households are a group of individuals living under the same roof who lack one or more (in some cities two or more) of the following conditions: security of tenure, structural quality and durability of dwellings, access to safe water, access to improved sanitation facilities, and sufficient living area. Based on this definition, Swaziland, does not have slums but informal settlements. An informal settlement represents unplanned household units (i.e., rented rooms or bed-sitters) in the areas surrounding urban areas. These areas usually lack standard residential structures and infrastructure services. Major informal settlements are found in the country s two cities (Mbabane and Manzini) which together make up about 85 percent of all informal settlements. Presently, Mbabane has a total of 9 informal settlements (Malagwane, Mangwaneni, Mvakwelitje, Nkwalini Zone 3, Mahwalala Zone 6C, Sitibeni, Fonteyn, Sidwashini and Manzana) respectively. All these 9 informal settlements are in the course of formalization as they received approval from the Human Settlements Authority. Presently, the Municipal Council of Mbabane is surveying them thereafter, the land parcels will be allocated to deserving members of the public with first preference being the present occupants. Swaziland Millennium Development Goals 2015 Report Page 103

104 Manzini on the other hand has a total of 5 informal settlements (Old Zakhele, Farm 9 at Moneni, Ticancweni, Mangwaneni and Murray Camp) respectively. Although Manzini City Council has the total number of Mangwaneni occupants, information on the rest is not available. Unfortunately, the numbers of Mangwaneni could not be obtained due to time constraints. Likewise, the total number of occupants of all 9 informal settlements/townships in Mbabane was to be provided by the local authority, but owing to time constraints, same could not be obtained. But generally, it is expected that once all nine 9 informal settlements in Mbabane are formalised, the City will be rid of informal settlements. This will drastically reduce the percentage of informal settlements in the country as a whole. Boundaries of country towns are small and tend to exclude areas of growing informal settlements such as Matsapha industrial town. Towns, as opposed to cities, do not have upgrading programmes because most of the informal settlements are outside their boundaries. Due to lingering delays in finalizing the National Land Policy, national programmes aimed at increasing access to secure tenure are growing slowly in the country. Indeed, the policy has remained in a draft form for 12 years. It was expected that the finalisation of the National Land Policy would eliminate major challenges, such as bias on the basis of place of birth and gender, and affordability to own property. The existence of informal settlements is mainly as a result of the above challenges. The situation is further exacerbated by existence of inflated private farm lands near towns and cities and the unavailability of Swazi Nation Land on which to establish formal residential townships. The private farm lands tend to be very expensive for Government to purchase for settlement purposes. In spite of the many challenges affecting access to secure tenure, there is visible significant progress in major cities. Under the World Bank s urban development upgrading projects in periurban areas, there has been a marked increase in the number of plots allocated to households for improving infrastructure services and improving lives. During the period 2000 to 2009, the volume of informal settlements was reduced by 32 percent in both Mbabane and Manzini as shown in Table In the capital city of Mbabane, informal settlements decreased at an average of 33 percent while the Manzini City Council upgraded two informal settlements and allocated plots to the households during the reference period. Figure 7.5 shows the trend on the existence of informal settlements in Mbabane and Manzini. It further indicates that the country is moving in the right direction and with more effort together with participation of the development partners; the country will considerably provide formal settlement. Table 7.13: Informal Settlements in Mbabane and Manzini City Year Mbabane Manzini Total Swaziland Millennium Development Goals 2015 Report Page 104

105 Percentage Source: MEPD; MDGR (2010), MHUD, 2014 COUNTRY SPECIFIC INDICATORS Indicator 7.11: Proportion of population using solid fuels The proportion of population using solid fuels is the percentage of the population that relies on biomass (wood, charcoal, crop residues and dung) and coal as the primary source of domestic cooking and heating. Biomass is a renewable energy source made from biological material. Biomass can be used as an energy source directly, or converted into other energy products such as bio fuel. Figure 7.7: Proportion of Population Using Solid Fuels Rural Urban National Source: CSO; SPHC vol. 4 (1997& 2007), SHIES (2001 & 2010), MNRE(Household Energy Access Report 2014), MICS(2014) The most commonly used biomass is wood which is used in a form of firewood and it is the dominant energy source in rural areas mainly for cooking and heating purposes. There has not been much change in the proportion of the population using solid fuels for cooking and heating. In 2014, the proportion was 62.3 percent compared to 62.1 percent in There has been a decrease in the use of solid fuels in both rural and urban areas by 5 and 6.5 percentage points respectively between 1997 and However, between 2013 and 2014, an upsurge in the use of solid fuels was observed in both the rural and urban areas. Swaziland Millennium Development Goals 2015 Report Page 105

106 Percentage A high proportion of the population still depends on wood as a major source of cooking. As depicted in the diagram below, between the period 1997 and 2014, the proportion of the Swazi population that cooks with wood declined from 81 percent to 61.8 percent but its usage remains significantly higher compared to the other energy sources. The proportion of the population that uses electricity has increased from 4 percent in 1997 to 27.1 percent in Figure 7.8: Energy Usage for Cooking wood electricity Paraffin LPG Source: MNRE, Household Energy Access Report, 2014 The usage of paraffin has decreased to 0.9 percentage of the population in 2014 due to increase in supply-side costs which have led to reduced supply especially in rural areas. The proportion of the population using liquefied petroleum gas declined by 8 percentage points in 2013 but increased again by 5.6 percentage points in Indicator 7.12: Proportion of population with access to electricity The proportion of population with access to electricity is the percentage of the population that uses electricity as a primary source of energy for either cooking or lighting. Electricity access in Swaziland is defined as the use of electricity by a household or institution through connection to the grid or some form of off-grid electricity which is in line with SADC definition. The country Swaziland Millennium Development Goals 2015 Report Page 106

107 envisions having 100 percent electricity access, as part of the initiative of the use of cleaner fuel by Electricity access contributes towards poverty alleviation, delivery of modern services in health facilities and schools, and improves the social gap between rural and urban communities in order to limit rural-urban migration. Table 7.14: Proportion of population with access, using electricity for cooking & lighting Year Rural (%) Urban (%) National (%) access cooking access cooking access cooking Source: CSO; SPHC 1997 (vol.4), SDHS 2007and SHIES 2010, MNRE Household Energy Access Report 2014 The country has made great improvements in the proportion of population with access to electricity. The proportion increased by more than double at national level from 14.3 percent in 1997 to 29.7 percent in 2007, showing an improvement of 15.4 percentage points. As of 2014, the proportion of the population estimated to have access to electricity is 65 percent. Urban and rural households had electricity access of 83.8 percent and 53.8 percent, respectively as shown in Table In order to improve access to electricity throughout the country a rural electrification programme was initiated to provide electricity to schools, health facilities, essential public institutions and communities. It is against this background that electricity supply and use is one of the most important themes within the energy sector in Swaziland and the availability of electricity has also been identified as one of the key contributing factors in eradicating poverty and improving health and education. In line with the rural electrification policy, the electricity lines were then routed through densely populated, re-settled areas and areas with high prospective for development on the way to the target areas; these included rural schools, health-care and rural development centres. The proximity of the electricity line to the communities aims to reduce connection costs and thereby encourage optimal access and use of the electricity lines. Indicator 7.13: Energy use in Swaziland (Tj oil equivalent) $1 GDP The main sources by which the country meets its energy needs are electricity, coal, petroleum products and renewables and waste. In 2009 the total energy supply in the country was 32, Swaziland Millennium Development Goals 2015 Report Page 107

108 TJ. The energy trends in 2011 showed that the electricity share decreased to 7 percent, while there has been a significant decline in the share of coal from 16 percent in 2007 to 6 percent in A decrease in the share of coal and coal products usage from 13 percent to 3 percent was observed in However, petroleum products consumption increased by 4 percent and Biomass energy increased by 8 percent. The increase in the energy from biomass is caused by the dominant use of woodfuel for cooking and the use of bagasse for cogeneration plants. Moreover, in rural areas, a very large proportion of the households use woodfuel as a primary source compared to a very small proportion of the urban households. Table 7.15: Trends in energy use, Energy Source 2000(%) 2005 (%) 2011(%) Hydro Bioenergy Coal and Coal products Petroleum Source: MEPD; MDGR (2010), MNRE, Energy balance report;(2010, 2012) Swaziland imports 100 percent of its liquid fuels and liquefied petroleum gas (LPG) as well as coal and other energy sources. The low grade bituminous is used in the local sugar and other industries. It exports 100 percent of the locally produced high grade anthracite coal. Due to this high dependency of the Swazi economy on imported fossil fuel based energy and the country imports almost 90 percent of its power from South Africa, despite being well endowed with renewable energy sources such as solar, small hydro, wind and biomass residues from the sugar and forestry industry. It is becoming feasible that the country considers alternative sources of energy in order to achieve self-sufficiency in terms of energy security. The local generated electricity accounts for 10 percent from hydro where there is 60 MW of installed generation which is used during peak hours and 9.5 MW of installed generation from diesel generators. Other companies generate electricity from bagasse and woodchips from cogeneration plants which is mainly used for their own consumption and excess power is sold to SEC. Swaziland consumes unleaded petrol (ULP 95) and lead replacement petrol (LRP 95) on the petrol grades. The average consumption for ULP 95 is 91 percent of total petrol consumed in the country and the remaining 9 percent is LRP 95. There are also two grades of diesel, 500parts per million (ppm) sulphur (S) and 50ppm sulphur, of which 88 percent consumption is the 500ppm and the remaining 12 percent is the low sulphur 50ppm. The sale of paraffin remains a challenge hence illuminating paraffin has dropped because it is sold at exorbitant prices and some oil companies have stopped distributing illuminating paraffin especially in rural areas since it is no Swaziland Millennium Development Goals 2015 Report Page 108

109 volume (kilolitre) longer financially attractive. However, illuminating paraffin is not used on its own but in different fuel mixes and fuel combination, i.e. mostly with electricity, wood and candles. The decrease in the consumption of illuminating paraffin is also pivoted around the systematic challenges involved in the marketing and distribution of the product. The country is currently promoting the development of Biofuels (Bio ethanol) industry which entails blending of 10% anhydrous ethanol with 90% unleaded petrol. The ethanol is produced from sugar cane molasses. Figure 7.9: The Consumption Volumes of Liquid Petroleum Products in Kilolitres LRP 95 ULP 95 Diesel 500ppm Diesel 50ppm Illuminating Paraffin Year Source: MNRE; (2014) The volume of ULP 95 is increasing because the number of cars using this fuel are also increasing whilst LRP95 is phasing out due to reduced demand. The diesel 500ppm sulphur is increasing because of increased industrial activity in terms of construction and related industries. The diesel 50ppm sulphur was introduced in 2011 as a mechanism of moving towards cleaner fuels and there has been an improvement in the uptake of this product in the transport sector as a result of the change in the technology of cars. Swaziland Millennium Development Goals 2015 Report Page 109

110 INEQUALITY ANALYSIS IMPROVED DRINKING WATER SOURCES Table 7.16: Proportion of Population Using Improved Drinking Water Sources, by Region (2014) Year Hhohho Manzini Shiselweni Lubombo Source: CSO, MICS 2010, Manzini at 79.8% has the highest proportion of the population with access to improved water source and Shiselweni had the lowest proportion at 56.8%. Whilst all regions recorded an improvement in the proportion of the population with access to improved water source, Hhohho experienced a decline. Interventions to improve water access in Manzini, Shiselweni and Lubombo have been implemented over the past 5 years thus resulting in the increased access. Educational Level Inequality Table 7.17: Proportion of Population Using Improved Drinking Water Sources, by Educational Level (2014) Year Education Level of Household head None Primary Secondary High Tertiary Source: CSO, MICS 2010, Access to improved drinking water source increases as the level of education increases. Households whose head had a Tertiary level of education had a coverage rate of 91.7 percent whilst those households whose heads have no education at all had a lower rate of 59.2%. Swaziland Millennium Development Goals 2015 Report Page 110

111 IMPROVED SANITATION FACILITY Regional Inequality Table 7.18: Proportion of Population Using Improved Sanitation Facility, by Region, Year Hhohho Manzini Shiselweni Lubombo Source: CSO, MICS 2010, The Hhohho region showed the highest coverage whilst the Lubombo region had the lowest coverage. Between 2010 and 2014, Manzini and Shiselweni experienced a decline in the proportion of the population with access to improved sanitation. Educational Level Inequality Table 7.19: Proportion of Population Using Improved Sanitation Facility by Educational Level, Year Education Level of Household head None Primary Secondary High Tertiary Source: CSO, MICS 2010, Access to improved sanitation facility increases as the level of education increases. Households whose heads had a Tertiary level of education had a coverage rate of 76.1 percent whilst those households whose heads have no education at all had a lower rate of 46.9%. However, between the year 2010 and 2014, the change in using improved sanitation facility for the proportion of households whose head had a Tertiary level of education was only 0.1 percentage points. Those with high education and primary education had a negative change of 1.2 and 0.3 percentage points respectively. Swaziland Millennium Development Goals 2015 Report Page 111

112 Table 7.20: Proportion of Population Having Access to Electricity by Region, Year Hhohho Manzini Shiselweni Lubombo Source: CSO, MICS The region with the highest proportion of the population having access to electricity is Manzini with a rate of 69.7 percent. Shiselweni had the lowest rate at 47.7 percent and this rate is about 28.3 percentage points below the national average of 65 percent whereas the other regions are slightly above the Region. Table 7.21: Proportion of Population Using Solid Fuel for Cooking by Region, Year Hhohho Manzini Shiselweni Lubombo Source: CSO, MICS 2014 Shiselweni had the highest proportion of the population using solid fuels for cooking and Manzini the lowest. This is expected because Shiselweni has the lowest proportion of the population with access to electricity compared to other regions and Manzini on the other hand had the highest proportion of households with access to electricity. SUPPORTIVE ENVIRONMENT The Energy Sector provides concrete objectives for a significant reduction of extreme poverty and in all the MDG goals. It plays a major role in promoting gender equality, education, health, and sustainable environment. Although none of the MDG refers to energy clearly, better energy services including modern cooking fuels and extended access to electricity are required for meeting all the goals. For instance, cooking with woodfuel or crop residues are associated with significant respiratory diseases associated with child mortality rates, diminishing maternal health and carbon dioxide emissions. The country has set a priority on infrastructural and service delivery associated with access to electricity especially on rural households. The policy is to ensure that the development goals of the country and the use of energy are for the benefit of all citizens in the country. However, in the rural areas the main challenges include lack/no infrastructure, topography, scattered settlements and households. Swaziland Millennium Development Goals 2015 Report Page 112

113 In order to ensure the universal access of electricity, the electrification programme is coupled with the alternative strategies of encouraging the use of renewable and efficient energy methods. As was the case with cooking, there is also more reliance on solid fuels for heating as well. Factors such as cost (affordability), availability and accessibility are key factors influencing household use of solid fuels for heating and cooking. Energy surveys have revealed that even when people are electrified they still use other sources of energy. This has serve as a lesson for the country in planning for its post-2015 agenda of improving infrastructure in the areas where it is mainly needed. There is a need to ensure affordable access and productive use of the relatively cleaner sources of energy, particularly among poor households, and this will be central to post agenda on energy access. Urban areas are increasingly being surrounded with informal settlements thus creating a demand for electrification yet focus is currently on rural electrification. The Forest Bill of 2010 is expected to further enforce the management and increase of carbon sinks in the form of forests. The government has signed different protocols and agreements e.g. the Montreal Protocol on carbon emissions which lay the foundation upon which sustainable environment can be improved among others. Swaziland ratified the Vienna Convention on the Protection of the Ozone Layer and the Montreal Protocol on substances that deplete the ozone Layer in All the amendments to the Protocol were ratified in ODS Regulations were promulgated in The existence of the National Energy Policy Implementation Strategy (NEPIS) A Programme for Basic Energy and Conservation (ProBEC) has been initiated in the country to raise awareness on fuel efficient stoves through campaigns, on alternative fuel, and study on rural development agencies and their role in energy. Draft petroleum bill Review of energy policy and sustainable energy for all Swaziland Millennium Development Goals 2015 Report Page 113

114 The Water Act of 2003 promotes the application of the principles of integrated water resources management. The establishment of the Department of Water Affairs has increased coordination in the sector by integrating rural water supply, ground water and surface water resources management. The availability of the Water, Sanitation and Hygiene (WASH) forum helps in the coordination and implementation of WASH services. The development of a National Multi-sectoral Bushfire Contingency Plan. The plan recognises the importance of the cross-border collaboration and provides network collaboration with the neighbouring states. The creation of the Swaziland Water Services Cooperation has improved access to safe drinking water. The recent introduction of Value Added Tax (VAT) in the country, water has been zero rated. This will make water remain affordable. Upgrading programme for informal settlements in the cities has reduced the number of households in informal settlements KEY BOTTLENECKS CONSTRAINING PROGRESS AND HOW TO ADDRESS THEM River Basin Authorities need to be strengthened and capacitated on proper management of water resources. The country also relies on imported petroleum products to meets in liquid fuels demand in the transport sector. The local production of bioethanol that can be used to blend the imported fuel will reduce the total import dependence. There is capacity shortage in the energy sector to monitor the level of carbon emissions, however the country, in-line with targets to reduce carbon dioxide emissions has introduced cleaner fuels such as diesel 50 ppm S. Woodfuel is still the most used solid fuel in the country especially at household level, however increasing demand threatens the availability of wood resources. The country is currently implementing the Programme in Basic Energy Conservation (ProBEC) which is promoting the efficient use of woodfuel for cooking using efficient and clean cookstove technologies. Swaziland Millennium Development Goals 2015 Report Page 114

115 Resources: Lack of resources needs to be examined for progress can only be made if resources are available. Land policy: The land policy needs to be finalized immediately to help in the achievement of this MDG. The data thus far do not indicate the quality and sustainability of the water and these issues should be addressed in studies to be conducted in future. Difficult financial situations force people to look for alternative ways of survival. Forests and the environment become a source of income.this therefore can affect the progress being made in environmental protection. The implementation of the sector wide approach (SWAp) remains a challenge in the water sector. Community capacity building on the maintenance and replacement of sanitation facility after the implementation period need to be strengthened. Communities should be continuously educated on the importance of improved sanitation facilities. Lack of maintenance of water supply infrastructure is constraining progress with regard to the proportion of population using an improved water source. Lack of resources hinders the progress in the implementation and maintenance of WASH services. The mushrooming of informal settlement proves to be a challenge in WASH services provision. Developments such as agricultural development, sugar cane production at LUSIP and KDDP, and the presence of invasive alien plants are contributing to a decline in the land covered by forests and need to be addressed HOW SWAZILAND WILL ACCELERATE PROGRESS IN THIS MDG The country needs to use the constituency (community) approach in dealing with environmental issues. There is need to strengthen the local leaders and their people to work together in the areas of environment. There is need for every department to take environment issues seriously and not only leave it in the hands of the department that is directly involved. Swaziland Millennium Development Goals 2015 Report Page 115

116 More efforts need to be put on waste management so as to reduce the emissions, which are currently on the increase. More resources are needed to achieve this MDG and the government needs to continue working together with the development partners to address the critical areas in the environment protection goal. A Programme for Basic Energy and Conservation (ProBEC) has been initiated in the country to raise awareness on fuel efficient stoves through campaigns, on alternative sources of fuel, and study on rural development agencies and their contributions to energy use efficiency LESSONS LEARNT In the case of data generated by different institutions at different times, there is strong need to create appropriate mechanisms for data consistencies and harmony Strong collaboration and involvement of relevant stakeholders including different government ministries helps improve implementation and service delivery Constant monitoring and evaluation helps in identifying challenges at an early stage and timely interventions. Swaziland Millennium Development Goals 2015 Report Page 116

117 MDG 8: DEVELOP A GLOBAL PARTNERSHIP FOR DEVELOPMENT TARGET 8.A DEVELOP FURTHER AN OPEN, RULE BASED PREDICTABLE, NON-DISCRIMINATORY TRADING AND FINANCIAL SYSTEM Indicator 8.1 Net ODA, total and to the least developed countries, as percentage of OECD/DAC donors gross national income. Official Development Assistance is the flow of official financing in the form of grants and loans administered with the promotion of economic development and welfare of developing countries as the main objective. The flows are concessional in character with a grant element of at least 25 percent. ODA flows comprise of contributions of donor government agencies, at all levels to developing countries and to multilateral institutions. Hence, ODA is used as a statistic to measure aid and is an indication of the flow of international aid. Over the years there has been an increase in the number of donor agencies. The table below shows the list of donor agencies contributing ODA to Swaziland. Table 8.1 List of all Donor agencies contributing ODA to Swaziland ADB Japan UNDP BADEA JICA UNESCO CHAI MSF (OCG + OCA) UNFPA European Union PEPFAR UNICEF FAO Republic of China Taiwan UNODC Global Fund (NERCHA) Taiwan FCF WHO Govt. of the USA Taiwan MM World Bank IFAD UNAIDS Source: MEPD;ACMS-ODA Report 2011 and ACMS - ODA 2015 Report The level of ODA contributed to Swaziland over the years by the different donor agencies differs according to the nature and the intensity of the social problem. Since the health sector was the most challenged amongst the sectors, most ODA focused on the alleviation of health related issues. In this regard, the PEPFAR organisation has been providing funding more especially for fighting HIV/AIDS in Swaziland. The organisation s budget for 2010 was E229.8 million, rising from E205.1 in the previous year. On another note, the inflow of ODA received by World Vision has been on a declining trend from US$31.3 million in 2008 to US$21.2 million in This trend is however being reversed in 2012 where ODA is expected to increase to US$ 33.8 million. Swaziland Millennium Development Goals 2015 Report Page 117

118 percentage flow The decline in ODA inflows to this NGO is largely explained by the depressed global economy over the years. In light of the aforesaid, the major contributors of ODA to Swaziland were the health oriented donor agencies namely; PEPFAR, European Union, Global Fund and the UN Agencies. Other donor agencies focused on the remaining economic development and social welfare problems. Percentage flow of ODA to Swaziland The percentage flow of ODA to Swaziland has generally been increasing over the years. There was a significant decline in ODA between 2009/10 and 2010/11 fiscal years by 35 percent compared to 89 percent growth experienced the previous fiscal year. The decline was mainly attributed to the global financial and economic crisis which started in the United States of America in 2009, and spread throughout both the developed and the developing countries. ODA rebounded slightly in 2011/12 fiscal year to 5 percent. However Aid is estimated to decrease by 14 percent in FY2014/15. This decline is attributed to an estimated reduction in funding received by PEPFAR, World vision and MSF which account for 39 percent of total ODA combined. On the other hand there is an estimated budgeted increase in total Aid in the FY2015/16 by 27 percent which is attributed to an increase in World Bank Funding. Despite the volatility in Aid, it can be argued that the donor community still perceives Swaziland as a country worth supporting, an indication of a strong global partnership that the country has developed. The following graph shows the percentage flow of ODA to Swaziland. Figure 8.1 A trend analysis on the flow of ODA to Swaziland in percentages 100% 80% 60% Percentage flow of ODA to Swaziland 40% 20% 0% -20% -40% -60% Source: MEPD- ACMS ODA Report 2015 *Estimated Budget Expenditure 2006/7 2007/8 2008/9 2009/ / / / / /1 5 *2015/ 16 Total ODA 40% 29% 89% -35% 5% % 27% Axis Title Swaziland Millennium Development Goals 2015 Report Page 118

119 TARGET 8.B ADDRESS THE SPECIAL NEEDS OF THE LEAST DEVELOPED COUNTRIES Indicator 8.2 Proportion of total bilateral, sector-allocable ODA of OECD/DAC donors to basic social services (basic education, primary health care, nutrition, safe water and etc. Table 8.2: Proportion of total bilateral ODA by sector Sector 2007/8 2008/9 2010/ / / /16** Health 28% 20% 59% 49% 57% 57% Agriculture 3% 1% 19% 15% 11% 12% Infrastructure - - 3% 13% 11% 9% Education and Training - 3% 12% 3% 4% 4% Social Protection - - 2% 3% 4% 3% Governance - - 0% 1% 1% 2% Water and Sanitation - 0% - 1% 2% 4% Environment - - 0% 0% 1% 1% Inform/Comm/Technology - - 4% 0% 0% 0% Finance % 1% 2% Other/Multiple - - 4% 2% 16% 11% Source: MEPD- ACMS ODA Report 2015 In the past nine years the heath sector has been the largest recipient of Aid, averaging 45 percent of total ODA. In the FY 2013/14 ODA Health expenditure was E709 million which accounted for 49 percent of total ODA expenditure. Health expenditure consisted mainly of HIV, HIV (including TB), Cross-Cutting activities and System strengthening which accounted for 52 percent, 25 percent, 10 percent, and 6 percent respectively. Post 2015, ODA expenditure on Health Sector as a percent of total ODA is expected to remain slightly above 50 percent of total Aid. This is mainly due to the growing need to accelerate programmes that will increase access to Reproductive Health and thus reduce maternal mortality rate and under 5 mortality rate. ODA support for Education recorded the lowest expenditure in 2009/10 at E28, 123 million from E57, 750 million in 2007/8.On the other hand the FY 2011/12 recorded the highest expenditure at E146 million. In the FY 2013/14 Aid to education returned to normal levels, hence the estimated budgeted expenditure for the FYs 2014/15 and 2015/16 is expected to average E50 million. ODA for safe water and sanitation showed a sharp decline from E58.5 million in 2007/8 to zero in 2008/9 and then rose to E4.0 million in 2009/10. In the the FY 2013/14 expenditure on this sector was E14 million and it is projected to increase by 59 percent and 167 percent in 2014/5 and 2015/6 respectively. The inflow of Agricultural ODA increased from E1.5 million in 2007/8 to E20 million in 2008/9 before recording a 31% decrease in 2009/10 to E13.8 million. In the FYs 2011/12 and 2013/14, Swaziland Millennium Development Goals 2015 Report Page 119

120 there was a notable increase in expenditure on this sector of E230 million and E224 million respectively. Projected expenditure 2014/15 is expected to decline by 44 percent from the previous FY and then recover by 44 percent in the FY 2015/16. The table below shows the level of total ODA each sector received since the year 2006/7 financial year. Figure 8.2: Sector Allocable Official Development Assistance to Swaziland 2007/8 2015/16 (E 000) Official Development Assistance per sector Total Source: MEPD- ACMS ODA Report 2015 From the above analysis of sector allocable development assistance, it can be deduced that ODA inflows to basic social services has been erratic. This implies that although ODA support to basic social services is flowing into the country, it is however not consistent. The country therefore needs to consolidate its support for basic social services from donors. It is very important to point out that the sector allocable ODA data may not be very accurate because most ODA consists of aggregated assistance for several sectors. It could be observed that ODA support has generally been increasing. However, global economic slowdown had a negative impact on ODA inflows into the NGO sector as well. In view of the above, one can say that Swaziland has been able to consolidate its partnership with the NGO sector. This conclusion however, needs to be taken with caution considering that the number of NGOs analysed are only those who submitted data. Indicator 8.3 Proportion of bilateral ODA of OECD/DAC donors that is untied There is little evidence in Swaziland that donors and government have made any progress in meeting the Accra Agenda for Action (AAA) commitment on conditionality, namely that they Swaziland Millennium Development Goals 2015 Report Page 120

121 would agree on a limited set of conditions drawn from the country s national development strategy. In this regard, all donor support to Swaziland is tied to specific projects and programmes. Furthermore, donors monitor the usage of resources to ensure that they are spent on targeted projects. Indicator 8.4: ODA received in landlocked developing countries as a proportion of their gross national income Table 8.3: ODA received as a proportion of Swaziland s GDP GDP at constant prices (SZL million) 36, , , , 601 Total ODA to Swaziland (SZL million) 1, 233 N/A 1, 453 1, 195 ODA as %GDP 3% N/A 4% 3% Source: MEPD- ACMS ODA Report 2015 TARGET 8.C ADDRESS THE SPECIAL NEEDS OF LANDLOCKED AND SMALL ISLAND DEVELOPING STATES Swaziland trade Swaziland s economy is very much open to trade. The country boasts of a small but comparatively diversified range of exports accounting for 42% of GDP. From 2011 to 2013 Swaziland saw an increase in exports as compared to Substantive exports included sugar, sugar based concentrates and beef. Other exports which indicated an increase included essential oils, perfumes, oils, cosmetics and toiletries accounting for 24% of total exports, followed by sugar and syrup concentrates used in the production of soft drinks, constituting 23% of total exports followed by other products. Imports also saw an increase from 2011 to 2013 with major imports being mineral fuels and distillation products which accounted for 18.5% of total imports, followed by motor vehicles at 8%, boilers machinery at 6.5%, plastic articles at 4% and others. To this extent, in 2010 and 2011 the country experienced a negative trade balance with some improvements beginning to show in 2012 and 2013 as shown in the Balance of Payments Table below. Swaziland Millennium Development Goals 2015 Report Page 121

122 Table 8.4: Balance of Payments E Million * Merchandise * Exports Merchandise ( ) ( ) ( ) ( ) (18 340) Imports Trade Balance ( ) (3 19.2) * Net Services ( ) ( ) ( ) ( ) (5774)* *Source: CBS (2013) preliminary Swaziland is highly dependent on the external world both as a source of demand for the goods and services it produces, as well as a source of intermediate inputs used in production by industry and as final products consumed by its household. As a small landlocked country, exports are crucial for Swaziland s economy, however the country s trade pattern is concentrated on one trading partner in the Southern African Customs Union (SACU), South Africa, who accounted for over 87.2% of its imports and 63% of its exports in 2014 as shown in Figure 8.3 below. Other SACU trading partners include the remaining 3 members namely; Botswana, Lesotho and Namibia. Other major trading partners within the region include the Southern African Development Community (SADC) and the Common Market for Eastern and Southern Africa (COMESA). Outside the region, the European Union is another major trading which receives mainly our sugar, beef and canned fruit exports. Figure 8.3: SACU imports and exports Exports share% Imports share % Republic of South Africa Namibia Botswana Lesotho Source: SRA Imports and export database Swaziland Millennium Development Goals 2015 Report Page 122

123 Figure 8.4 below shows the share of both imports and exports for Swaziland s major trading partners; SACU, SADC, COMESA and the EU. Figure 8.4 Share of imports and exports Imports share 30 Exports share SACU SADC COMESA EU Source: SRA Imports and export database Swaziland s share in global trade has fallen over the years, with its share in world merchandise exports increasing at around 0.02% of world trade in 2004, but falling sharply to 0.01% in Exports therefore declined as a source of economic growth over the last decade. The country s high dependence on SACU receipts is a risk due to their volatile nature. In 2011, total growth plunged to 0.6% as the country suffered its worst fiscal crisis since independence due to reduced SACU revenue as a result of the slowdown of the South African economy. Government is hoping to enhance domestic revenue generation over the medium term, partly through improvements to the system of value-added tax (VAT) collections through the Swaziland Revenue Authority (SRA). International Trade Cooperation and Market Access SACU Within the regional and international arena, Swaziland remains an active partner in a number of regional and international trade configurations. In the region the country still maintains its membership in SACU together with Botswana, Lesotho, Namibia and South Africa. The SACU Agreement excludes services and investment. SACU countries share a Common External Tariff (CET) and a Common Monetary Area (CMA) which excludes Botswana. Within the Common Monetary Area, the Lilangeni, for example, is pegged at par with the South African Rand. This applies to the Namibian Rand and the Maloti of Lesotho. Swaziland Millennium Development Goals 2015 Report Page 123

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