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National context


Swaziland has a population of about 1. 1 million, with over 40% of the population under the age of 15 years. Poverty levels are high at 63%, with a low economic growth rate of 2.8% and a national unemployment rate of 28%. Seventy seven percent of the country’s population resides in rural areas and 23% in urban settlements.


Due to fertility decline from 6.4 children per woman in 1986 to 3.3 in 2014, the country is the country is going through a demographic transition, with an increase in the working age population of 15-64 years from 46% to 56% between 1976 and 2007 and a projected to increase to 62% by the year 2022. With the right investment in the education, health and economic empowerment of young people, Swaziland has the potential to harness the demographic dividend that is occasioned by this expected demographic shift. 


HIV and AIDS is by far the most pressing national development challenge with an estimated HIV prevalence of 26 % among the population aged 15-49 years, with women disproportionately affected at 31% compared to 20% among men. HIV incidence is estimated at 2.38 % in the population aged 18 to 49 years, and with even higher levels of 3.84% among females aged 18 to 19 years, and 4.17 % among young females aged 20 to 24 year.

Maternal mortality

The 2012 Swaziland Demographic and Housing Survey shows that the Maternal Mortality Ratio remains high at 593 maternal deaths per 100 000 live births despite the high skilled birth attendance (88.2 %) and the high antenatal care attendance by pregnant mothers. Notably, 26 per cent of maternal deaths occur among youth aged 15-24 years. The underlying cause of maternal mortality include gap in quality of care and inadequate access to emergency obstetric care services, limited comprehensive and up-to-date data to inform programming in this area, gender inequality and socio cultural barriers as well as HIV and AIDS which indirectly contributes to over 45% of maternal mortality in the country. 

Adolescent birth rate

Adolescent birth rate remains high, though having declined from 111 births per 1,000 adolescents aged 15-19 years in 2007 to 87 births per 1,000 in 2014. Teenage pregnancy is largely attributable to early and unprotected sexual activity, which rapidly increases from about 3% by age 15 years to about 50% by the time adolescent girl reaches the age of 17 years. Contraceptive use among unmarried adolescents is low (15.5%) and condom use even lower at 9%. Although 75% of health facilities provide adolescent health services only 26% of these provided youth-friendly and integrated family planning services.

Gender-based violence

Gender-based violence is a persistent challenge, disproportionately affecting women and girls with approximately 1 in 3 females experiencing some form of sexual abuse by age 18 years, and 48 per cent of women reporting to have experienced some form of sexual violence in their lifetime. Some of the main drivers of GBV include gender inequality; weak mechanisms for coordinated prevention and response to gender based violence; limited integration of GBV in sexual reproductive health and HIV services; and weak implementation of policies that are addressing gender inequality.