The Government of Swaziland / eSwatini has cut budgets for public health services across the kingdom and rural areas in particular are suffering, according to the latest report from the World Health Organisation (WHO).
WHO reported there were not enough doctors, nurses and support staff. The report comes at a time when nurses have been demonstrating across Swaziland to draw attention to the crisis in the health service.
WHO recently conducted the Universal Health Coverage (UHC) scoping exercise in Swaziland. Its report just published stated, 'The country has inadequate health workforce in both numbers and skills. The distribution of health workforce is also skewed in favour of urban areas with some rural health facilities having staffing gaps. Other health workforce challenges include; retention of skilled staff due to frequent rotation of workers especially nurses; and government absorption of donor funded positions.'
WHO added, 'The distribution of health facilities and access to essential health services create inequities between rural and urban populations.'
In Swaziland about 76 percent of the estimated 1. 3 million population live in rural areas.
The United Nations International Children's Emergency Fund (UNICEF) in an analysis of Swaziland's national budget for 2017/18 revealed the Ministry of Health (MoH) was allocated E1.85 billion, representing 9.1 percent of the total budget and 3.2 percent of gross domestic product (GDP). The allocation represented a 9.2 percent nominal decline from the E2.04 billion allocated in the 2016/17 financial year.
In real terms, the allocation to the MoH declined by 15.7 percent from E1.94 billion to E1.63 billion mainly because the government had financial difficulties.
UNICEF reported, 'The 2017/18 allocation significantly falls short of the requirements in the sector.' It estimated a minimum of E2.5 billion would be required in 2017/18 'to ensure an equitable minimum package of healthcare services for all Swazis'.
In the 2018/19 budget heath was allocated E2 billion.
Public health services in Swaziland are in meltdown with reports that hospitals cannot afford to feed patients and vital medicines have run out - all because the government failed to pay suppliers.
In September 2018 it was reported at least six children in Swaziland had died from diarrhoea and many more were sick because the government was broke and could not pay for vaccines. It would cost US$6 for the vaccine to immunise a child.
Medicines of all sorts have run out in public hospitals and health clinics across Swaziland. Nurses have been protesting to draw attention to the crisis.
In June 2018 it was revealed there were only 12 working public ambulances in the whole of Swaziland because the government failed to maintain them. It had bought no new ambulances since 2013.