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Swaziland Human Development Report Hiv

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Swaziland Human Development Report Hiv SWAZILAND HUMAN DEVELOPMENT REPORT HIV AND AIDS AND CULTURE MARCH 2007 FOREWORD The HIV prevalence rates for Swaziland (at 25.9% of the 15-49 year age group), is estimated to be the highest in the world. The devastating effects of HIV&AIDS at personal, family, community and country levels remains a daunting challenge for our country. If this problem is not halted and ultimately reversed, the nation’s very existence is under threat. The current prevalence rates and projections as alluded to in the 2007 report “Reviewing Emergencies for Swaziland: Shifting the Paradigm in a New Era” (Whiteside and Whalley, 2007) points to a bleak future. Analysis of the aforementioned report indicates that coping mechanisms are seriously under stress and life expectancy has fallen to an all time low; from 60 years in 1997 to 31.3 in 2004. All critical social and economic indicators are in a state of serious decline. It is estimated that by 2015 the demographic profile of the country will consist of the older age groups and the very young. Our nation is indeed under siege. The 2007 National Human Development Report’s focus on HIV and AIDS and culture is timely as our nation searches for a way out of this crisis. Swaziland is regarded as a country that has combined modernity and tradition in the implementation of its governance framework. As culture and traditions in our country are to a great extent, regarded by many as sacrosanct, the consequences of the HIV and AIDS crisis compels us to think outside the box. The report seeks to provide insights on the interface between culture and contemporary society with the goal of identifying interventions that assist national stakeholders at all levels to effectively address the HIV/AIDS pandemic. It must be noted that behavior change is at the core of preventive approaches to combating the pandemic. Behaviour is to a great extent influenced by culture. It is therefore essential that our culture vis-à-vis HIV and AIDS be interrogated with a view to identify cultural practices that reinforce positive behavior towards combating HIV, and eliminate those negative practices and attitudes that undermine such efforts. It is only when we acknowledge the strengths and weaknesses of our culture that we can begin to address the challenges posed by the pandemic. The report clearly contextualizes culture and how it relates to HIV and AIDS; it clarifies the declining human development indicators and presents a graphic picture on the current HIV and AIDS trends, patterns and drivers of the pandemic in the country. The country’s efforts in addressing this scourge are also well articulated in the report, which helps us to identify key achievements and also gaps in our interventions. Most importantly, the report also recommends various policy options and strategies from which the leadership at all levels should carefully examine with a view towards developing lasting solutions as we attempt to save the nation from this calamity. I am grateful that the United Nations Development Programme (UNDP) has assisted with the development of this critical document which will go a long way in helping the country to find solutions regarding the devastating effects of HIV and AIDS on human development. It must also be noted that the document is a product of wide consultation with key stakeholders in the country to ensure that what is reflected in the report is factual, balanced and helpful to our course as a nation. Emmanuel Ndlangamandla Executive Director Coordinating Assembly of NGOs i The analysis and policy recommendations of this report do not necessarily reflect the views of the United Nations Development Programme, its Executive Board or its Member States. The report is an independent publication commissioned by UNDP Swaziland. It is the fruit of a collaborative effort by a team of eminent consultants and advisors. ACKNOWLEDGEMENTS UNDP Swaziland wishes to acknowledge with great thanks many groups of people for their various contributions to the preparation of this report. Many officers in the UNDP Swaziland office provided guidance and logistic support to the report team. The Steering Committee on the report was led by the UN Resident Coordinator and UNDP Resident Representative in Swaziland, Ms Chinwe Dike, and her deputy, Mr Neil Boyer. The committee members, who were from government ministries, United Nations agencies in Swaziland, the National Emergency Response Council on HIV and AIDS (NERCHA) and various non-governmental organisations, thought through the initial ideas and organisational structure of the report. Chapters of the report were drafted by a group of five international and national consultants led by Professor James Ntozi of Makerere University in Uganda as the team leader. Other consultants were Dr Larry Adupa of the Sustainable Development Centre in Uganda as the deputy team leader, Dr Dennis Chiwele of RuralNet Associates in Zambia as the development economist, Mr Rudolph Maziya of AMICAALL in Swaziland as the national team leader and Ms Thandi Khumalo of the University of Swaziland as the culture specialist. This group was assisted by Mr Robert Fakudze, a statistician from the Swaziland Central Statistical Office. The consultants worked with Dr Ngila Mwase, UNDP Senior Economic Advisor, Mozambique and Swaziland, Mr Jabulane Dhamini, national economist of UNDP Swaziland, and Sakinah Morris of UNDP Swaziland. Lare Sisay, former Deputy Resident Representative contributed to the preliminary efforts on the report. Various institutions, groups and individuals in Swaziland provided data that informed the report. The institutions included the deputy prime minister’s office; the ministries of finance, economic planning and development and health and social welfare; the Central Statistical Office, NERCHA, the WHO, UNICEF, the WFP, UNAIDS, the UNFPA, the FAO, UNESCO and various NGOs. The groups consisted of people living with HIV and AIDS (PLWHA), and rural and urban communities who participated in the focus group discussions. Individuals were mostly those who responded to the study as key informants. The report benefited from various groups of people and individuals. UNDP offices in New York, India, Pretoria and Swaziland made valuable comments on several drafts of the report. There was a workshop attended by many stakeholders in Swaziland whose comments greatly improved the report. Various individuals read the draft of the report put on the internet and contributed comments that were useful to preparation of the final version. ii TABLE OF CONTENTS PREFACE ...................................................................................................... Error! Bookmark not defined. FOREWORD................................................................................................................................................ i ACKNOWLEDGEMENTS ....................................................................................................................... ii TABLE OF CONTENTS ........................................................................................................................... ii SWAZILAND HUMAN DEVELPOMENT REPORT 2007 TEAM MEMBERS ............................. viii ABBREVIATIONS AND ACRONYMS .................................................................................................. ix GLOSSARY OF TERMS .......................................................................................................................... ix SISWATI WORDS AND THEIR MEANING ...................................................................................... xiv BALANCE SHEET OF HUMAN DEVELOPMENT IN SWAZILAND ......................................... xviii OVERVIEW .............................................................................................................................................. xx CHAPTER 1: CULTURE, HIV AND AIDS ............................................................................................ 1 1.1 INTRODUCTION ................................................................................................................................... 1 1.2 THE FAMILY ......................................................................................................................................... 1 1.3 THE ROLE OF CULTURE IN DEVELOPMENT ................................................................................. 2 1.4 SOCIALISATION OF CHILDREN ....................................................................................................... 2 1.5 PREVENTION OF POTENTIALLY HIGH-RISK BEHAVIOUR ........................................................ 5 1.6 TREATMENT AND SUPPORT ............................................................................................................. 9 1.7 IMPACT MITIGATION ....................................................................................................................... 11 1.8 CULTURAL SYSTEMS AND STRUCTURES ................................................................................... 13 1.9 CONCLUSION ..................................................................................................................................... 15 CHAPTER 2: HUMAN DEVELOPMENT IN DECLINE ................................................................... 16 2.1 INTRODUCTION ................................................................................................................................. 16 2.2 HUMAN DEVELOPMENT INCREASES PEOPLE’S CHOICES .....................................................
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