Sociocultural Factors in Women's Health in Swaziland

Swaziland is the 2^nd smallest African nation, yet it has the highest human immunodeficiency virus (HIV) rate of any country in the world: 26% of its citizens and 39% of its pregnant women are infected with HIV (World Health Organization, 2014; Global Health Observatory, 2014).  Tuberculosis deaths are increasing annually, maternal mortality is 9 times that of the US, cervical cancer rates are high, and the only current treatment for breast cancer is surgical.  The average lifespan for women in Swaziland is 55-years.  Until 2005, women in Swaziland had the status of “perpetual minors”, i.e. they were required to have a male guardian.  In rural areas (69% of the country), customary law is still the rule rather than the exception  and gender-related violence is high.  This presentation will examine ethnographic and qualitative data from 2014 including the life stories of four rural Swazi women.  These stories will clearly illustrate the impact of customs, relational power, and institutional ideologies on the daily lives of women in Swaziland and by extension on their health and that of their children. In a nation that has not yet implemented protections for its most vulnerable citizens, resilient women must find creative means to meet the most basic needs of food and shelter for their families.  As a result, personal health care must wait.  Before planning public health interventions in developing countries, social and cultural factors must be considered and incorporated at all levels of the ecological model. Women in Swaziland comprise a large portion of the population but are an underutilized and underappreciated resource in that plan.