The Kingdom of Eswatini, formerly known as Swaziland, is a mountainous, landlocked country in Southern Africa, with neighbors that include Mozambique and South Africa. It is one of the smallest countries in Africa, but despite its small size, it is home to a diverse geography and climate. Because of Eswatini’s mountainous geography, the population is unevenly distributed, with most people living in homestead settlements called imithi located in valleys and plains. About 25 percent of the population lives in urban areas, including Mbabane, the capital, home to 68,000 people. The country’s population of 1.1 million are majority ethnically Swazi, with English and siSwati as both the common and official languages. About 90 percent of the population identifies as Christian.
Eswatini is governed by an absolute monarchy. Formerly a protectorate of Britain, Eswatini gained independence in 1968. Since then, the country has suffered from high rates of poverty, with nearly 60 percent of the population living below the poverty line as of 2017. Poverty is exacerbated by weak economic growth, high rates of unemployment, inequality, extreme weather events, and one of the world’s highest rates of HIV/AIDS.
Eswatini faces several health challenges. The population has a life expectancy of 60 years, one of the lowest in the world. Contributing to this alarmingly low life expectancy is a high burden of infectious disease. While death due to HIV/AIDS decreased by over 60 percent between 2009 and 2019, it remains the top cause of death in the country. Other leading causes of death in Eswatini include lower respiratory infections. diabetes, tuberculosis, stroke, ischemic heart disease, diarrheal diseases, neonatal disorders, road injuries, and chronic kidney disease. The risk factors that contribute most to deaths and disabilities include unsafe sex, malnutrition, high body-mass index, insufficient clean water and sanitation, high fasting plasma glucose, air pollution, high blood pressure, alcohol use, dietary risks, and intimate partner violence.
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