People and Society of Eswatini

Nationality

Swazi(s)

Ethnic Groups

African 97%, European 3%

Population

1,192,271

Population in Major Urban Areas

MBABANE (capital) 66,000

Medical facilities are limited throughout Swaziland and emergency medical response capabilities (including ambulance transport) are almost non-existent. Although the Mbabane Clinic in the capital is small, it is well-equipped and well-staffed for minor procedures, as is the Manzini Clinic in Matsapha. For advanced care, U.S. citizens often choose to go to South Africa where better facilities and specialists exist. Most prescription drugs are available locally or can be imported from South Africa, but travelers are advised to bring sufficient quantities of their own required medication. A doctor’s note describing the medication may be helpful if questioned by authorities. Tuberculosis is an increasingly serious health concern in Swaziland.

Life Expectancy at Birth

Life expectancy at birth in Eswatini has undergone a dramatic and historically significant transformation over the past three decades, reflecting both the devastating impact of the HIV/AIDS epidemic and the country's subsequent public health recovery efforts. At its lowest point in the mid-2000s, life expectancy in Eswatini fell to approximately 45 years, making it one of the lowest figures recorded for any country in the world at that time. This collapse was driven primarily by one of the highest HIV prevalence rates ever documented globally. At the peak of the crisis, more than a quarter of the adult population was living with HIV, and AIDS-related deaths dramatically shortened average lifespans across the population. Since then, the country has made remarkable progress. Expanded access to antiretroviral therapy, increased testing programs, and significant investment in public health infrastructure have helped reverse the downward trend. By the mid-2020s, life expectancy at birth had recovered to approximately 60 to 61 years overall, with figures slightly lower for males and somewhat higher for females. While this remains below the sub-Saharan African regional average and well below the global average of approximately 73 years, the upward trajectory represents one of the more notable public health recoveries in modern African history. Noncommunicable diseases such as cardiovascular disease, diabetes, and respiratory illness are increasingly contributing to mortality as the HIV crisis becomes more manageable. Maternal and child health indicators also play a role in shaping overall life expectancy figures, with infant and under-five mortality rates remaining elevated compared to higher-income nations. Eswatini continues to face challenges including limited healthcare infrastructure in rural areas, food insecurity, and socioeconomic inequality, all of which influence health outcomes. The government, in partnership with international health organizations, continues to implement strategies aimed at extending healthy lifespans and further reducing preventable mortality across the kingdom.

Infant Mortality Rate

Eswatini faces significant challenges related to infant mortality, though the country has made measurable progress in reducing child deaths over recent decades. The infant mortality rate in Eswatini stands at approximately 43 to 45 deaths per 1,000 live births, placing it among the higher-rate nations in sub-Saharan Africa, though this figure represents a notable improvement from rates exceeding 80 per 1,000 live births recorded in the early 2000s. Several interconnected factors drive infant mortality in Eswatini. The HIV/AIDS epidemic has historically been a primary contributor, with mother-to-child transmission of HIV exposing newborns to elevated health risks from birth. Eswatini has one of the highest HIV prevalence rates in the world, and while prevention of mother-to-child transmission programs have expanded considerably, the virus continues to affect neonatal and infant health outcomes. Leading causes of infant death in Eswatini include neonatal complications such as preterm birth and birth asphyxia, as well as pneumonia, diarrheal diseases, and malnutrition. Access to skilled birth attendants and quality antenatal care remains unevenly distributed, particularly in rural and mountainous regions where healthcare infrastructure is limited. Many communities in Eswatini are located far from hospitals or health clinics, delaying emergency care for newborns and mothers during and after delivery. The government of Eswatini, in partnership with international organizations such as UNICEF and the World Health Organization, has pursued vaccination expansion programs, oral rehydration therapy campaigns, and improvements to maternal health services. Immunization coverage for diseases such as measles, diphtheria, and polio has increased, contributing to the overall decline in infant deaths. Poverty and food insecurity also play a contributing role. Malnutrition weakens immune systems in young infants and amplifies the severity of otherwise treatable illnesses. Addressing infant mortality in Eswatini requires sustained investment in healthcare access, maternal nutrition, clean water and sanitation infrastructure, and continued efforts to reduce HIV transmission between mothers and their children.

Major Infectious Diseases

Intermediate

Literacy Definition

Age 15 and over can read and write

• Zionist40.0%
• Anglican,Bahai, Methodist, Mormon,Jewish30.0%
• Roman Catholic20.0%
• Muslim10.0%

English (official, government business conducted in English), siSwati (official)

• SiSwati
• English

Crime Information

Violent crime is a concern and is the most significant threat to U.S. citizens visiting or working in Swaziland. Incidents of petty crime and violent crime are prevalent throughout Swaziland. Criminals will resort to force if necessary, including deadly force, in order to accomplish their goal. Gangs are not deterred by confrontations with their intended victims. Carjackings occur in Swaziland, and as with other crimes may become violent if victims do not immediately cooperate. Congested, dark urban areas are particularly dangerous at night, but daytime attacks are not uncommon. The presence of other people on the street should not be misinterpreted as an indication of security. Many victims report being robbed in the presence of witnesses. Pedestrians are cautioned not to wear jewelry or carry expensive or unnecessary valuables in public. U.S. citizens are also advised against displaying cell phones and large sums of cash, because they are targets for thieves. Money should only be converted at authorized currency exchanges and never with street vendors. Exercise caution when using local taxis. Ensure the taxi you use is from a reputable company. Never enter a taxi that is occupied by anyone else besides the driver. It is good practice to call a friend to let them know the plate number of the taxi you are using. Crime tends to increase during the holiday season from December to January.If you are the victim of a crime, you should immediately report the incident to the nearest police station. If there is an emergency, the police can be contacted by dialing 999. Don’t buy counterfeit and pirated goods, even if they are widely available. Not only are the bootlegs illegal in the United States, if you purchase them you may also be breaking local law.

Criminal Penalties

While you are traveling in Swaziland, you are subject to its laws even if you are a U.S. citizen. Foreign laws and legal systems can be vastly different than our own. In some places, you may be taken in for questioning if you don’t have your passport with you. In some places, it is illegal to take pictures of certain buildings. In some places, driving under the influence of drugs or alcohol could land you immediately in jail. These criminal penalties will vary from country to country. There are also some things that might be legal in the country you visit, but still illegal in the United States, and you can be prosecuted under U.S. law if you buy pirated goods. Engaging in sexual conduct with children or using or disseminating child pornography in a foreign country is a crime prosecutable in the United States. If you break local laws in Swaziland, your U.S. passport won’t help you avoid arrest or prosecution. It’s very important to know what’s legal and what’s not where you are going. Persons violating Swaziland’s laws, even unknowingly, may be expelled, arrested, or imprisoned. Penalties for possessing, using, or trafficking in illegal drugs in Swaziland are severe, and convicted offenders can expect long jail sentences and heavy fines. While some countries will automatically notify the nearest U.S. embassy or consulate if a U.S. citizen is detained or arrested in a foreign country, that might not always be the case. To ensure that the United States is aware of your circumstances, request that the police and prison officials notify the U.S. embassy as soon as you are arrested or detained in Swaziland.