Abstract:
Malnutrition is a major confounding factor for child morbidity and mortality in
developing countries. In Swaziland, about 31% of the under-five children are stunted
in growth, where-as 1% and 6% are wasted and underweight, respectively. Hhohho
region has the highest prevalence of underweight children (8.2%) relative to other
regions such as Shiselweni (7.3%), Lubombo (6.7%) and Manzini (6.4%). The
prevalence of infant and under-five children mortality rate (per 1,000 live births) are
85 and 102 deaths, respectively. Lubombo region has the highest cases of under-five
mortality rate (deaths per 1,000 live births) of 115 when compared to rates in other
regions, namely; Manzini (112), Shiselweni (100) and Hhohho (96). Despite the
several child healthcare programmes, the problem of high child malnutrition places a
significant hindrance towards the attainment of the Millennium Development Goals
(MDG) 4 on reduction of child mortality. Potential determinants of childhood
malnutrition and mortality in Swaziland can be categorized into three levels, namely:
(a) immediate causes (inadequate dietary intake of protein, energy and micronutrients;
diseases such as pneumonia, diarrhoeal diseases and HIV/AIDS, (b) underlying
causes (inadequate access to food due to poverty and decline in food production;
inadequate care of children and women, insufficient health services and unhealthy
environment), and (c) basic causes (inadequate mother’s education and nutrition
knowledge, insufficient human resources in child health care; inadequate policies on
child nutrition and health care; inequitable distribution of household and national
socioeconomic resources). This paper presents an in-depth analysis of the causal
factors of childhood malnutrition and mortality in Swaziland, and further explores
opportunities that could be adopted to address the malnutrition and mortality problem.
It also aims to reinforce that in order to ensure effectiveness and sustainability of
intervention programmes, there is need for multi-dimensional strategies and
collaboration between all the stakeholders concerned with child nutrition, health and
socio-economic development. However, the interventions must recognize the existing
socio-economic differentials between the rural and urban areas, and the administrative
regions.