Our Work in Swaziland

Swaziland has one of the most severe HIV and AIDS epidemics in the world, with an estimated HIV prevalence of 39.2%. The Government of Swaziland continues to prioritize HIV prevention in its national response. Swaziland has adopted a comprehensive HIV prevention approach in order to address the multiple factors that fuel the spread of infection in the country. As part of the prevention strategy, the Government of Swaziland is implementing a strategy on MC for HIV prevention. The strategy will help guide the roll out of MC services throughout the public and private health sectors. The implementation plan calls for conducting 150,000 circumcisions over the next five years.

The Family Life Association of Swaziland (FLAS) is the leader in providing MC services, and MC training for Swazi doctors. FLAS now regularly provides MC services at its clinic in Mbabane, the capital city. FLAS has the potential to expand the provision of MC services and increase the number of men in the target population who can benefit from the procedure. In order to help FLAS assure its readiness to scale up MC services quickly, the USG has asked the PSP-One project to build the capacity of FLAS in three areas: clinical services, financial management, and organizational management and leadership.

A PSP-One clinical consultant, a Zimbabwean Urologist, is advising FLAS and the Ministry of Health on MC clinical issues such as compliance with the latest WHO guidelines, appropriate MC techniques for the Swazi context, and training methods for Swazi physicians. The consultant, one of only two urologists in the country, trains Swazi physicians and surgeons at FLAS’s Mbabane clinic. PSP-One is also providing training and technical support to build FLAS’s capacity in cost accounting and financial management. Cost accounting will help FLAS start cost recovery for MC services which it is now providing MC services free regardless of patients’ ability to pay. Improved financial management will be important to make sure FLAS is sustainable as an organization. In addition, PSP-One is providing management and leadership training and technical support for the relatively new management team and executive director at FLAS. Management and institutional strengthening will be critical as FLAS plans for an extensive scale up of their MC services, opening a second MC clinic at their facility located in Manzini, the most populous city in the country.