Southern African Regional Poverty Network (SARPN) SARPN thematic photo
Regional themes > Food security Last update: 2020-11-27  
leftnavspacer
Search






  [table of contents]  

A study to determine the links between HIV/AIDS, current demographic status and livelihoods in rural Swaziland

 
Executive summary

The Swaziland Vulnerability Assessment Committee carried out a nationwide survey of rural areas in Swaziland to analyse the linkages between HIV/AIDS, the demographic trends of the country and how livelihoods and food security status may be changing as a result. Stakeholders of the Swazi VAC are keen to get a more accurate understanding of the impact of HIV/AIDS on mortality and morbidity around the country to support policy decisionmaking and programmatic interventions (including targeting) at a period when high HIV/AIDS prevalence rates indicate that normal demographic trends cannot be assumed. The field survey focused solely on rural areas and was carried out in May and June 2003 with staff from CSO. A random sample census was carried out in 15% of enumeration areas in the country with samples across all regional, agro-ecological and food economy / livelihood areas. Questions focused on household demography, morbidity and mortality levels as well as food and income sources. The study used morbidity, mortality and orphan levels as proxy indicators of HIV/AIDS impact. The shortcomings of this are discussed in Chapter 2. The large sample size (18,528 HHs) allows the disaggregation of data down to Inkhundla level.

Expected demographic transition trends found in developing countries represented by a shift from high mortality and fertility levels to low mortality and fertility levels over a period of decades has been ruled out in Swaziland as a result of HIV/AIDS. Swaziland has entered uncharted territory. Previously declining mortality levels have increased markedly since the mid-1990s reversing a positive trend of development. Mortality has increased dramatically among the age group 0-4 and the previously healthy age group between 20 and 50. The long term decline in fertility levels continues (primarily as a result of normal development processes) and is likely to be entrenched by the HIV epidemic. The decline in fertility and the rise in mortality are the main determinants behind the lessening of the population growth rate in Swaziland. Between 1997 and 2003 the rural population growth rate is estimated at 2.01% compared to a growth rate of 2.9% between 1986 and 1997. Ever-increasing mortality at younger ages has reduced life expectancy, possibly down to as low as 40 years. This study projects an annual increase in deaths with an annual total of 31,830 deaths in 2010 (without ARVs). The current crude death rate of 25.8 will increase to 26.8 by 2010 with a total population of 1,190,000. The study shows that females are suffering the brunt of the disease with much higher levels of chronic illness and projected mortality. Against expectations (assuming an increase in AIDS related deaths) the age dependency ratio of the country continues to decrease (improve) because of the steady decline in fertility levels. However, when factoring in levels of chronic illness around the country (which are used as a proxy for HIV/AIDS) the 'effective' dependency ratio provides important insights into vulnerability of households and areas in rural Swaziland. The Lowveld and Lomahasha areas have the highest (worst) effective dependency ratios. Orphan levels in the country are high. Overall, 3.2% of rural children less than 15 years are double orphans and there are approximately 19,206 (6%) maternal orphans in the rural areas. Further analysis of the data set is recommended and will provide geographic and socio-economic disaggregation of findings.

An initial analysis of the impact of HIV/AIDS on rural livelihood patterns implies that there is a qualitative shift occurring whereby households affected are changing their income sources to cope/compensate for losses of income from crops sales and remittances. In contrast to income sources, household's ranking of the importance of different food sources does not appear to be related to (proxy) HIV/AIDS status. This finding is intuitively challenging and further investigation is recommended. No strong consistency in the relationship between HIV/AIDS proxy indicators and cropping areas, inputs or yields was detected. Whilst the data tentatively indicates that affected households are in general "more" protective of tubers than non-affected households and are less concerned (or able) to preserve or increase cash crop and cereal production. Overall, further analysis of the current data set is recommended to improve our understanding of the impact of HIV/AIDS on rural food security/livelihoods.

Summary of demographic findings in rural Swaziland in 2003

  • The rural population growth rate between 1997 and 2003 has been 2.0% (and is likely to decline further in future).


  • The rural population is approximately 807,000 (not including institutions e.g. army/police camps in rural areas).


  • The survey confirms that fertility levels are declining with a greater percentage of the population in the age group 15 to 64 years than those above and below.

    • 43.7% of population aged 0-14 years


    • 52.6% of population aged 15-64 years


    • 3.7% of population aged 65+ years


  • The current age dependency ratio (at a level of 90) has improved mostly because of a significant decline in the fertility rate.


  • The effective dependency ratio is highest in the Lowveld and Lomahasha areas (this variant of the dependency ratio incorporates levels of chronic illness).


  • Female morbidity is higher than male morbidity at all ages and starts at a much younger age.


  • The survey confirms that mortality rates are rapidly increasing. The current mortality rate is 25.8 (per 1,000).


  • Female mortality is higher than male at the younger age groups (20-29 years).


  • Overall 78.3% of deaths were preceded by a bout(s) of chronic illness.


  • Orphan numbers are growing:

    • 2.3% (totalling 7,400) of rural children (0-15 years) have lost both parents


    • 5.9% (totalling 19,206) of rural children (0-15 years) are maternal orphans


    • Maternal orphan rates are highest for children between 10 years


  • The population is projected to grow to 1,190,000 by 2010 (this could be an underestimate considering the modelling predicted a population growth rate much less than the 2.0% found during the study).


  • The crude death rate is projected to increase to 26.8% by 2010 (totalling 31,830 deaths in that year).


  [table of contents]  


Octoplus Information Solutions Top of page | Home | Contact SARPN | Disclaimer