At another level, the quality of reproductive health care services is the major determinant for maternal and child health. Maternal mortality continues to be a major problem in Swaziland. Further, the health system faces several limitations which include shortage of adequately skilled nurse-midwives and doctors for maternal care, poorly equipped maternity units and the non-functionality of the referral system.[1]

Lastly, there are several systemic challenges that contribute to the weak health system in Swaziland. Generally, the health workforce is inadequate in terms of both numbers and specialisations. There is also a high attrition rate of health personnel. Moreover, there is an urban bias in the distribution of health personnel, thus, rendering the more rural populations inadequately covered. The Doctor and nurse to population ratios are also too high. There are also weak regulatory structures for the health system, a phenomenon that compromises quality assurance and standards. Procurement and supply management system for the health sector also suffers from systemic challenges. There is also limited access to family planning and reproductive health. Major human development challenges have also been brought about by HIV and AIDS. These factors have resulted in serious shortfalls in the country’s health service delivery system and have, consequently, affected human welfare and development.