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Strengthening Nurse Competencies in Swaziland


  • Swaziland has a high prevalence of HIV and TB/HIV co-infection.
  • Nurses can play a major role in leading health-system improvements.
  • The Abt-led HFG project helped develop competencies for entry-level nurses.
The Challenge

With the world’s highest prevalence of HIV and TB/HIV co-infection, Swaziland has a critical need for a well-trained and sustainable workforce of medical professionals. Aggravating Swaziland’s health problems, the health system lacks enough doctors, nurses, and midwives. Many Swazi doctors left for better working conditions abroad. This challenge has created an opportunity for Swazi nurses to take a more active role in leading improvements in the country’s health system.

The Approach

The Swaziland Nursing Council (SNC) ensures the quality of the country’s nursing workforce. To enhance the SNC’s regulatory capacity, the Abt-led Health, Finance, and Governance Project helped the organization develop entry-to-practice competencies for nurses and midwives. Nursing competencies outline the knowledge, skills, attitudes, and judgments nurses require. Two stakeholder workshops and technical working groups developed general competency documents and, given the particular disease burden, separate competencies targeting HIV, AIDS, TB and drug-resistant TB.

The Results

The competencies address the country’s lack of health workers and strengthen the SNC’s regulatory capacity in the long term while bolstering Swazi nurses’ capacity to provide HIV care and treatment services in the short term. Several nursing schools have contacted the HFG project to request the finalized competencies to update their curricula. To extend the impact of this work, HFG is creating a detailed document describing the competency development process. This guide will help other countries planning similar work. Learn more.