Eswatini has made marginal progress on improving access to basic hand hygiene (HH) service from 2015 to 2020, with coverage increasing by 0.27%. Eswatini ’s slow growth may be hampered by the limited financing available to the sector, despite strong progress recently on the policy front including the 2019 National Sanitation and Hygiene Policy and National Infection Prevention and Control Guidelines (2020-2023), reinforced by Eswatini ’s scores of 0.88 and 1.42 on the HHAFT Tracker and Assessment’s 4-point scale, respectively. As the country brings more focus to HH under the national policy, perhaps it will address some of the accelerators, especially financing, capacity development, and M&E.


Prepare for Action1.00
Analyse the Situation / Assess the Need1.00
Prioritise Actions1.00
Execute Plans1.00
Monitor, Evaluate and Course Correct0.25

In response to COVID-19, Eswatini made progress in preparing for action, including hand hygiene as a core COVID-19 response. With the collaboration of the Ministry of Health, municipalities, the National Disaster Management Authority, and Pakistan’s Security Agencies, Eswatini has also considered many settings for improving hand hygiene, including schools and health care facilities as well as public spaces, and other institutions. While the country works on addressing other milestones, the main barrier remains access to finance. Although a costed roadmap exists, it is not included in sectoral budgets nor a broader financing strategy. While financing was allocated to HH through the emergency health response budget during COVID, MoH does not have a budget for HH and no other entity has allocated financing, indicating that tying HH to COVID response may ultimately be limiting.


Data and Information0.75
Capacity Development0.50

Eswatini had approved the National Sanitation and Hygiene Policy in 2019, laying a strong foundation for the sector. The policy also included strong institutional arrangements, including identifying the Ministry of Health as the lead ministry. However, while the policy sets indicators and targets, no M&E system has been established, but one could potentially leverage the existing HMIS and health officers. Additionally, the existing WASH Stakeholder Forum can be utilized to bring greater emphasis on hand hygiene. A costed roadmap was created in conjunction with the policy; however, it has not been accompanied by a budget or financing plan, hampering the sector’s ability to proceed on other parameters.