Worldwide, millions of people still die from diseases associated with inadequate water supply, sanitation, and hygiene, despite the fact that the United Nations recognized access to clean drinking water and sanitation as a human right nearly a decade ago. e objective of this study was to describe the determinants of access to improved drinking water sources in Eswatini in 2010 and 2014. Using the Eswatini Multiple Indicator Cluster Surveys (EMICSs), data for 4,819 households in 2010 and 4,843 in 2014 were analyzed. Bivariate and multivariate complementary log-log regression analyses were conducted to identify the determinants of households' access to improved drinking water sources. e study found that households' access to improved drinking water sources significantly improved from 73.1% in 2010 to 77.7% in 2014 (p < 0.0001). In 2010, households whose heads were aged 35-54 and 55 years had lower odds of having access to improved drinking water sources than those with younger ones. In 2014, female-headed households had lower odds, while, in 2010, sex of the household head was not associated with access to improved drinking water sources. In both years, an increase in the number of household members was negatively associated with access to improved drinking water sources compared to those with fewer members. In both years, the odds of access to improved drinking water sources increased with an increase in the wealth index of the household, and households located in urban areas had higher odds of access to improved drinking water sources compared to those in rural settings. In both years, households from the Shiselweni and Lubombo regions had lower odds of access to improved drinking water sources. e government and its partners should continue to upscale efforts aimed at increasing access to improved drinking water, especially in rural areas, to reduce the disparity that exists between urban and rural households.

Introduction Understanding the risk factors for behavioral patterns in sexual relationships play a significant role in the reduction of the transmission of HIV/AIDS and other sexually transmitted infections. Objective To investigate individual and community level factors on the lifetime number of sexual partners of women in Eswatini Material and methods The study was a secondary cross-sectional analysis of the 2014 Eswatini Multiple Indicator Cluster Survey (MICS). A total of 2,832 women aged 15–49 years were asked in total, how many different people have you had sexual intercourse in your lifetime. The multilevel negative binomial regression model was used to analyze the data. Results The overall mean number of lifetime sexual partners was 2.78 (95% CI: 2.66, 2.91) in 2014. Compared to women aged 15–19, those aged 20 years and older, formerly married or never married reported more lifetime sexual partners compared to currently married women. Those that were aged 15 years and older at sexual debut reported fewer lifetime sexual partners compared to those that were aged less than 15 years. Compared to women that used a condom at last sexual intercourse, those that did not use a condom at last sexual encounter reported fewer lifetime sexual partners. Relative to women that lived with their sons and daughters, those that did not live with their sons and daughters reported more lifetime sexual partners. Women that lived in the Shiselweni and Lubombo regions reported fewer lifetime sexual partners compared to those residents in the Hhohho region. Conclusion Overall, lifetime sexual partners in Eswatini was significantly associated with individual characteristics and is unique across regions. Programs that aim to elucidate the factors associated with incident HIV infections among women in Eswatini should focus on individual and community-level factors that are associated with multiple sexual partnerships, which in turn might increase the risk of HIV exposure.

Introduction Child stunting is a significant public health problem in Eswatini. It is associated with a range of child health outcomes, including morbidity, physical and cognitive growth. Objective To determine the individual, household, and community-level factors associated with child stunting in Eswatini in 2010 and 2014. Methods Using the Eswatini Multiple Indicator Cluster Surveys conducted in 2010 and 2014, a secondary analysis was done of the children surveyed, aged 6–59 months. A total of 1,891 were surveyed in 2010, and 1,963 children in 2014. Univariate, bivariable analysis and multivariable multilevel logistic regression were used to establish the factors associated with stunting. Results The study found that stunting decreased significantly between 2010 and 2014, from 31.4% to 25.5% (p<0.001). In both 2010 and 2014, lower odds of stunting were observed among female children, in children born to women with tertiary education compared to those born to women with no formal education. Lower odds of stunting were observed among children from rich households compared to poorest households. In both 2010 and 2014, increased odds of stunting were observed among children aged 12–23, 24–35 and 36–47 months compared to children aged 6–11 months. At the household level, higher odds of stunting were observed among children from households with two and more children under five years of age compared to those with only one child and in 2010, among children from households with a pit latrine and no toilet facility compared to households with a flush toilet. At the community level, in 2010, higher odds of stunting were observed among children from the Shiselweni compared to those from the Lubombo region. Conclusion The findings highlight the individual, household, and community-level factors significantly associated with stunting and the changes between the two surveys.

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Introduction: Patients’ non-adherence to antiretroviral treatment remains a public health concern in many developing countries, especially in South Africa. Objectives: The objective of the study was to explore the barriers and facilitators of patients' ART adherence in one health care facility in Mpumalanga Province, South Africa. Methods: A qualitative, exploratory, and descriptive design was employed to collect data using a semi-structured interview guide through individual in-depth interviews among twenty (20) purposively selected patients. The thematic analysis approach was used to generate themes from the data. Results: A majority of the participants were female (n=12, 60%), married (n=13, 65%), and employed (n=12, 60%). Barriers to ART adherence include insufficient medical staff at the health center and waiting time being too long. Facilitators included service providers' positive attitude, clear instructions for taking medication, benefits of adhering to ART, and dangers of defaulting treatment. Conclusion: Barriers and facilitators for adherence included several factors related to the health system, health care workers, and the patients. Achievement of optimal adherence to ART requires the commitment of both patients and providers. Keywords: ART; Barriers; Facilitators; HIV/AIDS; South Africa.

Introduction: Handwashing with soap has received considerable attention due to its importance in the prevention and inter- ruption of the transmission of diseases. Regardless of the positive effects of handwashing with soap, developing countries still have a low rate of handwashing. Objective: The study aimed to determine the individual, household and community-level factors associated with handwash- ing behavior among households in Eswatini. Methods: Using the Eswatini Multiple Indicator Cluster Survey conducted in 2014, a secondary analysis was done of the households surveyed. A total of 1,520 households nested in communities with complete data on handwashing practices were included in the analysis. Univariate, bivariate analysis and multivariate multilevel logistic regression were used to estab- lish the factors that were associated with handwashing behavior. Results: The prevalence of handwashing among households was 56% in 2014. Households whose heads were aged 35-54 and 55 years and older were more likely to practice handwashing (AOR=1.88, 95% CI:1.39, 2.54); and (AOR=1.77, 95% CI: 1.205, 2.62) compared to those aged 15-34 years. Households with a pit latrine or no toilet facility at all, were less likely to practice handwashing (AOR=0.24, 95% CI: 0.17, 0.35); (AOR=0.28, 95% CI: 0.11, 0.71) respectively compared to those with a flush toilet. Region of residence was a community-level variable associated with lower odds of handwashing, with those from the Hhohho (AOR=0.22, 95% CI: 0.14, 0.35) and Manzini region (AOR=0.42, 95% CI: 0.27, 0.67) compared to Lubombo region. Households from communities where access to mass media was high were more likely to practice handwashing (AOR =1.47, 95% CI: 1.05, 2.03) compared to those from communities where access to mass media was low. Conclusion: Households headed by young adults, with pit latrine or no toilet facility at all and lived in the Hhohho and Manzini regions and with low access to mass media, should be targeted for interventions aimed at improving handwashing practices. Keywords: Handwashing; factors; Eswatini; households; multilevel logistic regression.

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