Lubombo is a picturesque region in the Eastern side of Eswatini (formerly Swaziland), divided between the rolling Lowveld and the Lubombo plateau. It has a predominantly rural population of 212,531 (2017 Census), with many people living in very isolated communities. Levels of prosperity are below-average for Eswatini with many dependent on subsistence farming.
Current HIV prevalence in Lubombo is 29.4% (SHIMS-2). This is the highest rate of any region in Eswatini (which has the highest HIV rate in the world). Other common infectious diseases include TB (frequently complicated by HIV) and malaria. Alongside these infectious diseases, there is also a steady increase in non-communicable diseases (such as diabetes and hypertension) which are responsible for significant ill health and premature death.
Population density in Lubombo is significantly lower than average for Eswatini. This has led to challenges in delivering healthcare with many communities facing challenges to access hospitals for routine care. Lubombo has pioneered novel approaches to the decentralisation of healthcare provision to its network of 40 nurse-led community clinics. This has covered diseases including HIV, TB, diabetes, hypertension and mental health.
The history of applied health research in Lubombo and the strong relationships between the Lubombo Health Research Unit and the community clinics make Lubombo an ideal location to test novel approaches to delivering healthcare in Eswatini.