Since 2018, URC has been implementing the Department of Defense HIV/AIDS Prevention Program Eswatini (DoD Eswatini URC Project) to support the Umbutfo Eswatini Defence Force (UEDF) to strengthen their HIV program in their 10 clinics across Eswatini.
Renovations Expand Space for Quality HIV Service Provision
To improve clinic infrastructure of UEDF HIV clinics, the DoD Eswatini URC Project, PEPFAR DoD, and UEDF identified four priority clinics with rudimentary infrastructure and inadequate space to provide comprehensive HIV/AIDS services: the UEDF clinics at Nkoyoyo, Garrison, Mlindazwe, and Gcina Barracks.
The project worked alongside UEDF both on the redesign and renovation of the clinics.
At Nkoyoyo, Garrison, and Mlindazwe barracks, the project brought in prefabricated buildings known as “park homes” – each containing 15-rooms to expand the clinics’ available space. The project also remodeled the two-room structure at Gcina and expanded it to seven rooms.
Clinic Resource Expansion and Accreditation
Prior to the accreditation and handover of the newly renovated and remodeled clinics, the project ensured the clinics had trained personnel to support the increased service capacity. This included HIV testing service counselors, nurses, psychologists, military paramedics, and peer educators. The project also ensured the clinics had functioning electricity and potable water, sanitary facilities, along with the necessary equipment, supplies, and commodities.
Once these essential resources were in place, the project supported the UEDF to obtain Ministry of Health accreditation of the sites to provide HIV/TB comprehensive care.
Engaging the Community for HIV Service Uptake
A comprehensive effort to support the renovations in partnership with UEDF – coupled with community mobilization activities – contributed to the remarkable increase in uptake of services by UEDF service members, their families, and surrounding communities.
| UEDF Clinic | Renovation completion | Average monthly patient flow in 12 months before renovation | Average monthly patient flow after renovation | % increase in patient flow |
| Mlindazwe | 10/2020 | 19 | 164 | 775% |
| Gcina | 12/2020 | 152 | 456 | 201% |
| Garrison | 3/2021 | 243 | 316 | 30% |
| Nkoyoyo | 9/2022 | 115 | 269 | 134% |
Improved Client Satisfaction and Care Quality
The larger clinic structures now have sufficient space for private counseling and exam rooms, basic laboratory services, and pharmacy services. The infrastructure improvements allowed for the expansion of HIV/AIDS services, improved quality of services, and increased human resources at each site, benefiting the military personnel, their families, and the communities around them.
The implemented customer feedback program has placed suggestion boxes at each site. To date, more than 90% of the feedback shows a high level of client satisfaction. The clients mainly cite excellent healthcare services from clinic staff as the standout feature.
As one client at the Garrison clinic shared, “I was not comfortable coming to this clinic because there was no privacy. But now, I’m happy that I can receive care in a private, clean, and decent space, and the nurses are very friendly.”
Investing in Health Workers’ Wellbeing for Sustainable, Quality Services
In 2023, URC renovated the old structure which provided staff accommodations at the Phocweni Clinic. The building posed a health risk due to the presence of asbestos and lacked adequate space to house the increased number of health workers at the clinic.
The renovation was a collaborative effort. The UEDF Combat Unit led the renovations. The Microprojects Unit of the Ministry of Economic Planning provided a structural and renovation engineer for technical support. The PEPFAR DoD Program Manager and URC provided procurement of materials, management oversight, and technical support throughout the renovation project.
In April 2024, Caitlin Piper, U.S. Chargé d’affaires and DHAPP Branch Chief, Dr. Michael Grillo, officially handed over the newly renovated and expanded staff housing building to the UEDF and the Eswatini government. The renovated housing, which increased the quality and quantity of available accommodations, offers the opportunity for more health officers to reside within a short distance of their workplace, increasing their ability to serve clients in urgent and emergency situations and improving the overall quality of the client experience.
