By Addy Hatch, College of Nursing

There is no medical school in Swaziland, a small African country that has the world’s highest HIV/AIDs rate. Much of Swaziland’s health care is provided by nurses.

In that environment, family nurse practitioners could fill a critical need for primary care, said Louise Kaplan, Ph.D., an associate professor at the WSU College of Nursing in Vancouver. Kaplan is working with a group of nonprofits to explore interest in and readiness for family nurse practitioners in Swaziland, and will travel there this month for more assessments.

Generally, the response has been positive to the idea of using family nurse practitioners to expand primary care, Kaplan said. The government seems to be supportive, and the country’s nursing council has adopted “scope of practice” rules to allow nurse practitioners a full range of practice privileges, she said.

Map highlighting Swaziland
Swaziland is a small country bounded on three sides by South Africa and on the fourth side by Mozambique.

Swaziland’s population is just under 1.5 million people in a country slightly smaller than New Jersey, according to the CIA World Factbook. It’s bound on three sides by South Africa, and on the fourth by Mozambique.

Kaplan spent a year there before joining the WSU College of Nursing, where she teaches in the family nurse practitioner program. She helped create the first FNP curriculum at the University of Swaziland in a project funded by Seed Global Health, the Peace Corps, and the U.S. President’s Emergency Plan for AIDS Relief.

She said the need for health care is great in Swaziland, where the average life expectancy is 52 years and the HIV/AIDS rate for adults is 27 percent.

But there are also opportunities, Kaplan noted.

“Registered nurses in Swaziland are doing counseling, testing, initiating and monitoring of HIV medications, which you would not see in the United States,” she said. “Nurses do so much more than we would expect to see them do.”

Kaplan will be in Swaziland for about 10 days, meeting with community members and stakeholders; she spent about a week there in November on the first phase of the work. She hopes to land a grant through the Fulbright Program to help the University of Swaziland set up clinical experiences for FNP students.

“It’s a rare privilege to be involved in the systematic introduction of the family nurse practitioner role to a country,” Kaplan said. “I feel a strong commitment to helping make this a successful program.”